American Fidelity Assurance Company

We are responding in regards to Complaint ID [redacted] We have discovered a discrepancy between the information submitted by the customer and what the provider's office is verifyingWe are currently working through this via investigationOnce the investigation is complete, we will have a more thorough response for this customer.Please contact our office for any further questions regarding this matter

This correspondence is in response to the additional information submitted by Ms [redacted] on 07/07/Ms [redacted] states that she was charged double so that her coverage would begin in September as evidenced by an email from her employerShe also states that she has not received any documentation regarding her payments and the amount of months she was covered.The application for coverage, attached to Ms***’s Certificate of Insurance, was signed by Ms [redacted] on 06/01/and has a Requested Effective Date of 10/01/On 05/06/2017, a letter was sent to Ms [redacted] stating, “We have received your request for cancellation of your Disability insurance coverage which was issued on October 01, Your coverage has been cancelled effective May 31, 2017.” We have received premiums in the amount of $per month for coverage during the time period of 10/01/through 05/31/This means Ms [redacted] was covered for eight months and paid a total of $in premiums for her Disability coverage.Premiums are not necessarily withheld during the month for which they are providing coveragePer theemail from Ms***’s employer, the payments for Ms***’s coverage should have started with the September payrollAs previously stated, that does not mean that her coverage was supposed to start in SeptemberMs***’s employer withholds the premiums from Ms***’s paycheck and then submits them to our office when premiums are dueAmerican Fidelity is not privy to the exact date the premiums were withheld from Ms***’s paycheckAs provided above, we can only provide how much premium was received and for which months of coverageIf Ms [redacted] feels that more premiums have been withheld from her paychecks than what American Fidelity has received, she needs to contact her employerIf additional premiums were withheld for coverage beyond 05/31/2017, they will berefunded to Ms***’s employer as soon as they are received.Hopefully this information addresses Ms***’s concerns, but if additional information is needed, please contact our office

Initial Business Response / [redacted] (1000, 5, 2015/07/23) */ Contact Name and Title: [redacted] Team Leader Contact Phone: XXX-XXX-XXXX [redacted] Contact Email: [redacted] @americanfidelity.com American Fidelity has been notified of your recent Revdex.com Case #XXXXXXXX that was opened on 7/9/This situation has been thoroughly reviewedA summary of the actions that transpired along with a response to your case is provided below You elected to participant in the Health Flexible Spending Account (Health FSA) offered by your employer, Auto Company XXI, Inc(formerly Barrier Motors)This election was for the plan year of 4/1/14-3/31/and was in the amount of $Claims were reimbursed in the amount of $A claim incurred on 4/2/in the amount of $was denied due to the incurred date being after the plan year had ended As the Section Plan Sponsor, Auto Company XXI, Incis responsible for establishing and maintaining the plan, including Flexible Spending AccountsThe prior plan year of 4/1/13-3/31/included the Grace PeriodAuto Company XXI, Inc(Barrier Motors at the time), notified American Fidelity on 3/12/that the Grace Period Provision should be removed from the plan in order to add the Carryover Provision effective 4/1/for the plan year of 4/1/14-3/31/Because the Grace Period Provision was removed from the plan, eligible expenses could be reimbursed only if the expenses were incurred between 4/1/and 3/31/ When you contacted American Fidelity on 4/20/to inquire about the claim denial for the claim incurred on 4/2/15, the representative documented your account stating you would be contacted upon review of the denied claimYour account is recorded that the representative followed up with you on 4/20/to inform you the reason your claim was denied was due to the plan not having the Grace Period Provision for the 4/1/14-3/31/plan year Your account is also documented that you contacted American Fidelity again on 5/1/to inquire about the claim denial for the claim incurred on 4/2/15, and you spoke with a different representative who noted your account to show you called regarding the claim denial, but there is no further detail of the conversationThen on 5/7/15, you contacted American Fidelity again and spoke with this same representativeThe note states the representative would verify with the FSA area to ensure the Grace Period Provision was not an option in the current plan year, since the previous plan year did have the Grace Period ProvisionOn 5/8/15, this representative emailed you to let you know to contact your Employer who was the Section Plan SponsorShe provided the contacts' names and phone numbers According to your comments in the complaint, there were contradictory statements made by the representativesThe sale of Barrier Motors did not impact the way claims were to be reimbursedThe decision to remove the Grace Period was made prior to 4/1/American Fidelity is committed to providing all of its customers with world-class serviceWe will take this opportunity to reinforce the knowledge of our representativesThank you for your detailed explanation of the situation At this time, your employer's Section Plan provisions do not allow for reimbursement of your claim incurred on 4/2/ Initial Consumer Rebuttal / [redacted] (3000, 7, 2015/07/23) */ (The consumer indicated he/she DID NOT accept the response from the business.) I would still like to know why American Fidelity did not let its flexible spending account users with Barrier Motors know that the grace period wasn't going to be validAutoNation aka "Auto Company XXI, Inc" didn't take over until 10/22/(we didn't even learn that Barrier Motors was being sold until 9/23/14, far after benefits for the year started) and if I recall when we signed up for our flex accounts in March, Renee, the rep, said nothing has changed from previous plan year which I took to mean there was still the grace periodIt all seems deceitfulThat is our hard earned money and we deserve to know if ANY provisions changeI'm upset that I wasn't told anything and could have expedited using the last of my fundsI will pass along this response to the others stuck in the same boat as me Final Business Response / [redacted] (4000, 9, 2015/07/31) */ It is not American Fidelity's standard operating procedure to send notification to the employees when the employer changes a provision under its Section PlanGenerally, employers prepare and distribute enrollment materials prior to the enrollment taking placeThe employer chose American Fidelity as its Section provider which included our annual and new hire enrollment servicesDuring the enrollment, the American Fidelity Account Representative explained the products available to Barrier Motors' employees as a whole and during one-on-one meetingsTo our knowledge, the Grace Period change was communicated

