Alaska Community Development Corporation

June 1, 2015Dear [redacted] :This letter is in response to your inquiry dated May 19, to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc(Health Plan) on behalf of [redacted] The inquiry was received on May 22, [redacted] stated that he applied for health insurance coverage through the Federally Funded Marketplace (Exchange) [redacted] requested an effective date of January 1, He indicated that he paid his premium but his coverage was cancelled [redacted] is requesting that the Health Plan refund his premium in the amount of $111.00.• According to our records, [redacted] 's coverage became effective January 1, The monthly premium was $111.00,• On February 12, Health Plan cancelled [redacted] 's coverage due to non-payment,• On February 13, Health Plan received [redacted] 's premium payment in the amount of $111.00.• On April 23, Health Plan processed a refund in the amount of $111.00.We regret the inconvenience that this situation has causedIf you and/or [redacted] have any additional questions, please contact Keyla W [redacted] at ( [redacted] ,Sincerely, Daisy S.Senior Manager, Member Services

Dear [redacted] ***;This letter is in response to your inquiry dated May 5, to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc(Health Plan) on behalf of [redacted] The Inquiry was received on May 7, [redacted] stated in her complaint that she would like the Health Plan to approve coverage for maternity care and delivery in Virginia Beach, VAShe indicated that she would like to deliver her child close to where the father of the baby lives, [redacted] is enrolled with the Health Plan through the [redacted] Health Benefits (***) programJurisdiction for her contract resides with the Office of Personnel Management (OPM).Virginia Beach, VA is outside of the service area for Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.Section of the [redacted] Health Benefit Program's (***) [redacted] benefit brochure states the following:"This Plan is a health maintenance organization (HMO)We require you to use specific physicians, hospitals, and other providersThrough the Mid-Atlantic Permanente Medical Group, PC (Medical Group), we will coordinate your health care services, including among other things, when care is medically necessary and what treatment is appropriate.”If a member requests coverage for services that are not covered under their benefit policy, the member's physician will refer the member to the Member Services Call Center to request a member benefit determinationThe Member Services Call Center Would need the name of the physician and/or facility, the phone number, the address, and the reason for the request.Health Plan attempted to enter a member request for coverage of maternity care and delivery to be provided in Virginia Beach, VAHowever, [redacted] did not provide the name of the physician or the hospital to complete her request.MsDebbie J [redacted] Communications Specialist with the Health Plan, made four (4) attempts to reach [redacted] MsJ [redacted] left detailed messages for [redacted] to call her back with the name, address, and phone number of the physician and hospital in Virginia Beach, VATo date, [redacted] has not provided the requested information to the Health Plan.If you and/or [redacted] have any additional questions, please contact Keyla W [redacted] at ###-###-####,Sincerely,Daisy SSenior Manager, Member Services

August 26, 2015Dear [redacted]:This letter is in response to your inquiry dated August 17, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted]. This inquiry was received on August 18, 2015.[redacted] stated in his complaint that he is...

being billed for services that were not performed. He also stated that he was not told about the fees prior to receiving the Services.[redacted] is covered under a High Deductible HMO Plan through an employer group, According to the Summary of Services and Cost Share Section of [redacted]'s Evidence of Coverage (EOC), he is responsible for a $1,300 individual deductible, or a $2,600 family deductible per contract year. [redacted] must first meet the stated deductible before Health Plan will begin to pay for covered services that he receives. After meeting the deductible, [redacted] is financially responsible to pay 20% of the allowable charges for behavioral health services. Exhibit A contains a copy of the relevant pages of [redacted]'s EOC.• On April 14, 2015 the Health Plan received a claim for date of service April 10, 2015 from [redacted], LCSW, The claim was denied on April 21, 2015 due to lack of authorization. Exhibit B contains copies of the claims and Explanation of Benefits (EOBs).• On April 18, 2015 the Health Plan received a claim for date of service April 17, 2015. The claim was processed on April 21, 2015 and $285 was applied towards [redacted]'s deductible. Exhibit B contains copies of the claims and Explanation of Benefits (EOBs).• On May 29, 2015 the Health Plan received a claim for date of service May 28, 2015. The claim was processed on June 1, 2015 and $182 was applied towards [redacted]'s deductible. Exhibit B contains copies of the claims and Explanation of Benefits (EOBs).If you and/or [redacted] have additional questions regarding this concern, please contact Keyla W[redacted] at ###-###-####.Sincerely,Daisy S.Senior Manager, Member Services

