Chevron USA, Inc.

Dear [redacted]    Please see our response to complaint #[redacted] for [redacted] that was received by us on November 02, 2017.  Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.   Upon receipt of...

the complaint we immediately reached out to our Claims department to have the member’s concerns reviewed. We were advised that the authorization on file had to be updated to correct how the claims were being processing under the member’s plan. We updated the authorization on file to have the claims processed at the full billed amount. We also had any claims on file that were not allowed at the full billed amount of $210.00, corrected. Additional payments will be released within 7-10 business days and a corrected explanation of benefits will also be sent to the member for her records. If the member has any other claims that process incorrectly in the future she can email me directly at the email address listed below and I will have them handled immediately.   Please accept my apology for the delay in processing the member’s claim correctly, and that it required multiple attempts on her part to resolve the issue. Unfortunately, in some instances, errors do occur. When they do, we take them very seriously and do our best to understand how and why the errors occurred and determine what we can do to prevent a recurrence. We continually use feedback like this to improve our service and prevent issues from reoccurring.   We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]   Sincerely,   Ashley W. Complaint and Appeals Consultant Executive Resolution Team

Hello,
Thank you for your inquiry, regarding complaint [redacted] Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.
Upon receipt of the complaint we immediately reached out to have the calls pulled related to...

the pregnancy coverage prior to services being rendered. The records indicate only general pregnancy benefits were provided during the call from the member. The claims in question were processed correctly in accordance to the member’s plan benefits.
When the child is born and is added to the policy as an individual, the facility is able to bill separately for both mom and child for any charges related to the pregnancy. The submitted charges were sent for both the mom and child; which triggered the individual copays. While we understand your concerns and recognize this is not the resolution you sought, our decision remains unchanged. Our actions are solely guided by the plan guidelines in order to administer fairly and equitably to all participants.
Aetna strives to provide the highest level of service, quality, and satisfaction, and to continually improve our processes. I want you to know that we appreciate your feedback because it gives us the opportunity to listen to our customers and make any improvements to our processes and the service we provide. Your opinion is valued at Aetna, and I trust that you will not hesitate to contact us when you need assistance.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Thank you,
Ashley S.
Complaint and Appeal Consultant
Executive Resolution Team

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sincerely,
[redacted]

Thank you for your inquiry received on [redacted] regarding complaint #[redacted] for [redacted].  Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.
 
We reached out to the Flexible Spending Account (FSA)...

department, and the member’s check for $20.00 has been reissued as of [redacted]. We apologize for any inconvenience this may have caused.
 
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns.  If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].

Hello,
Thank you for your inquiry, regarding complaint #[redacted]
for [redacted] Our Executive Resolution Team researched your concerns, and I
would like to share the results of the review with you.
Upon receipt of the complaint we immediately reached out to
our Pharmacy department...

