As Western Southern and [redacted] know I had surgery on my right hand and I write with my right hand.Even with considerable discomfort I will sign the HIPPA release with the exception of allowing Revdex.com to re-disclose this information to any specific party to whom I have not given a direct release.? Private medical information is not for general public review.? Further, I will mail the release form to you as I do not have access to a fax machine
As Western Southern and [redacted] know I had surgery on my right hand and I write with my right hand.Even with considerable discomfort I will sign the HIPPA release with the exception of allowing Revdex.com to re-disclose this information to any specific party to whom I have not given a direct release Private medical information is not for general public reviewFurther, I will mail the release form to you as I do not have access to a fax machine
The Western & Southern health plans are designed to provide choice to our members in the benefits they receive so that they can maximize the value of their benefits by tailoring them to their specific situationOur retiree medical plan is a low deductible, comprehensive plan that is highly subsidized by the Company, and which offers a unique solution for retiree health careWestern & Southern self– administers its health plans, and has as its mission to both manage and adjudicate heath claims in accordance with plan provisions, to service the needs of our members in a positive manner, and to protect the health information of our membersWe will always treat our members with dignity and respect.With regard to Mr [redacted] ’s Revdex.com complaint, please be advised that his complaint involves two different mattersThe first matter involves a predetermination of a procedure that Mr [redacted] was to have performed on August 26, On August 24, 2016, his physician’s office sent a predetermination request to the Western & Southern Benefits DepartmentOn that same day, the Benefits Department approved the procedure and then immediately notified both Mr [redacted] and his physician’s office of the approvalIn fact, the physician’s office complimented the Benefits Department for the quick responseClearly the process worked to Mr [redacted] ’s benefit.The second matter involves another surgery predetermination request for Mr [redacted] On October 12, 2016, Mr [redacted] ’s physician’s office called the Western & Southern Benefits Department to check on the status of a predetermination requestBecause the Benefits Department had not received any notification of an upcoming surgery involving Mr [redacted] , Benefits Department personnel requested clinical records to complete the predetermination processOn October 12, Mr [redacted] was notified that clinical records were requested to review to make a predetermination involving the upcoming surgeryOn October 13, the requested information was received and reviewed and the surgery request was approved that dayHowever, Mr [redacted] is questioning a fax sent by his physician’s office dated September 22, 2016.As explained to Mr [redacted] , the Benefits Department received the fax on October 12, on its secure fax machineOn October 13, 2016, as noted above, the fax and information contained in the transmittal was reviewed and the surgery request approvedWe suggested to Mr [redacted] that if he had any concerns involving the fax he should contact his physician’s office.Both of Mr [redacted] ’s predetermination requests were processed in a timely, confidential, and respectful manner
We regret that Mr [redacted] has not accepted our responseWe would like to reiterate that we have replied to all his inquiries and will continue to do so in the future
As a Western & Southern retiree, Mr [redacted] is eligible for health coverage under the Western & Southern Financial Group Retiree Health PlanAs such, like other participants, he receives eligible benefits pursuant to the terms of the plan, which provides for dispute resolution if a participant is not satisfied with a claims determination.? As head of the Benefits Department, [redacted] is responsible for all communications with plan participants and has decided to be the main contact with Mr [redacted] regarding his claims concerns? Because the health information of all of our members is protected, in order for us to address Mr [redacted] ’s allegations in more detail, we will need an authorization from him allowing us to disclose to the Revdex.com protected health information associated with his complaint.? It is our mission to service the needs of all participants, including Mr [redacted] , in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr [redacted] fairly and with respect
There should be attachments:1) My response to the Company's answer and 2) emails with SVP [redacted] from yesterday and 3) my prior email summary and stream to [redacted] ?