This letter is in response to your inquiry dated April 1, 2016 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf the complainant Mr. [redacted]. The inquiry was received on April 8, 2016.Mr. [redacted] stated in his complaint that he made an...

appointment for an annual health check. He subsequently received a bill from Kaiser Permanente Patient Financial Services Department (guarantor account #[redacted]) for a copayment of $20.00 for the office visit on date of service December 28, 2015. Mr. [redacted] disputes the $20.00 copayment for the office visit on December 28, 2015.Please be advised that this issue was referred to our Patient Financial Services Specialist for research and resolution. Our Patient Financial Services Specialist informed us that the $20,00 copayment for date of service December 28, 2015 was applied correctly, Additionally, Mr. [redacted] received an annual exam on February 23, 2015 for which no copayment was charged.I have enclosed a copy of Mr. [redacted]'s 2015 Federal Employees Health Benefit Program Brochure explaining the “Preventive Care, Adult Benefit" for your reference (see page 29). The information contained under this section indicates that this specific benefit is allowed at no cost once per calendar year for adults age 40 and older.Additionally, Mr. [redacted] has not exhausted the Internal Grievance Process.Therefore, he may request an appeal. Appeals should be submitted to the department and address reflected below:Kaiser Permanente Attn: Appeals Department [redacted] Rockville, MD 20849If you and/or Mr. [redacted] have any additional questions, please contact Ella L[redacted] at ###-###-####.Sincerely,Cynthia W[redacted] Manager, Appeals and Correspondence

This letter is an interim response to your inquiry dated July 6, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of Ms. [redacted]. This inquiry was received on July 8, 2015.Ms. [redacted] stated in her complaint that she contacted the Health Plan to...

terminate her coverage effective March 31, 2015. Ms. [redacted] stated that she was not advised that she would need to contact Maryland Health Connection to terminate her coverage. She indicated that she has been receiving premium billing statements after March 31, 2015. Ms. [redacted] is requesting that the Health Plan terminate her health insurance coverage effective March 31, 2015, and write off any premium balance after that date.Ms. [redacted]'s letter was forwarded to Mr. Victor N[redacted], Operations Manager of the Member Services Call Center for review and appropriate action.The Health Plan is unable to process Ms. [redacted]'s termination request without approval from the Maryland Health Connection (Marketplace).Ms. [redacted]'s coverage with Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. is currently active. She must request termination of her health insurance coverage through Maryland Health Connection. Ms. [redacted] may file an appeal with the Maryland Health Connection (###-###-####) to request termination of her coverage effective March 31, 2015.Upon receipt of the approval from Maryland Health Connection, the Health Plan will honor the request and terminate Ms. [redacted]'s coverage.I regret the circumstances that prompted Ms. [redacted]'s letter. At the same time I thank you for the opportunity to address her concerns.If you and/or Ms. [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####.Sincerely,Daisy S[redacted] Senior Manager, Member Services

September 4, 2015Dear [redacted]:This letter is in response to your inquiry dated August 25, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted]. This inquiry was received on August 27, 2015.[redacted] stated in her complaint that she...

is waiting for a refund from the Health Plan in the amount of $1322.00 under check number [redacted]. She also indicated that the she was advised that a refund check was mailed to her home address in June 2015 but she has not received it.On June 25, 2015 the Health Plan mailed [redacted] a refund check in the amount of $1,322.00. The check was mailed to [redacted], Washington, DC [redacted].Upon receipt of the inquiry from the Revdex.com, Health Plan found that the refund check (check number [redacted]) has not been cashed. The Health Plan updated [redacted]'s mailing address to add her apartment number **. Also, Health Plan will stop payment on the outstanding check and re-issue a new check in the amount of $1,322.00.On behalf of the Health Plan, I apologize for the inconvenience this situation has caused [redacted],If you and/or [redacted] have additional questions regarding this concern, please contact Keyla W[redacted] at ###-###-####,Sincerely,Daisy S.Senior Manager, Member Services

September 2, 2016Dear [redacted]:This letter is in response to your inquiry to Kaiser Foundation Health Plan dated August 12, 2016 of the Mid-Atlantic States, Inc. (Health Plan) from [redacted] regarding his mother, [redacted]. Your correspondence was received in our office on August...