to have the member’s concerns reviewed. We were advised
by our Aetna Rx Home Delivery department that on August 21, 2014, the member’s
physician called in three new prescriptions for the member. The order diverted
to a member outreach to obtain a payment method for the order. On August 26,
2014, a call was made to the member to obtain a payment method for the order;
the member was not available and a message was left. On September 03, 2014, the
member had not returned the call and the order was released and charged to the
credit card on file, which had been used for a previous order. The order
shipped the same day via [redacted].
On September 04, 2014, the member contacted Customer Care
regarding the order to advise that the order was charged to her credit card
without her approval. The member requested to have the credit card removed from
her account and a note added stating not to fill orders until she calls to
request them. The note was added to the account per the member’s request and on
September 20, 2014, the credit card charge was refunded in the amount of
$160.00. Due to this refund, the member then owed the charges incurred for the
August 21, 2014, prescriptions.
On December 30, 2014, the member contacted Customer Care and
requested to have a prescription refilled. A request was sent to the pharmacy
to fill the prescription and the order diverted for a member outreach to obtain
a method of payment. On December 31, 2014, and January 02, 2015, outreaches
were made to the member to obtain a payment method. The member returned the
call to the account receivable team on January 05, 2015, and provided a method
of payment for the order. She was also advised that the order would be released
as a courtesy and she is responsible for the past due balance of $160.00. The
member requested to speak to a supervisor and was transferred to a supervisor.
The member advised the supervisor that she called to cancel the August
prescription order and was assured that the order would be cancelled. The supervisor
said that she would have the call reviewed to verify if the member was told the
order would be cancelled and would call her back.
The supervisor called the member back on January 08, 2015,
to advise her of the call review results but the member was not available and a
message was left. The call review confirmed that the member was advised that
the order could not be cancelled but that a return label could be sent to
return the prescription and the member stated not to worry about sending the
return label, that she would dispute the charge with her bank.
We did not hear back from the member and on April 24, 2015,
a new prescription was received via fax from the physician. The order diverted
to the account receivable team for a member outreach to obtain a payment method
for the order and to resolve the outstanding balance of $160.00. Three separate
outreaches were made to the member on May 01, 2015, May 07, 2015, and May 08,
2015 and messages were left.
On August 21, 2015, the member requested two prescriptions
via the Aetna website. The order diverted for a member outreach because the
outstanding balance had to be resolved prior to the order being shipped. An
outreach was made to the member to obtain payment for the past due balance on
August 25, 2015 and a message was left for the member to call back. As a second
courtesy to the member, the prescriptions were released on August 26, 2015,
without member contact for the outstanding balance. The orders shipped the same
day and were charged to the credit card on file.
On March 02, 2016, a prescription was received
electronically from the physician and on March 03, 2016, the prescription was diverted
for a member outreach because of the $160 past due on the file. On March 07,
2016, an outreach was made to the member to obtain a method of payment for the
prescription order and a message was left for the member to call back. The
member called Customer Care back the same day regarding the balance and declined
to pay the outstanding balance of $160.00. She was transferred to the account
receivable department to assist with the payment. The member again declined to
pay the balance and requested that the prescription order be released. The
member stated that she would call back regarding the past due balance.
As a last and final courtesy for the member, the balance of
$160.00 has been written off due to the situation. The prescription has been
release and the $75.00 copay has been charged to the credit card on file. Due
to the previous chargebacks to the credit card going forward the member will be
required to send money orders for any future prescriptions.
We take customer complaints very seriously and appreciate
you taking the time to contact us and giving us the opportunity to address Ms.
Keith’s concerns. If you have any additional questions regarding this
particular matter, please contact the Executive Resolution Team at [redacted].
Thank you,
Ashley S.
Complaint and Appeal Consultant
Executive Resolution Team

Dear
[redacted]
Please
see our response to complaint #[redacted]
for [redacted] that was received by us on March 01, 2016.
During our review, we reached out to
our Billing and Enrollment department to address [redacted] concerns. It was
determined that the member had a policy...

that became effective for the month of January
2016 with a premium of $254.16; the policy was termed as of January 30, 2016. A
new policy became effective for this member as of February 01, 2016 and has
been effective since, this policy has a premium of $295.14 and is the policy
the member elected to have active.
A total of three payments were received
from the member, one for $254.16, another one for $295.14 and another one for
$295.14. The member was reimbursed to her MasterCard on February 12, 2016 for $254.16
+ $295.14= $549.30. The other premium payment of $295.14 was applied to the
current policy paying the month of February. 
In order for the member to be current in the premium payments, [redacted] would need to provide payment for January ($254.16) + March ($295.14).
I
apologize for any difficulties or confusion this may have caused [redacted]. We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address [redacted]’s concerns. 
If there are any additional questions regarding this particular matter, please
contact the Executive Resolution Team at [email protected].
Regards,
Julian
C[redacted]
Executive
Resolution Team

Dear
[redacted]:
 
Please
see our response to complaint #[redacted] for
[redacted] that was received by us on April 11, 2018.  Our Executive Resolution Team
researched your concerns, and I would like to share the results of the review
with...

you.
 