Please see attached responseThank you

Please find the attached response

Initial Business Response / [redacted] (1000, 5, 2016/01/12) */ Contact Name and Title: [redacted] Manager Contact Phone: XXX-XXX-XXXX Contact Email: [redacted] @americanfidelity.com Our records indicate that we received several requests for annuity distribution formsThere was a breakdown in communication and we failed to mail these forms to Ms [redacted] in the standard processing time of business daysWhen Ms [redacted] called and spoke to a Team Leader, these forms were faxed immediately to Ms [redacted] on 12/14/ Ms [redacted] faxed the completed forms to us on 12/15/Our records indicate that the distribution was processed as requested and the check was mailed to Ms [redacted] on 12/19/Ms [redacted] notified us on 12/28/that she had not received this checkUpon further research, we noticed that it was mailed to an incorrect addressAt that point, we stopped payment on that check and processed an ACH to her bank account on 12/29/Ms [redacted] confirmed that the funds were in her bank account the morning of 12/31/ Initial Consumer Rebuttal / [redacted] (2000, 7, 2016/01/13) */ (The consumer indicated he/she ACCEPTED the response from the business.)

Initial Business Response / [redacted] (1000, 5, 2015/08/21) */ Contact Name and Title: [redacted] Manager Contact Phone: XXX-XXX-XXXX, [redacted] Contact Email: [redacted] @americanfidelity.com Mr [redacted] has submitted several bills and EOBs for review of possible benefitsAmerican Fidelity has provided a surgical benefit from this information, but the other charges that we have received were for services for which his policy provides no benefitWe did ask Mr [redacted] for itemized billing that relates to some EOB expenses he submitted as we were unable to determine what these expenses were for, but in reviewing those EOBs, it doesn't appear that they are for covered expensesWe are happy to provide all due benefits from Mr [redacted] 's policy, but at this time we have provided all that is due based on the information he has submittedIf he has itemized billing for treatment that he has yet to submit, we are happy to review for additional benefitsWe are also more than happy to assist him in requesting any information for which he is having trouble obtaining if he lets us know the names of the providers from which he has been receiving his treatmentWe will be contacting him to offer our assistanceUntil receipt of this complaint, we were unaware that he may be having trouble submitting what we need for review Initial Consumer Rebuttal / [redacted] (3000, 7, 2015/08/24) */ (The consumer indicated he/she DID NOT accept the response from the business.) As is typical of insurance companies, although they say they are happy to comply with all contractual agreements, they usually do everything they can to avoid payment of any significant amount of money that is due their customerFrom their legal perspective, they are correctFrom my 'customer' perspective, they are sorely lacking any common-sense, and "friendly" customer serviceExample; They say they have "provided a surgical benefit" to meThey haveBut $of a $60,procedure is a jokeThe "hoops" one has to jump through, while fighting Cancer, is inhuman But, at least I'm wiser for it Final Business Response / [redacted] (4000, 9, 2015/09/02) */ The American Fidelity Cancer Policy carried by Mr [redacted] is a limited benefit specified disease policyThe benefits of the policy are not structured to provide a percentage of a billed charge such as you would find with a major medical insurance policy, but, rather, structured to pay charges incurred up to set amounts as listed in the Schedule of Benefits of his policy The $referenced in the complaint is the amount this policy will pay for the biopsy which was performedThis benefit amount can be found in the Schedule of Benefits of his policyWe understand that his provider may have billed much more than this, but the majority of that expense is to be paid by his major medical carrier rather than this, his supplemental cancer policy We have spoken on the phone with Mr [redacted] on August 21, and we have also called one of his providers to assist him in obtaining the billing information needed in order to determine benefits from the