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below.Western Southern Financial Group senior vice president [redacted] is personally handling my health insurance claims and inquiries, contrary to how other members are handled She has mishandled private medical information that delayed a test ordered by my surgeon She has not safe guarded my private medical file as required by federal law For days she refused to answer questions from the company's health insurance manual that direct members to send to her When she finally referred the questions to another individual that person's response omitted pertinent documents It has now been 60+ days without a complete answer.Rather than providing a complete answer, [redacted] decided to personally attack me.I feel the Revdex.com should make public how Western Southern Financial Group mistreats senior citizens who previously worked for them for years.Western Southern Financial Group should always promptly and completely answer questions from their customers Regards, [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below [To assist us in bringing this matter to a close, we would like to know your view on the matter.] Regards, [redacted] I understand it could take up to days for the business to reply.I wanted to send this message through your website but I did not see if that was possible.Reviewing the status on your webpage I see that WSFG responded from their Public Relations Dept., possibly on behalf of the Benefits Deptand/or [redacted] .As such I’m not sure if this is their only reply or if additional information is forthcoming.Regarding the release form to provide you with a full reply PLUS COPIES OF MY PRIVATE MEDICAL INFORMATION, I would prefer that WS Benefits answer the remaining questions, BUT PROVIDE ME WITH COPIES OF MY MEDICAL DOCUMENTATION WHICH UNDER HIPAA IS TO BE SAFEGUARDED AND KEPT IN A PRIVATE FOLDER I would be glad to follow up with you after WS Benefit’s replies and let you know if their provided that information as required under federal law.It is currently 60+ days since my initial request to Western Southern Financial Group and in my quest for a reply I have contacted CEO [redacted] , General Counsel [redacted] , Counsel [redacted] , SVP [redacted] and VP [redacted] [redacted]
The Western & Southern health plans are designed to provide choice to our members in the benefits they receive so that they can maximize the value of their benefits by tailoring them to their specific situationOur retiree medical plan is a low deductible, comprehensive plan that is highly subsidized by the Company, and which offers a unique solution for retiree health careWestern & Southern self?" administers its health plans, and has as its mission to both manage and adjudicate heath claims in accordance with plan provisions, to service the needs of our members in a positive manner, and to protect the health information of our membersWe will always treat our members with dignity and respect.With regard to Mr [redacted] ’s Revdex.com complaint, please be advised that his complaint involves two different mattersThe first matter involves a predetermination of a procedure that Mr [redacted] was to have performed on August 26, On August 24, 2016, his physician’s office sent a predetermination request to the Western & Southern Benefits DepartmentOn that same day, the Benefits Department approved the procedure and then immediately notified both Mr [redacted] and his physician’s office of the approvalIn fact, the physician’s office complimented the Benefits Department for the quick responseClearly the process worked to Mr [redacted] ’s benefit.The second matter involves another surgery predetermination request for Mr [redacted] On October 12, 2016, Mr [redacted] ’s physician’s office called the Western & Southern Benefits Department to check on the status of a predetermination requestBecause the Benefits Department had not received any notification of an upcoming surgery involving Mr [redacted] , Benefits Department personnel requested clinical records to complete the predetermination processOn October 12, Mr [redacted] was notified that clinical records were requested to review to make a predetermination involving the upcoming surgeryOn October 13, the requested information was received and reviewed and the surgery request was approved that day.? However, Mr [redacted] is questioning a fax sent by his physician’s office dated September 22, 2016.As explained to Mr [redacted] , the Benefits Department received the fax on October 12, on its secure fax machineOn October 13, 2016, as noted above, the fax and information contained in the transmittal was reviewed and the surgery request approvedWe suggested to Mr [redacted] that if he had any concerns involving the fax he should contact his physician’s office.Both of Mr [redacted] ’s predetermination requests were processed in a timely, confidential, and respectful manner
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.Western Southern Financial Group senior vice president *** *** is personally handling my health insurance claims and inquiries, contrary to how other members are handled. She has mishandled private medical information that delayed a test ordered by my surgeon. She has not safe guarded my private medical file as required by federal law. For days she refused to answer questions from the company's health insurance manual that direct members to send to her. When she finally referred the questions to another individual that person's response omitted pertinent documents. It has now been 60+ days without a complete answer.Rather than providing a complete answer, *** decided to personally attack me.I feel the Revdex.com should make public how Western Southern Financial Group mistreats senior citizens who previously worked for them for years.Western Southern Financial Group should always promptly and completely answer questions from their customers
