Caro Financial Service

I was charged a bill for insurance without a bill, and after my mother was told repeatedly that I did not have a bill I am here to clarify what is going on and I am requesting that the bill is eliminated I don't understand the sudden charges and it is inaccurate

Thank you for the opportunity to review Mr [redacted] complaint that was filed with the Revdex.com Your office assigned an Identification number of [redacted] to the complaint We have reviewed Mr [redacted] concerns about his COBRA premium refund request totaling $(Account# [redacted] ) and we respond as follows Our records reflect that Anthem administers Mr [redacted] COBRA plan, which is offered through his [redacted] COBRA employer group, which was active from October 3, through April 30, Mr [redacted] COBRA plan is showing termed effective May 1, Please be advised that when COBRA payments are sent to and received by Anthem, we forward the payments on to the group The premium Mr [redacted] sent in was forwarded back to his employer group plan On June 2, 2015, Anthem’s COBRA administration department sent an email to the employer group, asking them to return the payment so Anthem can refund the member We have to await a reply from the employer group before Anthem can process and issue Mr [redacted] COBRA refund At this time, Anthem has not received any monies back from the group to process his refund As such, Mr [redacted] can contact his employer and request the refund Should Mr [redacted] employer group issue a refund directly to him, Anthem’s COBRA administration records will still reflect he is owed a refund, unless the employer returns the money to Anthem for refund processing Anthem generally requests that the employer refund us, and then we issue a refund to Mr [redacted] so to track the refund in our systemsMs [redacted] , we appreciate your efforts on behalf of Mr [redacted] and we hope this information is helpful If Mr [redacted] has additional questions or concerns he may contact us by calling the telephone number on his Identification card Sincerely, Donna W***Grievances and Appeals Analyst SrAnthem Case Reference Number: [redacted]

Thank you for bringing this matter to our attentionPlease note that due to the nature of this complaint and that it would require disclosing [redacted] ***'s Personal Health Information (PHI) we are unable to directly respond to your office as we would be in violation of the Health Information Portability and Accountability Act (HIPPA)This matter will be thoroughly investigated by our Grievances and Appeals Department and a response will be issued directly to Ms [redacted] ***.Sincerely, Anthem Blue Cross Blue ShieldGrievances and Appeals Department

Thank you for forwarding Ms [redacted] ' complaint to our officeDue to the sensitive nature involved, and privacy laws, we are able to offer the following limited information in response to Ms [redacted] ' concerns regarding [redacted] .Our records reflect that Anthem's appeals department spoke with the member's mother, [redacted] , on November 2, 2015, ans advised of the appeal options for [redacted] 's caseOur appeals department called the facility on November 4, 2015, and spoke with [redacted] in the facility's utilization review department and provided the facility with the right to appealThe facility declined to verbally initiate an appealMs [redacted] , if you have any questions, please contact our officeOur reference number I [redacted] .Sincerely, Kathy H***

Please find attached the Anthem Authorization FormThank you very much,Lucica A [redacted]

Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Thank you for the copy of the recent letter you received concerning my dealings with Anthem Blue Cross/Blue Shield referencing the unpaid balances and or the lack of refund of my December payment,
Anthem neglected to reflect that I did not receive a letter from them telling me of their November termination of my coverage, but did relay that to me in a further telephone call (many numerous calls) over the past few months
Per a 3:pm call ( on July 8th 2015) to my primary physician, I asked their billing department if the December bills had been paid ( which Anthem Cobra stated had been reprocessed for payment between December and June18,2015.) The bookkeeper replied that the bills had been paid (by Anthem) and then in May of Anthem retracted their payment from the Doctor's officeNo further payment has been received from Anthem up to the date of this writingThere was no mention of that in the response they sent to you dated 6/26/
In the coming next day or so I will be contacting Anthem (again) and will reference their short-comingsI am also in close contact with the Deptof Labor since Cobra programs are governed by the U.SGovernmentThey, too are asking questions of Anthem as to why only certain elements of this case are being released to entities such as the Revdex.com, EBSA, etc
Respectfully,
*** *** (Jr.)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me.
Regards,
*** ***

Please see attached

credit card charges without approvalmonies owed due to deductible (my opinion)Lies on respponse to first grievanceContinuus robo calls medicine ordered by [redacted] an Anthem company that did not need orderedtheres more

Thank you for forwarding Ms. [redacted]' complaint to our office. Due to the sensitive nature involved, and privacy laws, we are able to offer the following limited information in response to Ms. [redacted]' concerns regarding [redacted].Our records reflect that Anthem's appeals department spoke...

with the member's mother, [redacted], on November 2, 2015, ans advised of the appeal options for [redacted]'s case. Our appeals department called the facility on November 4, 2015, and spoke with [redacted] in the facility's utilization review department and provided the facility with the right to appeal. The facility declined to verbally initiate an appeal. Ms. [redacted], if you have any questions, please contact our office. Our reference number I [redacted].Sincerely, Kathy H[redacted]

I was charged a bill for insurance without a bill, and after my mother was told repeatedly that I did not have a bill.  I am here to clarify what is going on and I am requesting that the bill is eliminated.   I don't understand the sudden charges and it is inaccurate.

