Coventry Health Care, Inc.

February 4, 2014
Dear **. [redacted]:
This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to a complaint submitted by [redacted] regarding a change in policy and premium increase for...

his CoventryOne policy effective since February 1, 2012. The request was received by CHC Carolinas on February 3, 2014.
CHC Carolinas does not have a signed authorization release form from **. [redacted] indicating that the Revdex.com is representing him in this matter. CHC Carolinas will respond directly to **. [redacted].
Please contact me if you have any further questions involving this issue. I can be reached at ###-###-####-[redacted] between the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday.
Sincerely,

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because: I received a letter from Coventry, that THEY were terminating my coverage as of December 2013. I was working with one of their sales reps. who was to enroll me in a plan for $298. per month for my husband and myself, to begin in January.  They then tried to deduct $700. per month from my checking, which is what I stopped payment on.I NEVER agreed to this amount!! I spoke to SEVERAL people at Coventry, who were to cancel my coverage completely. Why would you then in February deduct two months of $700. plus late fees that for a policy that is canceled!! Your company dropped the ball several times, and will not admit it!! I have enrolled with another provider! Do you continue to try to collect premiu** for someone who obviously does not want your coverage!!  This is THIEVERY!!  I still have not gotten any call-backs from any supervisor! Great customer service!
Regards,
[redacted]

I am still working with a hospital to receive a hard copy of the bill. I am rejecting the response because Coventry has been difficult to work with and I feel I am owed more than them simply correcting their mistake after months of involvement with the customer. I have spent countless hours trying to figure this out. While trying to figure all of this out I was unable to go to the doctor rendering my health insurance useless for the past four months while I pay close to $200.00 a month. I would like reimbursed for these months I was not able to use my health insurance due to the confusion they caused by telling me the wrong info on Jan 30th and them not informing me of my plan change; not to mention the hassle it took for Coventry to admit their mistake and fix it. Also, I was never informed of my plan change. I would like Coventry to allow me out of my current health insurance plan and chose another one since they picked one for me and didn't tell me my plan was changing.
 Complaint: [redacted]
I am rejecting this response because:
Regards,
[redacted]

June 23, 2014
Dear [redacted]:
The Member is participating in the Coventry Health and Life Insurance Company (“CHL”) HealthAmerica One individual PPO health benefit plan.[redacted] (the “Member”) has filed a complaint. The Member’s complaint concerns an alleged billing error....

The member states that he was overcharged a total of $489.51 due to a billing error and is asking for a refund for that overcharge.Below is a timeline of events leading up to the resolution of the Member’s complaint.
November 20, 2013 – The Member contacted Billing & Enrollment to inquire about 2014 rates. The call dropped.
November 20, 2013 –The Member contacted Billing & Enrollment in regards to 2014 rates. The member was advised that we did not have those rates available yet and he was given his agent’s information.
May 7, 2014 – The Member contacted Billing & Enrollment because he states that he is owed a refund in the amount of $489.51. The member was advised that there was not a refund due. The last draft took place December 5, 2013. The member was advised to send in a rolling bank statement of the charges.
ROOT CAUSE:The member is requesting a refund for an overcharge; our system does not reflect this charge.
RESOLUTION:Our records do not show the member was drafted $526.90 or $594.89 in the past. He has been drafted $320.68 for his terminated policy, with the last draft being December 5, 2013. Or, the member has been drafted $316.14 for their current policy. If the Member could supply a rolling bank statement of the charges, as we do not see the charges that the member states has been coming out of his account, we would welcome the opportunity to investigate further.If you have any questions or concerns regarding this matter I can be reached at ###-###-####.Sincerely,

Dear [redacted],
Please see our response below to the additional concerns reported in complaint #[redacted] for [redacted] that were received by us on December 29, 2014.
We do apologize for the frustration **. [redacted] has experienced during this situation.  We have issued refunds for the $208 dollars that were applied for overdraft fees on her bank account in the form of paper checks.  The initial check for $156 was dated December 29, 2014.  The second check was for $52 and was dated January 2, 2015. 
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 you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Regards,
Chris B[redacted]
Executive Resolution Team

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:My employer terminated the billing, and I called in January, on the 26th or 27th, as soon as I received notification that Coventry was requesting payment, and advised that I did not want the policy and it should be terminated at that point. I called again in February after receiving another letter to explain it had been terminated and I did NOT wish to continue it. I then received a letter indicating it had been terminated for non-payment, and I was being sent to collections. At that point I requested the refund, and it was promised to me. At no point after that did anyone disagree to the fact that I was due a refund after the struggle I had from the very beginning of the policy. While the policy was "available" to some degree during the year I had it, it took me 5 months to get my cards, when I tried to fill my prescriptions, they were not compatible with the policy thereby requiring me to pay out of pocket instead. The extremely limited availability of this policy could've been overlooked aside from the fact that I've now spent more than 12 hours on the phone attempting to get a very simple matter resolved. The vast majority of that time has been on hold, waiting for a supervisor who never materialized.
I will be submitting the payment record provided to Coventry, which will hopefully fulfill the requirements and allow them to finish processing the refund.
Regards,
[redacted]

Dear...