Upon
receipt of the complaint we immediately reached out to our [redacted] department
to have the member’s concerns reviewed. We were advised that we previously
handled a grievance for this issue and the member’s enrollment call was
listened to and it was verified that she received the correct information
during enrollment. Below is a timeline of what occurred and also the details
of her enrollment call.
•
[redacted] enrolled in the Aetna [redacted] Plan [redacted]  effective January 01, 2017, and disenrolled effective September 30, 2017. [redacted]
transitioned from Disability Eligible to Age Eligible for [redacted].
•
On July 28, 2017, [redacted] submitted an enrollment application to enroll
in Aetna [redacted] Plan ([redacted] with an effective date of October
01, 2017. At the time of [redacted]’s enrollment, neither we nor our
enrolling agents would not have known what her premiums or deductible would be
in 2018.
•
We conducted an agent investigation against the enrolling agent regarding [redacted]’s
allegations. Upon review of the enrollment call, [redacted] contacted our
Sales department looking for a standalone drug plan. She explained to the
agent that she is turning 65 in [redacted]. [redacted] opted to enroll in the
Aetna [redacted]. [redacted] asked will the plan
start in October. The agent verified that her plan will start October 01, 2017,
as she is in her special election to enroll in a plan due to turning 65. The
agent provided her with the correct copayment, coinsurance, premium,
formulary, and pharmacy information for the 2017 contract year. The agent
explained that she will receive her new I.D. card and membership materials to
be used for her new plan effective October 01, 2017. The agent clearly
explained that her plan with Aetna [redacted] Plan [redacted]  will terminate September 30, 2017. The agent explained that she will receive a
new membership I.D number as she was changing plans. [redacted] agreed to
the enrollment and accepted all terms and conditions of the enrollment.
 
Effective
October 01, 2017, [redacted]’s monthly premium was $25.40 per month through December
31, 2017. Our Aetna [redacted] Plan ([redacted]) did not have a
deductible in 2017. On September 05, 2017, a Summary of Benefits was mailed to
[redacted] regarding her 2018 benefits. We advised the monthly premium for
2018 will be $23.80 and advised of the deductible for 2018 as $350.00. This
deductible does not apply for Tier One or Tier Two medications.
 
The
agent would have not had the benefits for the 2018 contract year as the
enrollment was completed on July 28, 2017, and the following year information is
not released until early October. Based on review of the available information
and the agent’s call recording, the findings in this case are unfounded and
unsubstantiated. We will not waive or change the member’s deductible for this
plan.
The
member’s deductible is processing correctly and she was notified about the
deductible for 2018 and did not change plans when she had the opportunity to
do so. [redacted] is a Tier Three medication. Her tiering exception
request was denied. The member or her provider can file an appeal by calling
###-###-####.
 
There
are programs available for [redacted] members on fixed or limited incomes. These
programs may help with your plan copays and monthly premiums. To see if you
qualify for any of these state or federal programs, you can call [redacted]  at ###-###-####. She can also contact:
[redacted] [redacted]
[redacted]
 
We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address [redacted] concerns.  If there are any additional questions
regarding this particular matter, please contact the Executive Resolution Team
at [redacted]
 
Sincerely,
 
Ashley
W.
Complaint
and Appeals Consultant
Executive
Resolution Team

Dear Ms. [redacted]
Please see our response to complaint #[redacted] for [redacted] that was received by us on October 7, 2016. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you. Upon receipt of the complaint, we contacted our Claims department to address the member’s concerns. We verified that all claims have been reviewed and reprocessed to show the correct rate. We also confirmed that the provider’s contracted rate is $65 for HMO products. The $80 rate is for non-HMO products.  We apologize for the inconvenience in regards to the delay in processing the member’s claim. We have provided feedback to improve service and to prevent these issues from reoccurring. We appreciate the member’s comments and have submitted the recommendations to leadership for review. We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]
Sincerely, [redacted]Complaint and Appeal Consultant Executive Resolution Team