Thank you for bringing this matter to our attention. Please note that due to the nature of this complaint and that it would require disclosing [redacted]'s Personal Health Information (PHI) we are unable to directly respond to your office as we would be in violation of the Health Information...

Portability and Accountability Act (HIPPA). This matter will be thoroughly investigated by our Grievances and Appeals Department and a response will be issued directly to Ms. [redacted].Sincerely, Anthem Blue Cross Blue ShieldGrievances and Appeals Department

Thank you for the opportunity to review Mr. [redacted] complaint that was filed with the Revdex.com.  Your office assigned an Identification number of [redacted] to the complaint.  We have reviewed Mr. [redacted] concerns about his COBRA premium refund request totaling...

$439.39 (Account# [redacted]) and we respond as follows.    Our records reflect that Anthem administers Mr. [redacted] COBRA plan, which is offered through his [redacted] COBRA employer group, which was active from October 3, 2014 through April 30, 2015. Mr. [redacted] COBRA plan is showing termed effective May 1, 2015.   Please be advised that when COBRA payments are sent to and received by Anthem, we forward the payments on to the group.  The premium Mr. [redacted] sent in was forwarded back to his employer group plan.  On June 2, 2015, Anthem’s COBRA administration department sent an email to the employer group, asking them to return the payment so Anthem can refund the member.  We have to await a reply from the employer group before Anthem can process and issue Mr. [redacted] COBRA refund.  At this time, Anthem has not received any monies back from the group to process his refund.  As such, Mr. [redacted] can contact his employer and request the refund.  Should Mr. [redacted] employer group issue a refund directly to him, Anthem’s COBRA administration records will still reflect he is owed a refund, unless the employer returns the money to Anthem for refund processing.  Anthem generally requests that the employer refund us, and then we issue a refund to Mr. [redacted] so to track the refund in our systems. Ms. [redacted], we appreciate your efforts on behalf of Mr. [redacted] and we hope this information is helpful.  If Mr. [redacted] has additional questions or concerns he may contact us by calling the telephone number on his Identification card.   Sincerely,  Donna W[redacted]Grievances and Appeals Analyst Sr. Anthem Case Reference Number: [redacted]

Thank you for the opportunity to review Mr. [redacted] complaint that was filed with the Revdex.com. Your office assigned an Identification number of [redacted] to the complaint. We have reviewed Mr. [redacted] concerns about his refund request of $1020.28 and we respond as follows.
Our...

records reflect that Mr. [redacted] had COBRA coverage with [redacted] Inc. from August 1, 2013 to December 31, 2014, which was administered by Anthem.
Please be advised that COBRA premiums are due on the first of the month with a 30-day grace period. This information is included in the COBRA election notice and monthly premium notices issued to Mr. [redacted]. The invoices state, "It is very important that your payment is on time and is postmarked no later than the end of the grace period shown on the invoice. Payments postmarked after the grace period end date will automatically terminate your coverage, and it cannot be reinstated." Anthem's records show that we did not receive Mr. [redacted] payment for December by the December 31, 2014 grace period end date. As a result, his COBRA was initially canceled for nonpayment of premiums effective November 30, 2014, and a cancel notice dated January 7, 2015 was sent to inform him of this. Anthem then received his payment in January 2015 with the postmark date of December 31, 2014. Since his payment was postmarked on the last day of the grace period, the payment was accepted and applied to his December coverage period. Anthem later received notice that his employer, [redacted] Inc. canceled their COBRA administration services with Anthem. Therefore, Mr. [redacted] COBRA coverage ended on December 31, 2014. The Changes in Coverage: Termination, Continuation & Conversion section of Mr. [redacted] Anthem health benefit plan (page M-66) in part states, "If you elect coverage under another carrier's health benefit plan or under any other non-Anthem plan which is offered by, through, or in connection with the Employer as an option instead of this Plan, then coverage for you and your Dependent(s) will generally terminate at the end of the billing period for which Fees have been paid."
 
Based on Mr. [redacted] employer group cancelling their COBRA administration plan with Anthem and the aforementioned plan language, his COBRA coverage termed correctly as of December 31, 2014. The refund request of his December 2014 premium is denied.
In regards to Mr. [redacted] December 2014 claims, please note that Anthem has several claims on file. Our records show that each claim was reprocessed and paid in accordance with Mr. [redacted] benefit plan language between December 23, 2014 and June 18, 2015.
Ms. [redacted], we appreciate your efforts on behalf of Mr. [redacted] and we hope this information is helpful. If Mr. [redacted] has additional questions or concerns he may contact us by calling the telephone number on his Identification card.
Sincerely,
Donna W[redacted]
Grievances and Appeals Analyst Sr. Grievances and Appeals Department

Please find attached the Anthem Authorization Form. Thank you very much,Lucica A[redacted]

We are in receipt of your letter dated  May 9, 2016 regarding Complaint ID [redacted].  In his letter, the complainant indicated he had made a payment on February 18, 2016 but that his account was not yet showing as active.   We have identified an issue with this member’s account...

and are in the process of correcting the issue.   Our Customer Service Team spoke with the complainant on May 16, 2016 to let him know that we are updating his account to show that his payment has been applied.  Please let me know if you have questions or need anything else.     Best regards, Elizabeth E[redacted]