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
We regret that Mr. [redacted] has not accepted our response. We would like to reiterate that we have replied to all his inquiries and will continue to do so in the future.
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]
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
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 situation. Our 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 care. Western & 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 members. We 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 matters. The first matter involves a predetermination of a procedure that Mr. [redacted] was to have performed on August 26, 2016. On August 24, 2016, his physician’s office sent a predetermination request to the Western & Southern Benefits Department. On that same day, the Benefits Department approved the procedure and then immediately notified both Mr. [redacted] and his physician’s office of the approval. In fact, the physician’s office complimented the Benefits Department for the quick response. Clearly 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 request. Because 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 process. On October 12, Mr. [redacted] was notified that clinical records were requested to review to make a predetermination involving the upcoming surgery. On 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, 2016 on its secure fax machine. On October 13, 2016, as noted above, the fax and information contained in the transmittal was reviewed and the surgery request approved. We 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 [redacted], 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 12132016 ASKING FOR WS CLARIFICATION
Regards,
[redacted]
As a Western & Southern retiree, Mr. [redacted] is eligible for health coverage under the Western & Southern Financial Group Retiree Health Plan. As 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 Plan. We have and will always treat Mr. [redacted] fairly and with respect.
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 57 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 35 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 30 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 Dept. and/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
We regret that Mr. [redacted] has not accepted our response. We would like to reiterate that we have replied to all his inquiries and will continue to do so in the future.
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]
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
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 situation. Our 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 care. Western & 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 members. We 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 matters. The first matter involves a predetermination of a procedure that Mr. [redacted] was to have performed on August 26, 2016. On August 24, 2016, his physician’s office sent a predetermination request to the Western & Southern Benefits Department. On that same day, the Benefits Department approved the procedure and then immediately notified both Mr. [redacted] and his physician’s office of the approval. In fact, the physician’s office complimented the Benefits Department for the quick response. Clearly 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 request. Because 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 process. On October 12, Mr. [redacted] was notified that clinical records were requested to review to make a predetermination involving the upcoming surgery. On 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, 2016 on its secure fax machine. On October 13, 2016, as noted above, the fax and information contained in the transmittal was reviewed and the surgery request approved. We 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 [redacted], 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 12132016 ASKING FOR WS CLARIFICATION
Regards,
[redacted]
As a Western & Southern retiree, Mr. [redacted] is eligible for health coverage under the Western & Southern Financial Group Retiree Health Plan. As 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 Plan. We have and will always treat Mr. [redacted] fairly and with respect.
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 57 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 35 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 30 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 Dept. and/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]