25, 2016.[redacted] submitted a complaint stating that he had requested an investigation and responses to his questions and concerns regarding the care his mother, [redacted] received at the [redacted] Nursing Center in Silver Spring.Given [redacted]' concerns, a copy of his concerns was forwarded to the staff in our Quality Management Department for review. This review may involve staff and doctors from Kaiser Permanente and the particular medical specialty involved. The quality review findings help Kaiser Permanente continue to improve the way we deliver care and service to all members.This review is performed under special provisions of the Federal Health Care Quality Improvement Act (HCQIA) §11137, and state laws, which encourage physicians to participate in identifying issues and improving care for patients.[redacted]' concerns and questions were also referred to the Kaiser Permanente Service Chief Of Continuing Care (Skilled Nursing Facilities and Palliative Care Programs).We were informed that as a part of the investigation the Service Chief met with the executive leaders of [redacted] Nursing Facility. Multiple attempts and messages were left for [redacted] and no callbacks were received.Please refer to the chronology of the calls below;•The Center Nurse Executive, Michelle D[redacted], called the office, home and cell phone numbers on file for [redacted] in the afternoon of June 9th. She left a message informing him that we knew of his concerns and wished to discuss them with him to answer any questions he might have, and asked that he return her call.•Michelle D[redacted] called again at 5:40pm on June 9th, and left her cell phone number at that time.•Finally, she called again on June 10th and left another message.•Elliot R[redacted], Center Executive Director also called [redacted] on his cell phone at 8:30pm on June 9th and left a message as well, explaining that we were following up on his concerns regarding his mother's stay at [redacted] Center. Mr. R[redacted] informed him that Michelle D[redacted] had left messages and that if he was willing to speak with us to give her a call on the number she left. Finally Mr. Roth said that if he could not reach Michelle D[redacted] to contact him.I have spoken with Mr. R[redacted] and he still looks forward to the opportunity to talk with [redacted] Please inform [redacted] that he can contact Elliot Roth or Michelle D[redacted] at ###-###-####.If you and/or [redacted] have additional questions regarding this complaint, please contact Ella L[redacted] at ###-###-####.Sincerely,Daisy S.Manager, Appeals and Correspondence

This letter is in response to your inquiry dated September 21, 2016 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted]. The inquiry was received on September 27, 2016.The [redacted] stated in her complaint that she was enrolled with the Health...

Plan from January 2014 through March 2016. However, she received a billing statement after her termination date. [redacted] is requesting that the Health Plan terminate her coverage effective March 31, 2016 and cease all premium billing statements after that date.Ms. Jackson's concern was escalated to the Client Services Department to process her termination request effective March 31, 2016. Any outstanding premium balance after March 31st will be adjusted.If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at [redacted].Sincerely,Däisy S[redacted] Manager, Appeals and Correspondence

---------- Forwarded message ----------From: <[redacted]@kp.org>Date: Fri, May 15, 2015 at 12:12 PMSubject: Case # [redacted]To: [redacted]@[redacted].Revdex.com.orgHello [redacted]: RE: Case# [redacted] I am sending this email as a follow up to our conversation yesterday, May...

14, 2015. As we discussed during our telephone conversation, the Health Plan has been unable to identify **. [redacted] in our system.  We will need her identification number, and the name and identification number of her daughter to complete the review process. You indicated that the inquiry will be forwarded to the Revdex.com's Washington, DC office because your office does not have jurisdiction. Thank you, Keyla W[redacted]Senior Communications SpecialistAppeals and Correspondence, Member ServicesKaiser Foundation Health Plan [redacted]Rockville, MD [redacted]###-###-#######-###-#### FaxBe healthy. Live well. Thrive.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted]. I received the refund from Kaiser, and consider my complaint to be resolved.
Thank you,
[redacted]