policyWe have also instructed Mr [redacted] as to what is needed from the hospital to review for possible benefits from that expense as wellAmerican Fidelity is more than happy to provide all due benefits of a policyGiven that the benefits of this policy are determined by charges incurred, itemized billing is a necessity in order to determine those benefitsWe are happy to assist as needed if an Insured expresses trouble in obtaining the information needed to file their claim As soon as we receive the requested information from his surgical provider we will promptly review for due benefitsIf Mr [redacted] needs assistance in obtaining the hospital billing in question, we are also happy to help him with this also If Mr [redacted] disagrees with our claim decision, he has the right to appealHis appeal must be made in writingWritten comments, documents, records and other information relating to the claim should be included with his appeal If there is anything else we can do to assist Mr [redacted] with this claims process, we are happy to do soI will have an adjuster reach out to him again via phone to follw up with him

Initial Business Response /* (1000, 5, 2015/07/28) */
Contact Name and Title: *** ***
Contact Phone: XXXXXXXXXX
Contact Email: ***@americanfidelity.com
Mrs*** initially applied for cancer coverage with American Fidelity in May for an effective date of coverage of
November 1, The application for coverage was for a policy covering herself, her spouse, and any eligible children
In May 2001, Mrs*** applied for a second cancer policy with American Fidelity for an effective date of July 1, This second policy was a policy which would provide a one-time lump sum payment upon diagnosis of cancerThe application for coverage was for a policy which covered only Mrs*** Dependent children and her spouse were not covered under this policy
This lump sum policy is the policy under which benefits have not been paid for her husband's recent diagnosis as he is not covered under this policyWe have explained to Mrs*** in May prior to their initial claim filing that only she was covered under this policy and we explained this to her again in July when they contacted us inquiring as to why this policy didn't provide benefits for his diagnosis
As for the policy that does cover Mr*** initial benefits have been paid as of July 20, and additional information has been requested in order to consider other possible benefits that may be due

Complaint: ***
I am rejecting this response because:It is unacceptable for a representative to not recall meeting with a client and to provide information in the meeting Also, my concern about providing double the premium for October when I showed them documentation for a
September start date via my email from HR I should not have paid double for that October date and should be owed a refundI also paid for more months than when my coverage ended and I should be refunded for a total of months after my coverage ended I do not believe they have given me any documentation about my payments and the amount of months I was covered because I believe I have been charged for more than the months my policy was in effect for I would like then to send me documentation about my payments and how many months were covered and show me that I did not over pay
Sincerely,
*** ***

We are currently working on a response to the complaint, however our records indicate we did not receive the original complaint notification on April 11, Thank you

Complaint: ***
I am rejecting this response because: They are not telling the truthAs you will see on my letter, they said one thing but are trying to justify anotherThey told me that the loan balance would be added to hardship
Sincerely, *** ***
*** ***

Initial Business Response /* (1000, 5, 2015/08/13) */
Contact Name and Title: *** ***, Manager
Contact Phone: XXX-XXX-XXXX ***
Contact Email: ***@americanfidelity.com
The Policy does not cover any loss, which results from Injury or Sickness arising out of and in the course
of any occupation for wage or profit or for which You are entitled to Workers' CompensationAlthough Workers' Compensation benefits have ended, because the disability resulted from Injury or Sickness through the course of employment, the loss is not payable under the Policy