Regards,
*** ***
As a Western & Southern retiree, Mr*** *** is eligible for health coverage under the Western & Southern Financial Group Retiree Health PlanAs such, like other participants, he receives eligible benefits pursuant to the terms of the plan, which provides for dispute resolution if a
participant is not satisfied with a claims determination. As head of the Benefits Department, *** *** is responsible for all communications with plan participants and has decided to be the main contact with Mr*** regarding his claims concerns Because the health information of all of our members is protected, in order for us to address Mr***’s allegations in more detail, we will need an authorization from him allowing us to disclose to the Revdex.com protected health information associated with his complaint. It is our mission to service the needs of all participants, including Mr***, in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr*** fairly and with respect
We regret that Mr*** *** has not accepted our responseWe would like to reiterate that we have replied to all his inquiries and will continue to do so in the future
CEO *** ***, General Counsel *** ***, Counsel for Benefits *** *** and VP for Benefits *** *** were each sent a copy of my request but none will provide a responseSVP *** *** was chosen as the Company’s spokesperson since the issues relate to benefits.Due to a prior complaint against *** she purposely delayed precertification of a test ordered by my surgeon which caused me to reschedule the testPresently she is purposely delaying the precertification for surgery recommended and scheduled by my surgeon.Further, *** has acknowledged reading multiple copies of my email requests starting more than days ago but still will not answer my questions.It is my believe that Senior Officers at Western Financial Group have joined *** in purposely discriminating against me and purposely violating the terms of their Summary Plan Description which explains their medical benefits and options.*** responded to you (Revdex.com) that I have a dispute resolution process within the Summary Plan Description; however both Altenau and *** have sent me correspondence saying *** is my only course for communication*** is in charge of Benefits and is also in charge of the Benefits’ Appeal CommitteeIf she will not respond to my initial questions a prudent person would not feel *** would respond to an Appeal nor would she be impartial based on her action over the last days.On August 24, I sent an email with questions/requestsOnly item #would include private medical informationIn item # 3, under HIPAA I was entitled to a copy of my medical file so I asked for a copy of the medical information sent from my physician to WS including the fax date time and phone numberMy physician had faxed the information to obtain testing precertification to the fax number provided by WSWS claimed they did not receive the information which caused the test to be postponedMy physician provided me with their copy of the fax and I am entitled under HIPAA to the copy at WS.None of my other questions would include private medical information in the response, so, once again, WS is using this ploy to delay their responseI cannot understand why it has been days since my request was submitted and the private medical information would be allowed in a direct response to me from WSThe release is only an issue to provide the same information to a third party.Lastly, my surgeon has recommended surgery, supporting medical substantiation has been sent to WS, and again they will not reply with the precert authorizationAs such I will have to reschedule the surgery because WS’ Summary Plan Description states that if members to not obtain a precert that WS can reduce or decline any reimbursement through the medical insurance I voluntarily purchased and pay forWS’ medical insurance is not a free benefit
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. SEE THE ATTACHMENT FROM ASKING FOR WS CLARIFICATION
Regards,
*** ***
Western & Southern responded to its former employee and current retiree Mr*** ***’s inquiries and requestsAs for Mr***’s request to remove *** *** from the handling of his current and future claims under the Western & Southern Financial Group Retiree Health Plan, we communicated to him that Ms***, under the circumstances, will continue to be his main contact regarding his claims. As for his request for timely service, it is our mission to service the needs of all participants, including Mr***, in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr*** fairly and with respect
Western & Southern responded to its former employee and current retiree Mr*** ***’s inquiries and requestsAs for Mr***’s request to remove *** *** from the handling of his current and future claims under the Western & Southern Financial Group Retiree Health Plan, we communicated to him that Ms***, under the circumstances, will continue to be his main contact regarding his claims. As for his request for timely service, it is our mission to service the needs of all participants, including Mr***, in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr*** fairly and with respect
As Western Southern and *** *** know I had surgery on my right hand and I write with my right hand.Even with considerable discomfort I will sign the HIPPA release with the exception of allowing Revdex.com to re-disclose this information to any specific party to whom I have not given a direct release. Private medical information is not for general public review. Further, I will mail the release form to you as I do not have access to a fax machine