Ms. [redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on February 2, 2015.
Our review of Ms. [redacted]’s policy shows that a refund was issued in the amount of $559.78 for the premium that was drafted from her account on January 5, 2015.  The posting date for the refund in Coventry’s system shows February 10, 2015.  The actual date of deposit displayed on her bank statement may vary due to the processing time required by the bank.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms. [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Regards,
Chris B[redacted]
Executive Resolution Team

May 23, 2014Dear [redacted]:The Appeals Department of Coventry Health Care of Georgia, Inc. (“Coventry Health Care”) writes this letter in response to your request dated May 15, 2014 and received at our office on that day. This letter is in response to the consumer complaint filed by...

[redacted] regarding termination of her policy and refund of her premium.Coventry’s records show that on March 17, 2014, the member called to terminate coverage as of April 1, 2014 and to change the address of record to [redacted], GA [redacted]. On May 12, 2014, the member called in to advise that her account had been drafted when the policy should have been terminated. A review of Coventry’s records found that the termination was not processed in enough time to avoid the draft.On May 15, 2014, the policy was terminated as of March 31, 2014 as requested and a refund issued on May 19, 2014. The amount deposited back to the drafted account is $474.44 which is two premiums of $237.22 (for April and for May). Depending on the members banking institution, funds will appear within 1-5 days from May 19, 2014.If you have any questions, please contact the Customer Service Department at [redacted].Sincerely,

Coventry Health Care, Inc. respectfully requests an extension of time in order to further its investigation of the above-referenced Complaint.
Thank you,
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
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. 
I want to again thank the Revdex.com for helping to resolve this for me.
As you can see, this was a failure in service and promises from Coventry Health care that resulted in me making numerous contacts to their local and corporate offices.
Ultimately they did deliver the debit cards but it took too much effort from me.
Regards,
[redacted]

Dear...

[redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on January 6, 2015.
We were able to have the termination of [redacted]’s policy backdated to April 30, 2014.  A refund has been approved for the premiums she paid for her policy for May and June.  The refund will be deposited directly into the account we have on file for her and will occur within the next 1-5 business days. 
If [redacted] incurred overdraft fees in relation to this issue, we are able to review for possible reimbursement of those fees.  In order to have the review performed, we will require a bank statement supporting the amounts and dates for any fees that were applied.  Our Enrollment department then makes the decision on whether or not to approve the reimbursement.
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].
Regards,
Chris B[redacted]
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. 
Regards,
[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because the last day I called was December 3rd.  Why is it taking so long to get a refund? I was told on December 3rd by a manager that it would be 7-10 business days.  Which means I would of received my refund on Nov 15th by the latest. Now you are telling me that this request was submitted on Dec 13th which is  7 business after the fact. I should of had this money back in my bank account in Nov. Your company is not taking any Responsibility for their actions. Your phone calls are recorded, so there is no reason you shouldn't be able to uphold what your customer service reps are telling your customers.  Training your employees on what your polices are is not my problem nor fault. I would like a reasonable  explanation why on Nov 7th when you received the paper work that was requested, my policy was not terminated and my refund not processed. This is More than a month from the time you took the money out of my bank account that I will receive it back. This is bad business and someone from your company needs to be held accountable.  
Regards,
[redacted]