This letter is in response to your inquiry dated September 13, 2016 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted] [redacted].[redacted] received a copy of the Health Plan's response letter dated September 8, 2016; however he rejected the response. [redacted] rejected the response because he believes that he has not received adequate treatment; therefore, he should not be responsible for his Copayments.As previously stated, a copy of [redacted]'s letter was also forwarded to the Physician Chief of the Northern Virginia Service Area, Dr. Cheryl K[redacted] for review.A team of Patient Safety experts and physicians have met, thoroughly investigated and discussed this case. Their findings revealed that the medical care provided to [redacted] was appropriate. Health Plan has a clear plan of action and recommendations for his continued care in place and have communicated that to [redacted].Section 3-Benefits of [redacted]'s Evidence of Coverage states the following; In addition to Premium Payments, you may be required to pay a Cost Share for some Services. The Cost Share is the Copayment, and Coinsurance, if any in the Summary of Cost Shares. You are responsible for payment of all Cost Shares. Copayments are due at the time you receive a Service. You will be billed for any Coinsurance you owe." If [redacted] continues to dispute the cost share for the medical services provided to him, he may submit a written appeal to:Appeals and Correspondence [redacted] Rockville, MD [redacted] FAX: [redacted]Please note that [redacted]'s appeal request must be filed in writing within 180 days from the date of receipt of the original denial notice (Explanation of Benefit statement).If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####.Sincerely,Daisy S[redacted]Manager, Appeals and Correspondence

This letter is in response to your inquiry dated December 16, 2016 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of Mr. [redacted]. The inquiry was received on December 20, 2016.Mr. [redacted] stated that on December 11, 2016 he refilled his medication through...

the Health Plan's website and was promised a 2-5 day delivery timeframe. He stated that he contacted the customer service department, and was advised that the medication would take 10-15 days for delivery. Mr. [redacted] is requesting a $22 refund for the mail order medication.According to the Health Plan's records, Mr. [redacted] ordered his medication on December 14, 2016 at 2:23pm via kp.org. The delivery time for mail order medication is up to 10 days. On December 20, 2016 the Health Plan delivered Mr. [redacted]'s medication to his home address, Mr. [redacted] declined the delivery.Mr. [redacted] obtained his medication from the [redacted] Center's Pharmacy Department. Health Plan will process a refund in the amount of $22.00 for the mail order medication that was declined by Mr. [redacted].If you and/or Mr. [redacted] have any additional questions, please contact Keyla Washington at ###-###-####.Sincerely,Daisy S[redacted]Manager, Appeals and Correspondence

July 14, 2015Dear [redacted]:This letter is in response to your inquiry dated June 29,2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted]. The inquiry was received on July 6, 2015.[redacted] stated in his complaint that he...

received a delinquent notice for his monthly premium prior to receipt of his welcome letter.On behalf of the Health Plan, I apologize for the inconvenience this situation has caused [redacted].[redacted] is enrolled in the VA Silver 1500/30 Dental Plan which became effective February 1, 2015.On February 7, 2015 the Health Plan sent [redacted] a warning letter informing him that the first month's premium payment was still outstanding. The delinquent notices are used to inform members of arrears. The February 2015 premium payment was subsequently received on March 5,2015.On February 11, 2015 the Health Plan sent [redacted] a "welcome letter" advising him of his plan coverage, effective date, and medical record number.[redacted] also stated that the Health Plan enrolled him in the automatic monthly premium payment debit program without his consent or knowledge.On the initial enrollment application, [redacted] [redacted] completed the automatic monthly payment section authorizing the Health Plan to automatically debit his credit card for his monthly premiums. Exhibit A contains a copy of the application. Please see page 7 of the application for the automatic monthly payment information.If [redacted] would like to discontinue the automatic monthly premium payments, he must submit a letter to the Health Plan requesting cancellation of the automatic monthly payments. The notice may be sent to the following address and/or fax number:Kaiser Permanente Attn: Membership Administration/Direct Pay Unit PO Box 6306 Rockville, MD 20852-6306 Fax: ###-###-####Once the automatic monthly premium payment debit program has been cancelled, [redacted] may use the Health Plan's online premium payment system to pay his monthly premiums.If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####.Sincerely,Daisy S. Senior Manager, Member Services

June 1, 2015Dear [redacted]:This letter is in response to your inquiry dated May 19, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted]. The inquiry was received on May 22, 2015.[redacted] stated that he applied for health...