Complaint: [redacted]
I am rejecting this response because: This is not entirely resolving my problem with Aetna.  I am still being harassed by AETNA RX home delivery for a balance of $220.  My tier exception should have been applied to this order according to different associates spoken to in the last few months.  Since a mistake was made in applying a prescription against my deductible when it should not have been, this problem needs to be fixed as well.  According to the different representatives I spoke to, I paid more than I should have for my prescription back in January because of the tier exception which backdates to January the first of this year.  The response from Aetna does not explain what the reimbursement consists of.  Am I receiving a reimbursement for paying too much for the medication back in January? Or, am I receiving one for the emergency medication I had to purchase from a local pharmacy back in January because your company was negligent and left me without medication? I am tired of being harassed by these letters.  I am so tired and stressed from this mess, I cannot take it anymore! Your company does not even understand or care how much stress and anguish you have caused me since December.  This entire mess needs to be fixed, not just part of the problem but the whole! Lastly, I want to make sure that the person that responded to this complaint from Aetna understands that I am a female! I am not [redacted]. I am [redacted] That really shows me how much Aetna cares about their customers' complaints when they cannot even address the customer by their appropriate gender.
Sincerely,
[redacted]

Hello,
Thank you for your inquiry, regarding complaint #[redacted]
for [redacted]. Our Executive Resolution Team researched your concerns, and
I would like to share the results of the review with you.
Upon receipt of the compliant we immediately reached out to
[redacted]...

to confirm the children were not active under the
policy. We were able to confirm the children were never active on any other
plan, making Aetna the primary payer for the claims on file.
After confirming that Aetna is
the primary payer, we immediately reached out to our Claims department to have
all the claims reprocessed and paid as primary to the providers. Please allow
7-10 business days for the providers to receive the payments as well as the
corrected explanation of benefits. Please accept my apology for the delay in
processing the claims correctly, and that it required
multiple attempts on the member’s part to resolve the issue. Unfortunately,
in some instances, errors do occur. When they do, we take them very seriously
and do our best to understand how and why the errors occurred and determine
what we can do to prevent a recurrence.  We
continually use feedback like the member’s to improve our service and prevent issues
from reoccurring.
Our goal is to provide
exceptional service to our customers, and immediately resolve issues when they
do occur. These actions are not consistent with Aetna’s service standards and
we appreciate you notifying us of the member’s experience. I would like to
assure you that we have taken the appropriate actions to address the service
issues the member experienced.
We take customer complaints very seriously and appreciate
you taking the time to contact us and giving us the opportunity to address Dr.
Jain’s concerns. If you have any additional questions regarding this particular
matter, please contact the Executive Resolution Team at [email protected].
Thank you,
Ashley S.
Complaint and Appeal Consultant
Executive Resolution Team

Complaint: [redacted]
I am rejecting this response because:
[redacted] stated in their response that the policy was "terminated" Jan 1, 2015.  Why then have I been paying them for this coverage all of 2015?   They just made my case for me.  Thank you.  I want a return of my premiums for a policy that I am paying for that was cancelled, Jan 1 2015, according to the response from [redacted].  Also [redacted]s response indicates that they do not keep accurate and/or comprehensive records of EVERY call from their members.  I called Atena at least 4 times about this issue.  Including a call on or the day before I filled this complaint with the Revdex.com.  I have a record of that call and I received a call back from a manager out of their South Carolina office.  [redacted]s response doesn't indicate a record of those calls to and from [redacted] therefore they CLEARLY are not capturing records of EVERY calls which explains why they may not have a record of my call with my request to cancel their coverage or confirmation that was given my wife and I.  My wife was on the cancellation request call me & the recent calls aforementioned and can attest to the validatity of my complaint & dealings with [redacted] regarding this matter.  Based on [redacted]s response and unwillingness to resolve this I am inclined to fill further complaints with the attorney general(s) office of the various states where they conduct this part of their business.  I may also consider legal action for fraud.   [redacted] can resolve this with me directly or I will pursue additional action.  
Sincerely,
Jared G[redacted]