There should be attachments:1) My response to the Company's answer and 2) emails with SVP *** from yesterday and 3) my prior email summary and stream to ***
CEO *** ***, General Counsel *** ***, Counsel for Benefits *** *** and VP for Benefits *** *** were each sent a copy of my request but none will provide a responseSVP *** *** was chosen as the Company’s spokesperson since the issues relate to benefits.Due to a prior complaint against *** she purposely delayed precertification of a test ordered by my surgeon which caused me to reschedule the testPresently she is purposely delaying the precertification for surgery recommended and scheduled by my surgeon.Further, *** has acknowledged reading multiple copies of my email requests starting more than days ago but still will not answer my questions.It is my believe that Senior Officers at Western Financial Group have joined *** in purposely discriminating against me and purposely violating the terms of their Summary Plan Description which explains their medical benefits and options.*** responded to you (Revdex.com) that I have a dispute resolution process within the Summary Plan Description; however both Altenau and *** have sent me correspondence saying *** is my only course for communication*** is in charge of Benefits and is also in charge of the Benefits’ Appeal CommitteeIf she will not respond to my initial questions a prudent person would not feel *** would respond to an Appeal nor would she be impartial based on her action over the last days.On August 24, I sent an email with questions/requestsOnly item #would include private medical informationIn item # 3, under HIPAA I was entitled to a copy of my medical file so I asked for a copy of the medical information sent from my physician to WS including the fax date time and phone numberMy physician had faxed the information to obtain testing precertification to the fax number provided by WSWS claimed they did not receive the information which caused the test to be postponedMy physician provided me with their copy of the fax and I am entitled under HIPAA to the copy at WS.None of my other questions would include private medical information in the response, so, once again, WS is using this ploy to delay their responseI cannot understand why it has been days since my request was submitted and the private medical information would be allowed in a direct response to me from WSThe release is only an issue to provide the same information to a third party.Lastly, my surgeon has recommended surgery, supporting medical substantiation has been sent to WS, and again they will not reply with the precert authorizationAs such I will have to reschedule the surgery because WS’ Summary Plan Description states that if members to not obtain a precert that WS can reduce or decline any reimbursement through the medical insurance I voluntarily purchased and pay forWS’ medical insurance is not a free benefit
There should be attachments:1) My response to the Company's answer and 2) emails with SVP *** from yesterday and 3) my prior email summary and stream to ***?
As Western Southern and [redacted] know I had surgery on my right hand and I write with my right hand.Even with considerable discomfort I will sign the HIPPA release with the exception of allowing Revdex.com to re-disclose this information to any specific party to whom I have not given a direct release.? Private medical information is not for general public review.? Further, I will mail the release form to you as I do not have access to a fax machine
As Western Southern and [redacted] know I had surgery on my right hand and I write with my right hand.Even with considerable discomfort I will sign the HIPPA release with the exception of allowing Revdex.com to re-disclose this information to any specific party to whom I have not given a direct release Private medical information is not for general public reviewFurther, I will mail the release form to you as I do not have access to a fax machine
The Western & Southern health plans are designed to provide choice to our members in the benefits they receive so that they can maximize the value of their benefits by tailoring them to their specific situationOur retiree medical plan is a low deductible, comprehensive plan that is highly subsidized by the Company, and which offers a unique solution for retiree health careWestern & Southern self– administers its health plans, and has as its mission to both manage and adjudicate heath claims in accordance with plan provisions, to service the needs of our members in a positive manner, and to protect the health information of our membersWe will always treat our members with dignity and respect.With regard to Mr [redacted] ’s Revdex.com complaint, please be advised that his complaint involves two different mattersThe first matter involves a predetermination of a procedure that Mr [redacted] was to have performed on August 26, On August 24, 2016, his physician’s office sent a predetermination request to the Western & Southern Benefits DepartmentOn that same day, the Benefits Department approved the procedure and then immediately notified both Mr [redacted] and his physician’s office of the approvalIn fact, the physician’s office complimented the Benefits Department for the quick responseClearly the process worked to Mr [redacted] ’s benefit.The second matter involves another surgery predetermination request for Mr [redacted] On October 12, 2016, Mr [redacted] ’s physician’s office called the Western & Southern Benefits Department to check on the status of a predetermination