Revdex.com:
At this time, I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me as I finally received the formsPayout has not been made to the claim yet as I am
still awaiting my brothers form to be sent to me. My mother died days before my father, I sent the change of primary beneficary form in on the 11th of NovemberHere is the USPS tracking # 94***. No, it not being updated in their system is NOT an excuseI feel in this case, it is deplorable, in this time of greiving, of how I was treated. I feel they had ample time, almost weeks to get it into their systemNo one returned my calls after ThanksgivingI gave them another week, still no calls after I sent emails and a contact through their siteThe only time I received a call back from them was once I contacted the Revdex.com.If payout (once forms are received by the company) occurs in a timely manner, there will be no further issuesHowever, if payout turns out to be an issue, I will contact the Revdex.com once again
Sincerely,
*** ***

This correspondence is in response
to the complaint from Mr*** *** regarding benefits due to him under
the Policy held by his spouse, Mrs*** A***, which was received by
our office on 05/30/Mr*** states that he has received multiple
requests for information
that he has already sent and that he wants the
benefits to be paid.The Employee’s Disability Benefits
Application was received on 04/05/In order to consider benefits, there is
a form needed from the insured, her Physician and her EmployerAn Explanation
of Benefits was sent on 04/11/stating that the Employer’s Report of Claim
and Attending Physician’s Statement were needed in order to process the claim. These additional forms were received on04/27/The forms indicated
that Mrs*** had passed away on 04/14/An Explanation of Benefits
was sent in care of her estate on 05/05/which requested a copy of the
death certificate, and the mailing address and Social Security number of Mr
*** as the beneficiaryAs of 05/19/2017, no additional information had
been received so another Explanation of Benefits was sent on that date
requesting the same information.A copy of the death certificate,
along with Mr***’s mailing address and Social Security number, was
received on 05/23/The benefits payable to Mr*** under Mrs
***’s Policy were processed on 05/30/and they mailed out on
05/31/2017.Hopefully this information
explains the processing of Mr***’s claimIf any additional information
is needed, please contact our office

Initial Business Response /* (1000, 5, 2016/01/22) */
After review of the account we found that the participant had submitted claims in on October 14, that were keyed and processed to pay on October 16, We received correspondence from the participant that he wanted to have the claims
moved to pay out of different accounts than what they were originally paid fromWe made the adjustment as requested which caused him to be overpaid by $at the timeWe billed the employer for these funds on Nov 6th, Nov 16th, Dec 8th, and Dec 13th When we were contacted by the participant on January 12, we reviewed the group information and found the money was received on December 15, 2015, and had not been applied to the customer's accountOn January 14, 2016, money was applied to the customer's account and the customer was contacted
Initial Consumer Rebuttal /* (2000, 7, 2016/01/22) */
(The consumer indicated he/she ACCEPTED the response from the business.)
The money was paid outIt was, however, frustrating being given the run-around for three months and having to submit a Revdex.com complaint to receive paymentThank you Revdex.com for your help running interference

Initial Business Response /* (1000, 5, 2015/04/16) */
while we received portions of the claim form the fully completed claim form required to file a claim was not received until 4/6/for disability that began 2/17/due to mental illnessHer coverage was issued 11/1/subject to the health
history she revealed on the applicationBefore any benefits can be considered we must verify the health history and information she provided on the applicationWe have advised her to submit verification of medical providersOnce medical recs are received we will evaluate entitlement to coverage and advise her accordinglyNo benefits are payable until we obtain the medical records necessary to confirm she provided accurate information on her application for coverage
Initial Consumer Rebuttal /* (3000, 7, 2015/04/21) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The company stopped returning phone calls and emailsWhen I call them, they transfer me to talk to someone else and I never get answersAmerican Fidelity is a shady company
Final Consumer Response /* (4200, 11, 2015/05/06) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Why does it matter how many times I had to contact you? calls for a claim filed over days ago should not be an issueAs far as your Sales Rep, my HR department got him involvedNot meAll of the EOBs sent to me were duplicatesNot very helpfulALL of my doctors have faxed them the last years of my medical records and I still wait
I know my claim will be denied because they are digging for a loopholeI have been with them since continuouslyNow they are saying I stopped my coverage in although I was still deducted on my pay stubsI was emailed a drop form that I have never seen before with my electronic signatureHow convenient for them that they were able to "find" that document
Final Business Response /* (4000, 13, 2015/05/15) */
She signed a request to cancel her coverage effective 11/1/She then signed an application for new coverage 8/22/and answered health history questions indicating she had not had any of the conditions asked including a mental nervous condition within the mos preceding 8/22/We received her medical records indicating she actually was treated for a mental nervous condition during the months so her coverage is in the process of being rescinded retroactive to the 11/1/effective date and all premiums paid will be refunded to her in the near futureDue to this action no benefits are payable on her claim