Complaint: [redacted]
I am rejecting this response because:
Please see attached handwritten response.
Regards,
[redacted]. [redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
I have contacted both eHealthInsurance and the Marketplace. Both of these entities are showing that the plan was canceled on November 11, 2014. It seems that the only people who haven't gotten the memo about the cancellation is Coventry.
It seems to me that if Coventry insists that I go through the Marketplace to cancel the insurance, and the Marketplace is telling me the insurance was cancelled in November, then, AGAIN, I say to Coventry to please recognize that this insurance plan is cancelled and stop sending me bills and notices that state otherwise.
Regards,
[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
That is not correct at all. I spoke with your Customer Service Supervisor Jenee on 3-30-2015. I faxed over proof of payment from my previous company that was received on 3-30-2015. This document shows that my previous employer had paid $1,239.85 for January and February. Jenee confirmed receipt of that document and sent over to billing again to apply funds to my account. Attached is a copy of the List Bill that was sent from Coventry to my previous employer where Coventry Confirmed payment (highlighted in blue). Coventry conveniently lost these records of the $1,239.85 that had been paid to them.  
Jenee and I walked through each months balance due and what was paid. According to her for December 2014 I owed $301.55, for January 2015 I owed $356.53, for February 2015 I owed $671.53 and finally for March I owed $671.53. Total amounts due $2001.14.  My previous employer has paid $1,239.85, I paid $89.76 on 2/6/2015 for the remainder due in February, I have also paid $671.53 on 3-2-15, and finally I have paid an additional $586.77 on 3-27-15. The payment for $586.77 was made after being threatened that Coventry would cancel my policy despite me knowing that I should not have a negative balance. The total amount I have paid to Coventry is $2587.91, which is an over payment of exactly $586.77. Please review your Coventry Customer Service Notes to confirm. Jenee gave me reference number: [redacted] & [redacted] that should have all of this detailed. She also sent in a request to refund my overdue payment of $586.77 and said that it should be paid back within 5-7 business days. Jenee said that my policy will be canceled as of 3-31-15 so I do not receive and additional charges. 
Every single person I have spoke with at Coventry has had a completely different story. I have been given different information from every single customer service rep I have spoke with. Its extremely difficult as a consumer to have consistent miss-information. There is a reason Coventry is rated so poorly with the Revdex.com. Please confirm the conversation I had with Jenee via reference number [redacted] & [redacted], that I am receiving my over payment of $586.77 and that my policy was cancelled as of 3-31-15.
Regards,
[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because: I called and left a message for my case manager last Friday and he has yet to return my phone call 7 days later. This is par for the course as his has happened for the last 4 months. Every manager has said they would call me back and none do. Regards,
[redacted]

Dear...

[redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on February 12, 2015.
In review of [redacted]’s policy, it was noted that he is covered by a policy applied for through the Health Insurance Marketplace.  The initial premium payment was posted to his account with Coventry on January 6, 2015.  The enrollment process was then completed on January 7, 2015, and [redacted] was assigned an ID number at that time.   We are showing that [redacted] contacted Coventry on January 13, 2015, and requested and was provided with his ID number. 
The order to create and mail the ID cards for his policy was also placed on January 7, 2015.  The standard timeframe for the cards to be received by our members once the order is placed is 7-10 business days.  While this delay causes them to be without an ID card, other options are available to help those who can’t wait for the card to be received.  These options include our website, member.cvty.com, where an account can be created that will give access to view the ID card, which can then be printed and given to health care professionals until the permanent card is received.  Coventry’s representatives are also able to fax copies of the card if a request is made. 
Unfortunately, Coventry is not able to change the effective or termination date on this Marketplace policy, as there was no error found in the billing or enrollment process.  [redacted]’s policy is showing a termination date of January 21, 2015.  He had previously sent a premium payment for coverage for the full month of January, so a prorated refund was sent for the portion of January that he paid for but for which he no longer has active coverage.  The refund process was completed on January 12, 2015.  The refund was in the amount of $15.15.
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].
Regards,
Chris B[redacted]
Executive Resolution Team

February 17, 2014
Dear **. [redacted]:
This letter is in response to your request for Coventry Health Care of Virginia, Inc. to respond to a complaint submitted by [redacted] regarding termination of his CoventryOne policy which was effective January 1, 2011. **....

[redacted] is also requesting a refund for the premium paid for January and February 2014. The request was received by Coventry Health Care of Virginia, Inc. on February 7, 2014.
Coventry Health Care of Virginia, Inc. does not have a signed authorization release form from **. [redacted] indicating that the Revdex.com is representing him in this matter. We will respond directly to **. [redacted].
Please contact me if you have any further questions involving this issue. I can be reached at ###-###-####-[redacted] between the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday.
Sincerely,

September 30, 2014
To Whom It May Concern:Coventry Health Care of Kansas, Inc. and Coventry Health and Life Insurance Company (collectively “Coventry”) received the complaint filed with the Revdex.com of Metro Washington DC & Eastern Pennsylvania in our office on September 12,...

2014.A letter of explanation has been mailed directly to the member on this date. A refund of $481.75 will be returned to [redacted]’s account within 7-10 business days. We apologize for any inconvenience or confusion this has caused.Coventry hopes this provides the Revdex.com with the necessary information to complete the investigation of this matter. If you have any further questions or concerns, please feel free to contact me at ###-###-####.Respectfully,Brandy HAppeals Department