requestBecause the Benefits Department had not received any notification of an upcoming surgery involving Mr [redacted] , Benefits Department personnel requested clinical records to complete the predetermination processOn October 12, Mr [redacted] was notified that clinical records were requested to review to make a predetermination involving the upcoming surgeryOn October 13, the requested information was received and reviewed and the surgery request was approved that dayHowever, Mr [redacted] is questioning a fax sent by his physician’s office dated September 22, 2016.As explained to Mr [redacted] , the Benefits Department received the fax on October 12, on its secure fax machineOn October 13, 2016, as noted above, the fax and information contained in the transmittal was reviewed and the surgery request approvedWe suggested to Mr [redacted] that if he had any concerns involving the fax he should contact his physician’s office.Both of Mr [redacted] ’s predetermination requests were processed in a timely, confidential, and respectful manner
We regret that Mr [redacted] has not accepted our responseWe would like to reiterate that we have replied to all his inquiries and will continue to do so in the future
As a Western & Southern retiree, Mr [redacted] is eligible for health coverage under the Western & Southern Financial Group Retiree Health PlanAs such, like other participants, he receives eligible benefits pursuant to the terms of the plan, which provides for dispute resolution if a participant is not satisfied with a claims determination.? As head of the Benefits Department, [redacted] is responsible for all communications with plan participants and has decided to be the main contact with Mr [redacted] regarding his claims concerns? Because the health information of all of our members is protected, in order for us to address Mr [redacted] ’s allegations in more detail, we will need an authorization from him allowing us to disclose to the Revdex.com protected health information associated with his complaint.? It is our mission to service the needs of all participants, including Mr [redacted] , in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr [redacted] fairly and with respect
There should be attachments:1) My response to the Company's answer and 2) emails with SVP [redacted] from yesterday and 3) my prior email summary and stream to [redacted] ?
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below.Western Southern Financial Group senior vice president [redacted] is personally handling my health insurance claims and inquiries, contrary to how other members are handled She has mishandled private medical information that delayed a test ordered by my surgeon She has not safe guarded my private medical file as required by federal law For days she refused to answer questions from the company's health insurance manual that direct members to send to her When she finally referred the questions to another individual that person's response omitted pertinent documents It has now been 60+ days without a complete answer.Rather than providing a complete answer, [redacted] decided to personally attack me.I feel the Revdex.com should make public how Western Southern Financial Group mistreats senior citizens who previously worked for them for years.Western Southern Financial Group should always promptly and completely answer questions from their customers Regards, [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below [To assist us in bringing this matter to a close, we would like to know your view on the matter.] Regards, [redacted] I understand it could take up to days for the business to reply.I wanted to send this message through your website but I did not see if that was possible.Reviewing the status on your webpage I see that WSFG responded from their Public Relations Dept., possibly on behalf of the Benefits Deptand/or [redacted] .As such I’m not sure if this is their only reply or if additional information is forthcoming.Regarding the release form to provide you with a full reply PLUS COPIES OF MY PRIVATE MEDICAL INFORMATION, I would prefer that WS Benefits answer the remaining questions, BUT PROVIDE ME WITH COPIES OF MY MEDICAL DOCUMENTATION WHICH UNDER HIPAA IS TO BE SAFEGUARDED AND KEPT IN A PRIVATE FOLDER I would be glad to follow up with you after WS Benefit’s replies and let you know if their provided that information as required under federal law.It is currently 60+ days since my initial request to Western Southern Financial Group and in my quest for a reply I have contacted CEO [redacted] , General Counsel [redacted] , Counsel [redacted] , SVP [redacted] and VP [redacted] [redacted]
The Western & Southern health plans are designed to provide choice to our members in the benefits they receive so that they can maximize the value of their benefits by tailoring them to their specific situationOur retiree medical plan is a low deductible, comprehensive plan that is highly subsidized by the Company, and which offers a unique solution for retiree health careWestern & Southern self?" administers its health plans, and has as its mission to both manage and adjudicate heath claims in accordance with plan provisions, to service the needs of our members in a positive manner, and to protect the health information of our membersWe will always treat our members with dignity and respect.With regard to Mr [redacted] ’s Revdex.com complaint, please be advised that his complaint involves two different mattersThe first matter involves a predetermination of a procedure that Mr [redacted] was to have performed on August 26, On August 24, 2016, his physician’s office sent a predetermination request to the Western & Southern