insurance coverage through the Federally Funded Marketplace (Exchange). [redacted] requested an effective date of January 1, 2015. He indicated that he paid his premium but his coverage was cancelled. [redacted] is requesting that the Health Plan refund his premium in the amount of $111.00.• According to our records, [redacted]'s coverage became effective January 1, 2015. The monthly premium was $111.00,• On February 12, 2015 Health Plan cancelled [redacted]'s coverage due to non-payment,• On February 13, 2015 Health Plan received [redacted]'s premium payment in the amount of $111.00.• On April 23, 2015 Health Plan processed a refund in the amount of $111.00.We regret the inconvenience that this situation has caused. If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ([redacted],Sincerely, Daisy S.Senior Manager, Member Services

July 2, 2015Dear [redacted]:This letter is in response to your inquiry dated June 25, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted]. The inquiry was received on June 25, 2015.[redacted] stated that she applied for health...

insurance coverage through the DC Health Link (Exchange). [redacted] requested an effective date of January 1, 2014. She further indicated that the problems began when her dependent son, [redacted], was born on September 26, 2014,She outlined the following issues in her letter;• Her son was erroneously added to her policy from January 1, 2014 through September 25, 2014, prior to his date of birth• After her son's birth he was removed from the policy• When she renewed through DC Health Link for this year (2015), her son was enrolled twicePlease be advised that the Health Plan has reviewed and verified the correct information regarding the dependent son's enrollment. Our records have been updated and adjusted to reflect the correct enrollment period for [redacted] of September 26, 2014 through December 31, 2014 and a current enrollment of January 1, 2015 to date.Additionally, action requests have been submitted for review of the premium account and billing invoices to determine any necessary adjustments.We called [redacted] today to inform her of the actions taken to address and correct this matter and answer any questions for her. Since we were unable to reach her, we left a message for a callback.We regret the circumstances that caused this issue and the inconvenience to [redacted]. If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####.Sincerely,Daisy S.Senior Manager, Member Services

September 11, 2015Dear [redacted]:This letter is in response to your inquiry dated August 27, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of Mr. Ian Whibley. This inquiry was received on September 1, 2015.[redacted] stated in his complaint that...

he applied for health insurance Coverage through the Maryland Health Connection (Exchange). He also indicated that his coverage terminated. [redacted] stated that he paid $119.63 for the first month's premium.• According to our records, [redacted] applied for health insurance coverage through the Maryland Health Connection. He requested an April 1, 2015 effective date.• On April 17, 2015 the Health Plan mailed [redacted] a letter advising him of the amount of his monthly premium. The letter also requested the initial premium payment by April 30, 2015 to continue processing his enrollment. Exhibit A contains a copy of the letter.• On May 11, 2015 the Health Plan cancelled [redacted]'s enrollment request because the initial payment had not been received.On May 19, 2015 the Health Plan received a payment in the amount of $119.63. Exhibit B Contains a copy of the cancellation notice. Since the payment was received after the Cancellation date, a refund request was forwarded to the Client Services Department for processing. [redacted] will receive a refund within 4-6 weeks,If you and/or [redacted] have additional questions regarding this concern, please contact [redacted] at ###-###-####.Sincerely,Daisy S.Senior Manager, Member Services

This responds to your inquiry on behalf of [redacted] dated 07/21/2016, received on 08/05/2016 by Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan). Unfortunately, under Federal and state privacy laws, without an authorization from [redacted] to release...

protected health information to the Revdex.com, Health Plan is unable to respond to the concerns raised in your inquiry.Although we are unable to discuss [redacted]'s specific concerns, we are disappointed that [redacted] is dissatisfied with the service she has received from Health Plan. We encourage her to continue to work with Health Plan staff to resolve her concerns. In addition, depending upon how [redacted] obtains her coverage, Federal or state law provide her with an avenue for review of her concerns by the appropriate insurance regulator.Again, we regret that we are unable to address the concerns raised in the 07/21/16 inquiry. If you and/or [redacted] have any additional questions, please Cynthia W[redacted] at ###-###-####.Sincerely,Cheryl T[redacted] Director, Appeals and Correspondence

This letter is in response to your inquiry dated April 11, 2016, to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan), submitted by the complainant, Mr. [redacted].Mr. [redacted] indicated in his complaint that effective February 1, 2015 he enrolled with the Health...