Please find two separate responses along with supporting documentation. One addresses Ms. [redacted] disability policy and the other is regarding her annuity. I was unable to attached the policy, should you need that information, please contact me and I will submit it by email.[redacted]...

[redacted]###-###-####J[redacted]

Initial Business Response /* (1000, 5, 2015/07/23) */
Contact Name and Title: [redacted] Team Leader
Contact Phone: XXX-XXX-XXXX [redacted]
Contact Email: [redacted]@americanfidelity.com
American Fidelity has been notified of your recent Revdex.com Case #XXXXXXXX that was opened on 7/9/2015. This...

situation has been thoroughly reviewed. A summary of the actions that transpired along with a response to your case is provided below.
You elected to participant in the Health Flexible Spending Account (Health FSA) offered by your employer, Auto Company XXI, Inc. (formerly Barrier Motors). This election was for the plan year of 4/1/14-3/31/15 and was in the amount of $600.00. Claims were reimbursed in the amount of $520.75. A claim incurred on 4/2/15 in the amount of $77.92 was denied due to the incurred date being after the plan year had ended.
As the Section 125 Plan Sponsor, Auto Company XXI, Inc. is responsible for establishing and maintaining the plan, including Flexible Spending Accounts. The prior plan year of 4/1/13-3/31/14 included the Grace Period. Auto Company XXI, Inc. (Barrier Motors at the time), notified American Fidelity on 3/12/2014 that the Grace Period Provision should be removed from the plan in order to add the Carryover Provision effective 4/1/2014 for the plan year of 4/1/14-3/31/15. Because the Grace Period Provision was removed from the plan, eligible expenses could be reimbursed only if the expenses were incurred between 4/1/14 and 3/31/15.
When you contacted American Fidelity on 4/20/15 to inquire about the claim denial for the claim incurred on 4/2/15, the representative documented your account stating you would be contacted upon review of the denied claim. Your account is recorded that the representative followed up with you on 4/20/15 to inform you the reason your claim was denied was due to the plan not having the Grace Period Provision for the 4/1/14-3/31/15 plan year.
Your account is also documented that you contacted American Fidelity again on 5/1/15 to inquire about the claim denial for the claim incurred on 4/2/15, and you spoke with a different representative who noted your account to show you called regarding the claim denial, but there is no further detail of the conversation. Then on 5/7/15, you contacted American Fidelity again and spoke with this same representative. The note states the representative would verify with the FSA area to ensure the Grace Period Provision was not an option in the current plan year, since the previous plan year did have the Grace Period Provision. On 5/8/15, this representative emailed you to let you know to contact your Employer who was the Section 125 Plan Sponsor. She provided the contacts' names and phone numbers.
According to your comments in the complaint, there were contradictory statements made by the representatives. The sale of Barrier Motors did not impact the way claims were to be reimbursed. The decision to remove the Grace Period was made prior to 4/1/14. American Fidelity is committed to providing all of its customers with world-class service. We will take this opportunity to reinforce the knowledge of our representatives. Thank you for your detailed explanation of the situation.
At this time, your employer's Section 125 Plan provisions do not allow for reimbursement of your claim incurred on 4/2/15.
Initial Consumer Rebuttal /* (3000, 7, 2015/07/23) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I would still like to know why American Fidelity did not let its flexible spending account users with Barrier Motors know that the grace period wasn't going to be valid. AutoNation aka "Auto Company XXI, Inc" didn't take over until 10/22/14 (we didn't even learn that Barrier Motors was being sold until 9/23/14, far after benefits for the year started) and if I recall when we signed up for our flex accounts in March, 2014 Renee, the rep, said nothing has changed from previous plan year which I took to mean there was still the grace period. It all seems deceitful. That is our hard earned money and we deserve to know if ANY provisions change. I'm upset that I wasn't told anything and could have expedited using the last of my funds. I will pass along this response to the others stuck in the same boat as me.
Final Business Response /* (4000, 9, 2015/07/31) */
It is not American Fidelity's standard operating procedure to send notification to the employees when the employer changes a provision under its Section 125 Plan. Generally, employers prepare and distribute enrollment materials prior to the enrollment taking place. The employer chose American Fidelity as its Section 125 provider which included our annual and new hire enrollment services. During the enrollment, the American Fidelity Account Representative explained the products available to Barrier Motors' employees as a whole and during one-on-one meetings. To our knowledge, the Grace Period change was communicated.