Benefits DepartmentOn that same day, the Benefits Department approved the procedure and then immediately notified both Mr [redacted] and his physician’s office of the approvalIn fact, the physician’s office complimented the Benefits Department for the quick responseClearly the process worked to Mr [redacted] ’s benefit.The second matter involves another surgery predetermination request for Mr [redacted] On October 12, 2016, Mr [redacted] ’s physician’s office called the Western & Southern Benefits Department to check on the status of a predetermination requestBecause the Benefits Department had not received any notification of an upcoming surgery involving Mr [redacted] , Benefits Department personnel requested clinical records to complete the predetermination processOn October 12, Mr [redacted] was notified that clinical records were requested to review to make a predetermination involving the upcoming surgeryOn October 13, the requested information was received and reviewed and the surgery request was approved that day.? However, Mr [redacted] is questioning a fax sent by his physician’s office dated September 22, 2016.As explained to Mr [redacted] , the Benefits Department received the fax on October 12, on its secure fax machineOn October 13, 2016, as noted above, the fax and information contained in the transmittal was reviewed and the surgery request approvedWe suggested to Mr [redacted] that if he had any concerns involving the fax he should contact his physician’s office.Both of Mr [redacted] ’s predetermination requests were processed in a timely, confidential, and respectful manner
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.Western Southern Financial Group senior vice president *** *** is personally handling my health insurance claims and inquiries, contrary to how other members are handled. She has mishandled private medical information that delayed a test ordered by my surgeon. She has not safe guarded my private medical file as required by federal law. For days she refused to answer questions from the company's health insurance manual that direct members to send to her. When she finally referred the questions to another individual that person's response omitted pertinent documents. It has now been 60+ days without a complete answer.Rather than providing a complete answer, *** decided to personally attack me.I feel the Revdex.com should make public how Western Southern Financial Group mistreats senior citizens who previously worked for them for years.Western Southern Financial Group should always promptly and completely answer questions from their customers
Regards,
*** ***
As a Western & Southern retiree, Mr*** *** is eligible for health coverage under the Western & Southern Financial Group Retiree Health PlanAs such, like other participants, he receives eligible benefits pursuant to the terms of the plan, which provides for dispute resolution if a
participant is not satisfied with a claims determination. As head of the Benefits Department, *** *** is responsible for all communications with plan participants and has decided to be the main contact with Mr*** regarding his claims concerns Because the health information of all of our members is protected, in order for us to address Mr***’s allegations in more detail, we will need an authorization from him allowing us to disclose to the Revdex.com protected health information associated with his complaint. It is our mission to service the needs of all participants, including Mr***, in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr*** fairly and with respect
We regret that Mr*** *** has not accepted our responseWe would like to reiterate that we have replied to all his inquiries and will continue to do so in the future
CEO *** ***, General Counsel *** ***, Counsel for Benefits *** *** and VP for Benefits *** *** were each sent a copy of my request but none will provide a responseSVP *** *** was chosen as the Company’s spokesperson since the issues relate to benefits.Due to a prior complaint against *** she purposely delayed precertification of a test ordered by my surgeon which caused me to reschedule the testPresently she is purposely delaying the precertification for surgery recommended and scheduled by my surgeon.Further, *** has acknowledged reading multiple copies of my email requests starting more than days ago but still will not answer my questions.It is my believe that Senior Officers at Western Financial Group have joined *** in purposely discriminating against me and purposely violating the terms of their Summary Plan Description which explains their medical benefits and options.*** responded to you (Revdex.com) that I have a dispute resolution process within the Summary Plan Description; however both Altenau and *** have sent me correspondence saying *** is my only course for communication*** is in charge of Benefits and is also in charge of the Benefits’ Appeal CommitteeIf she will not respond to my initial questions a prudent person would not feel *** would respond to an Appeal nor would she be impartial based on her action over the last days.On August 24, I sent an email with questions/requestsOnly item #would include private medical informationIn item # 3, under HIPAA I was entitled to a copy of my medical file so I asked for a copy of the medical information sent from my physician to WS including the fax date time and phone numberMy physician had faxed the information to obtain testing precertification to the fax number provided by WSWS claimed they did not receive the information which caused the test to be postponedMy physician provided me with their copy of the fax and I am entitled under HIPAA to the copy at WS.None of my other questions would include private medical information in the response, so, once again, WS is using this ploy to delay their responseI cannot understand why it has been days since my request was submitted and the private medical information would be allowed in a direct response to me from WSThe release is only an issue to provide the same information to a third party.Lastly, my surgeon has recommended surgery, supporting medical substantiation has been sent to WS, and again they will not reply with the precert authorizationAs such I will have to reschedule the surgery because WS’ Summary Plan Description states that if members to not obtain a precert that WS can reduce or decline any reimbursement through the medical insurance I voluntarily purchased and pay forWS’ medical insurance is not a free benefit
