38 Minute Indian Village Cleaners, Inc.

Thank you for allowing us the time to thoroughly research your recent report to us
MDX Hawaii is the Third Part Administrator (TPA) for *** ***, the consumer’s insurer or carrier for Temporary Disability Insurance (TDI)Although we empathize with the claimant, we must respectfully dispute her allegations of being followed and harassed by employees of our company
We have serviced the claimant seven (7) times telephonicallyWe document all encounters with our TDI claimants and have never suggested any information received was inaccurateThe claimant did state that people were showing up at her residence attempting to gain information from herWe attempted to assure her that no one from our company would visit her residence or follow herWe informed her that the only face-to-face interaction we may have with claimants is if they come to our office with questions or concerns
The claimant corresponded with us once and requested her benefits be terminatedWe reached out to her and advised her of her entitlement to the TDI benefitsShe agreed to submit an updated doctor’s note to continue benefits, but we never received oneThat call, our last contact was on December 14,
Please let us know if we can be of further assistanceThank you
Jeri *** *** K***
Vice President, Operations
MDX Hawaii

The Revdex.com forwarded your concerns to our company. As a valued network provider, we sincerely regret your experience with our organization. Our call center usually provides excellent service. We are taking steps to ensure the situation does not recur and hope you
will give us the opportunity to prove it to you. I understand our Customer Service Supervisor recently reached out to you. Resolving the member eligibility problem took longer than anticipated, but the claims in question were paid earlier this week. I apologize it was not more timely. If you should have any further questions or concerns, please ask for me. We appreciate your patience in allowing us to investigate and resolve this issue. Thank you

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted]. Please add your rejection comments below. 
[If you are rejecting the business's response please enter your rejection comments here.] MDX of Hawaii has accepted my disability claim.  I have been sending in medical documents to them.  They are a subsidiary of [redacted].   It may be that company that has conducted the surveillance.  
Regards,
[redacted]

Dear Revdex.com,Thank you for listening to [redacted]'s ([redacted]) concerns and passing the concerns to MDX Hawaii. There is no doubt that MDX would have continued to ignore [redacted]'s pleas for help had you not intervened.  I got a call from Jason on November 8th. He is supposed to be one of the customer service managers.  I asked him what was going on with customer service at MDX and that MDX has the worst customer service of any organization that I dealth with (this opinion is shared by other medical practices).  He asked me if I had examples of what happened. I told him my complaints were detailed in the query I sent to Revdex.com and that is probably why he is calling.  He then acknowledged the voice mails I sent him which he did not return. He also acknowleged that customer service "lead" Tracy just took my phone call from customer service but never passed on my message to the MDX claims department.  He told me he would call me back in two days to update me on what was happening to the claims and that he would give me further information as to who is [redacted]'s MDX account representative if it was my desire not to deal with MDX customer service in the future.  I did not get a call back from him.  In the mean time, a family member of [redacted]'s client called MDX customer service and was told "all mentioned claims were paid 30-60 days from the submission of the claims which is MDX policy." This was a huge lie that left my client's familiy member baffled; the family member was wondering why Revdex.com was contacted if the claims were paid.Having said all the above, [redacted] finally received a check from MDX on 11/11/2017.  There was some customer service supervisor who called me this week and I was unable to talk with her since I was with patients. I will be calling her back next week.Although, obviously, I acknowlege that MDX finally paid long overdue claims, this organization in no way provides "excellence service" and it is an organization full of people who have no clue what is happening and lie their way thru customer service.Ohana, another health insurance company, used to have poor customer service.  This company actually sent out customer service surveys and took serious actions and now has some of the best customer service.  If MDX really cares (which I doubt at this point that it does), it would do the same.[redacted]      Complaint: [redacted]
I am rejecting this response because:
Sincerely,
[redacted]

Due to the confidential nature of the information surrounding the member’s concerns, MDX Hawai‘i is responding directly to the member.

We appreciate your bringing this report to
our attention so we could research and address its contents.
MDX Hawaii is the Third Party Administrator
(TPA) for [redacted] and their insured for Temporary Disability Insurance
(TDI) benefits.  Upon review of the claim, we...

discovered and acknowledge
the request for a call back on Thursday, February 11, 2016, was inadvertently not
fulfilled.  We apologize for this oversight and any inconvenience this may
have caused the claimant.
All encounters with our claimants are
documented and we have serviced the claimant 11 times telephonically.  This
does not include the numerous contacts and coordination with her employer and
physician also required to resolve date discrepancies.  The claimant
requested a call back on Thursday, March 31, 2016, and we returned the call on
Friday, April 1, 2016. We were not able to speak with the claimant, but did
leave a message for her to please contact us.  We again reached out to the
claimant on Tuesday, April 5, 2016 and informed her we were able to reconcile
the inconsistencies and her TDI claim could now be approved.
It
takes time to thoroughly research and clear up differences found in a claim and
we regret the claimant felt our communication was lacking.  However,
please assure her we take her comments seriously and continually work to
improve our service.  We appreciate her patience and allowing us to resolve
the situation, hopefully to her satisfaction.  Thank you.

Your STD claim was denied on October 21, 2015 on the basis that we did not receive proof of disability. To date, we have received no medical records to evaluate your claim.   As outlined in our October 21, 2015 you may appeal the denial determination.   Our records do not reflect that...

[redacted] has conducted any surveillance nor have we stated that that you were “faking “your disability. Any questions regarding your STD claim should be directed to Amanda S[redacted] at: [redacted]