Plan through the Marketplace and setup automatic deduction of payment of his monthly premiums. In August 2015, Mr. [redacted] learned that his policy was terminated for non-payment of his monthly premiums as of May 31, 2015. Mr. [redacted] also indicated that he quickly sent a payment of $1,045.36 by check to the Health Plan to prevent his account from being cancelled. Mr. [redacted]' policy was not reinstated and he did not receive a refund of payments applied to his monthly premium. Therefore, Mr. [redacted] is requesting from the Health Plan to refund payment of $1,045.36.As a result of our research, it was determined that Mr. [redacted]' refund premium payments totaling $1,045.36 was processed. A check for payment was mailed on May 3, 2016, to Mr. [redacted]' home address on file as of May 3, 2016. He should expect to receive payment on or before May 17, 2016. If you and/or Mr. [redacted] have any additional questions or concerns regarding this matter, please contact Enia Walker at ###-###-####.Sincerely,Cynthia W[redacted] Manager, Appeals and Correspondence

October 3, 2017 OCT 6 207[redacted]Revdex.com of Metro Washington DC and Eastern Pennsylvania 1411 K St. NW, 10th Floor Washington, DC 20005-3404RE: Complainant: [redacted]ID #: [redacted] Member Number [redacted]Dear [redacted]:This letter is in response to your inquiry to Kaiser...

Foundation Health Plan of the MidAtlantic States, Inc. (Health Plan) on behalf of [redacted]. The inquiry was received on September 28, 2017.[redacted] stated in her complaint that her premium was increased without notice. Therefore, she is requesting that the Health Plan refund her $823.86.[redacted]'s was enrolled into a Kaiser Permanente Silver $6000/30/idental plan on November 22, 2016 with a premium of $274.62. On January 24, 2017, the Health Plan was notified by the exchange to enroll [redacted] into a Silver Plan $2750.00/20%/HSA/Dental Plan with a premium of $248.20. The Health Plan senta plan change letter to the members address on January 24, 2017. The Health Plan also sent monthly statements of account to [redacted]s home address which included her monthly premium. A warning letter was sent to [redacted]s home address on March 7, 2017 and a termination letter was sent on April 5, 2017. Enclosed for your review are the members notifications and monthly statements.We regret that we are unable to refund [redacted] $823.86 because she was covered under her exchange policy from January 1, 2017 to April 1, 2017. If [redacted] would like to appeal her enrollment into the Silver Plan, she may dispute her enrollment though the Maryland Health Connection. [redacted] may appeal by mail, by email or by phone.By Mail: Complete the Request for Case Review form or write a request to:Maryland Health Connection P.O. BOX 857 Lanham, MD 20703-0857O: Office of Administrative Hearings 11101 Gilroy Road Hunt Valley, MD 21031By Email: Complete and SCan the Request for Case Review form and send an email to: MHBE.Appeals (Gmaryland.govBy Phone: Call Maryland Health Connection at [redacted] (TTY ###-###-####)If you and/or [redacted] have any additional questions, please contact Evral M[redacted] at ###-###-####.

Kaiser Foundation Health Plan of the Mid-Atlantic States - 2101 East Jefferson Street - Rockville, Maryland 20852January 22, 2016[redacted]Revdex.com of Metro W[redacted] DC and Eastern Pennsylvania 1411 K St. NW, 10th Floor Washington, DC 20005-3404RE: Complainant: [redacted]...

[redacted]ID #: [redacted] Patient: [redacted] Member Number: [redacted]Dear [redacted]:This letter is in response to your inquiry dated January 11, 2016 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted], authorized representative for her daughter, [redacted]. The inquiry was received on January 14, 2016.[redacted] stated in her complaint that she received a bill in the amount of $57,50 for a nipple shield that she received on October 30, 2015. [redacted] believes that that nipple shield should cost $7. She indicated that she paid the bill to avoid collections.The claim in question was forwarded to the Patient Financial Services Department to be reviewed by the Billing and Collections Auditor. Once the review has been completed, [redacted] will receive a corrected bill. If the charges for date of service October 30, 2015 are incorrect, the claim will be reprocessed. If there is an overpayment on [redacted]'s account, she may be due a refund.If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####. Sincerely,Cheryl T[redacted] Director, Appeals and Correspondence