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. SEE THE ATTACHMENT FROM ASKING FOR WS CLARIFICATION
Regards,
*** ***
Western & Southern responded to its former employee and current retiree Mr*** ***’s inquiries and requestsAs for Mr***’s request to remove *** *** from the handling of his current and future claims under the Western & Southern Financial Group Retiree Health Plan, we communicated to him that Ms***, under the circumstances, will continue to be his main contact regarding his claims. As for his request for timely service, it is our mission to service the needs of all participants, including Mr***, in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr*** fairly and with respect
Western & Southern responded to its former employee and current retiree Mr*** ***’s inquiries and requestsAs for Mr***’s request to remove *** *** from the handling of his current and future claims under the Western & Southern Financial Group Retiree Health Plan, we communicated to him that Ms***, under the circumstances, will continue to be his main contact regarding his claims. As for his request for timely service, it is our mission to service the needs of all participants, including Mr***, in a positive manner in accordance with the provisions of the Western & Southern Financial Group Retiree Health PlanWe have and will always treat Mr*** fairly and with respect
As Western Southern and *** *** know I had surgery on my right hand and I write with my right hand.Even with considerable discomfort I will sign the HIPPA release with the exception of allowing Revdex.com to re-disclose this information to any specific party to whom I have not given a direct release. Private medical information is not for general public review. Further, I will mail the release form to you as I do not have access to a fax machine
There should be attachments:1) My response to the Company's answer and 2) emails with SVP *** from yesterday and 3) my prior email summary and stream to ***
CEO *** ***, General Counsel *** ***, Counsel for Benefits *** *** and VP for Benefits *** *** were each sent a copy of my request but none will provide a responseSVP *** *** was chosen as the Company’s spokesperson since the issues relate to benefits.Due to a prior complaint against *** she purposely delayed precertification of a test ordered by my surgeon which caused me to reschedule the testPresently she is purposely delaying the precertification for surgery recommended and scheduled by my surgeon.Further, *** has acknowledged reading multiple copies of my email requests starting more than days ago but still will not answer my questions.It is my believe that Senior Officers at Western Financial Group have joined *** in purposely discriminating against me and purposely violating the terms of their Summary Plan Description which explains their medical benefits and options.*** responded to you (Revdex.com) that I have a dispute resolution process within the Summary Plan Description; however both Altenau and *** have sent me correspondence saying *** is my only course for communication*** is in charge of Benefits and is also in charge of the Benefits’ Appeal CommitteeIf she will not respond to my initial questions a prudent person would not feel *** would respond to an Appeal nor would she be impartial based on her action over the last days.On August 24, I sent an email with questions/requestsOnly item #would include private medical informationIn item # 3, under HIPAA I was entitled to a copy of my medical file so I asked for a copy of the medical information sent from my physician to WS including the fax date time and phone numberMy physician had faxed the information to obtain testing precertification to the fax number provided by WSWS claimed they did not receive the information which caused the test to be postponedMy physician provided me with their copy of the fax and I am entitled under HIPAA to the copy at WS.None of my other questions would include private medical information in the response, so, once again, WS is using this ploy to delay their responseI cannot understand why it has been days since my request was submitted and the private medical information would be allowed in a direct response to me from WSThe release is only an issue to provide the same information to a third party.Lastly, my surgeon has recommended surgery, supporting medical substantiation has been sent to WS, and again they will not reply with the precert authorizationAs such I will have to reschedule the surgery because WS’ Summary Plan Description states that if members to not obtain a precert that WS can reduce or decline any reimbursement through the medical insurance I voluntarily purchased and pay forWS’ medical insurance is not a free benefit
There should be attachments:1) My response to the Company's answer and 2) emails with SVP *** from yesterday and 3) my prior email summary and stream to ***?