We are responding in regards to Complaint
ID [redacted]. We have discovered a discrepancy between the information submitted by the customer and what the provider's office is verifying. We are currently working through this via
investigation. Once the investigation is complete, we will have
a more...

thorough response for this customer.Please contact our office for
any further questions
regarding this matter.

Initial Business Response /* (1000, 5, 2015/08/21) */
Contact Name and Title: [redacted] Manager
Contact Phone: XXX-XXX-XXXX, [redacted]
Contact Email: [redacted]@americanfidelity.com
Mr. [redacted] has submitted several bills and EOBs for review of possible benefits. American Fidelity has provided...

a surgical benefit from this information, but the other charges that we have received were for services for which his policy provides no benefit. We did ask Mr. [redacted] for itemized billing that relates to some EOB expenses he submitted as we were unable to determine what these expenses were for, but in reviewing those EOBs, it doesn't appear that they are for covered expenses. We are happy to provide all due benefits from Mr. [redacted]'s policy, but at this time we have provided all that is due based on the information he has submitted. If he has itemized billing for treatment that he has yet to submit, we are happy to review for additional benefits. We are also more than happy to assist him in requesting any information for which he is having trouble obtaining if he lets us know the names of the providers from which he has been receiving his treatment. We will be contacting him to offer our assistance. Until receipt of this complaint, we were unaware that he may be having trouble submitting what we need for review.
Initial Consumer Rebuttal /* (3000, 7, 2015/08/24) */
(The consumer indicated he/she DID NOT accept the response from the business.)
As is typical of insurance companies, although they say they are happy to comply with all contractual agreements, they usually do everything they can to avoid payment of any significant amount of money that is due their customer. From their legal perspective, they are correct. From my 'customer' perspective, they are sorely lacking any common-sense, and "friendly" customer service. Example; They say they have "provided a surgical benefit" to me. They have. But $100.00 of a $60,000.00 procedure is a joke. The "hoops" one has to jump through, while fighting Cancer, is inhuman...
But, at least I'm wiser for it.
Final Business Response /* (4000, 9, 2015/09/02) */
The American Fidelity Cancer Policy carried by Mr. [redacted] is a limited benefit specified disease policy. The benefits of the policy are not structured to provide a percentage of a billed charge such as you would find with a major medical insurance policy, but, rather, structured to pay charges incurred up to set amounts as listed in the Schedule of Benefits of his policy.
The $100 referenced in the complaint is the amount this policy will pay for the biopsy which was performed. This benefit amount can be found in the Schedule of Benefits of his policy. We understand that his provider may have billed much more than this, but the majority of that expense is to be paid by his major medical carrier rather than this, his supplemental cancer policy.
We have spoken on the phone with Mr. [redacted] on August 21, 2015 and we have also called one of his providers to assist him in obtaining the billing information needed in order to determine benefits from the policy. We have also instructed Mr. [redacted] as to what is needed from the hospital to review for possible benefits from that expense as well. American Fidelity is more than happy to provide all due benefits of a policy. Given that the benefits of this policy are determined by charges incurred, itemized billing is a necessity in order to determine those benefits. We are happy to assist as needed if an Insured expresses trouble in obtaining the information needed to file their claim.
As soon as we receive the requested information from his surgical provider we will promptly review for due benefits. If Mr. [redacted] needs assistance in obtaining the hospital billing in question, we are also happy to help him with this also.
If Mr. [redacted] disagrees with our claim decision, he has the right to appeal. His appeal must be made in writing. Written comments, documents, records and other information relating to the claim should be included with his appeal.
If there is anything else we can do to assist Mr. [redacted] with this claims process, we are happy to do so. I will have an adjuster reach out to him again via phone to follw up with him.