Can you please request either the member’s ID number or Date of Birth to be able to start an investigation for this complaint? We are not able to locate him with just his name and zip code search. Thank you,Ashley

Complaint: [redacted]
I am rejecting this response because: The response did not address the fact that tens of thousands of dollars of x-Rays and MRIs were not covered from a recent hospital stay, and those services were covered at s rate of 100% per my plan policy. Additionally, there's a $3,000 out of pocket maximum, therefor, Aetna should not be sending me bills for anything in excess of the $3,000 out of pocket maximum. This includes a bill I received from Aetna for in excess of $119,000 that I received this week for a portion of that hospital stay. Please re-review these claims and adjust.
Sincerely,
[redacted]

Hello, Thank you for your inquiry, regarding complaint # [redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you. Upon the receipt of the complaint, we contacted our Customer Service department to review your concerns. We have requested that all non-required letters and correspondence be stopped from both the medical and prescription portions of [redacted] policy. The member will continue to receive any pertinent correspondence for his current prescription and medical coverage. In regards to the request of having 3 months of premiums waived, we would need to receive proof of denial of access to medical or prescriptions coverage in order to justify premium waiver. That premium waiver would require home office exception. We apologize for any frustrations and difficulties the member has experienced with this matter. We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at s[redacted].   Thank you, Tanika K. Complaint and Appeal Consultant Executive Resolution Team

Complaint: [redacted]
I am rejecting this response because: I want it to be noted I have not received any such phone calls as I would have jumped at the chance to speak with someone other than "let me pass it on to my supervisor and someone will get back to you". I have been waiting for a call back from a supervisor since my initial call in December. It wasn't until these contacts through the Revdex.com that I now have two correspondence emails. No responses from my initial complaints through customer service, no phone calls since filing this complaint. I have requested to hear the recorded calls and to no avail. I clearly understand now the individual co pays for mom and baby as it has FINALLY been explained to me. Had this information been presented to me a year ago when I was initially inquiring on my expected fees there would not be any disputes. It's this simple: "I'm pregnant. What are my expected fees if I deliver at hospital A as I'm trying to decide between my (employer) hospital and this other and I do not want any surprise bills?" "$500. You have no deductible, which some people have, so you are only going to pay $500." Twice this happened with no mention of a second copay for baby from either rep. When a member calls, twice, to make sure they have accurate information and the rep verifies benefit/copay amounts, on two separate occasions, I think it's fair to believe the presented information is accurate when what it stated are identical responses. There was no room for error or misinterpretation in my questioning or answers received. At this point in time, I will be proceeding through small claims. Thank you, Revdex.com, for providing me the channel to have dialogue with someone higher up. 
Sincerely,
[redacted]

Dear [redacted]   Please see our response to complaint #[redacted] for [redacted] that was received by us on June 27, 2016. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.   Upon receipt of the complaint we immediately reached out to our Claims department for clarification on why the claim was processed correctly according to the member’s benefits. We were advised that the physician billed a routine physical procedure code, which falls under the routine office visit benefits. The claim was paid at 100% for the office visit.   The bloodwork was billed as an outpatient diagnostic lab by a different provider who performed the tests. Based on how the claim was billed to Aetna, it falls under the benefit of participating lab benefits. Page five of the member’s Schedule of Benefits shows that the member’s in-network, outpatient diagnostic lab is covered at 100% after Calendar Year deductible was met. The member’s deductible had not been met so the member’s responsibility correctly applied to the deductible.   We assure you that it is not our intent to mislead or misrepresent any benefit that may or may not be available under the member’s health plan. I understand the member’s concerns and recognize this is not the outcome that was desired. However, we must make coverage decisions in accordance with the member’s plan. The member does have the right to appeal the claims if the member still disagrees with our decision. Please send the appeal request to: Appeals Resolution Team [redacted]   We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. [redacted]s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]   Sincerely,   Ashley W. Complaint and Appeals Consultant Executive Resolution Team

Dear Ms. [redacted]:   Please see our response to complaint #[redacted] for [redacted] that was received by us on November 10, 2017.  Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.   Upon receipt of the...

complaint we immediately reviewed the member’s file to have the member’s concerns addressed. I requested that a Supervisor who handles this member’s account through the employer contact her directly to attempt to resolve. At this time we discovered that the doctor that referred her son referred them to [redacted]. The member went to the center in [redacted] and the sign read [redacted] and also [redacted]. It appears that the services were actually performed by [redacted] which does the billing through [redacted] Hospital. The member understands that we quoted her the correct rate for [redacted] and that the issue lies with the bill that was received from [redacted] Hospital not [redacted].   The member asked to the Supervisor to contact [redacted] to clarify the billing and to follow up with her on the findings. We did advise the member that in order for us to make any changes to this billing we would have to have a corrected bill from [redacted]. The Supervisor spoke to a representative at [redacted]. She advised that if an [redacted] provider refers the patient to them it is then billed as an [redacted] provider [redacted] Hospital. If a non [redacted] provider refers the patient to them it is billed by [redacted]. The representative also advised there are signs within the facility to warn the patients. However, she was going to escalate the issue to her manager and will follow up with the Supervisor the week of November 27, 2017. The Supervisor followed up with [redacted] and shared the above information with her and advised her we would follow up with her the same week after talking to the facility. We will continue to work directly with this member in an attempt to resolve this to the member’s satisfaction.      We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].   Sincerely,   Ashley W. Complaint and Appeals Consultant Executive Resolution Team

Hello,
Thank you for your inquiry, regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.
Upon receipt of the complaint we immediately reached out to our Claims department to have...

the member’s concerns reviewed. We were advised that the claims are processed correctly per the benefits.
Prenatal benefits are for routine care prenatal care which is billed as a global fee by the physician. These tests are not part of routine care based on policy and therefore covered under the medical benefit not the prenatal benefit.
The Maternity benefit includes:
• All prenatal and postpartum visits, including the 6-week postpartum check-up
• Routine urinalysis
• Delivery
Per policy all prenatal tests billed separately from the global fee are to be covered the same as any other medical test to diagnosis or treat a disease. Please refer to your plan booklet, which states:
“PRENATAL TESTS: Pay expenses for covered prenatal tests on the same basis as tests to diagnose or treat disease.”
I understand your concerns and recognize this is not the outcome you desired. I want to assure you we reviewed all the documents and available information before issuing this response. Our actions are solely guided by the plan guidelines in order to administer fairly and equitably to all participants.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [email protected].
Thank you,
Ashley S.
Complaint and Appeal Consultant
Executive Resolution Team

Dear Ms. [redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on July 15, 2015.
We contacted our Medicare department and asked them to review Mr. [redacted] concerns. They advised that the claim submitted by Dr. [redacted] for March 25, 2015, was...

processed correctly. Dr. [redacted] billed the claim with a nonparticipating tax identification number (TIN), which does not accept the Aetna Medicare PPO plan. Dr. [redacted] is participating under a different TIN than the one used on the claim. However, we cannot tell providers how to bill their claims. The Medicare department sent Mr. [redacted] a letter on August 04, 2015, which includes a detailed explanation of their review and his next steps.
 
I apologize for any difficulties this situation has caused Mr. [redacted].  We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. [redacted] concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]
Regards,
[redacted]
Executive Resolution Team

Hello,
Thank you for your inquiry, regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.
I sincerely apologize that we originally reviewed the first request incorrectly. Our executive team will make an exception if the member wishes and reopen the open and waive the timely filing so we can have the services reviewed based upon wrong information given. We already have the request in writing from the first appeal request, which is required by the employer, so if the member wishes to pursue this exception please have her send an email to my attention to the email address below and we will start an appeal immediately.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mrs. [redacted]’s concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Thank you,
Ashley S.
Complaint and Appeal Consultant
Executive Resolution Team