Coventry Health Care, Inc.

Hello,
size="3">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 Coventry’s Billing and Premium department to verify if the credit had been added to your account per the member’s request. We were advised that they received a request to term the policy effective March 31, 2015. Due to this request we did not have the policy credited the $722.30, instead we refunded the money to the member on April 13, 2015 directly back to their account.
I sincerely apologize for the frustrations and difficulties you have experienced.  These actions are not consistent with our standards.  We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mrs. Jones’ 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

September 26, 2014Dear [redacted]:Your letter of September 19, 2014 to Coventry Health Care of Virginia, Inc. (“Coventry Health Care”) was referred to my attention for review and response. [redacted] is covered under Coventry effective July 1, 2014.
On May 8, 2014, Coventry...

initially received information from the Health Insurance Exchange (“Marketplace”) advising [redacted] would have coverage effective June 1, 2014 once she made her initial binder payment. Coventry received a corrected file feed from the Marketplace updating the effective date to July 1, 2014.On July 31, 2014, [redacted] paid the initial binder payment and her policy was issued with a July 1, 2014 effective date based on the enrollment information received from the Marketplace. Policies purchased on the Marketplace require full payment of the initial binder payment in order to enroll the member. Therefore, [redacted] would not have received any member materials until she paid the initial binder payment.
On September 26, 2014, Coventry reached out to [redacted] to discuss her concerns in detail and explained we were unable to change her effective date to the now requested August 1, 2014 based on Exchange rules and regulations. The Marketplace has advised her effect date is July 1, 2014 and not August 1, 2014. [redacted] was provided with the premium amount required to bring her account current.
Coventry is unable to process any changes to a policy that was initiated through the Marketplace per the Exchange rules and regulations that we as an insurance company must follow.
Coventry apologizes for any inconvenience this has caused [redacted]. However, as stated above the change must come through the Marketplace as Coventry is unable to change the effective date based on the Exchange rules and regulations.If you have any questions, please contact the Customer Service Department at ###-###-####.
Sincerely,Teresa E
Manager, Complaint and Appeal Program

face="Calibri">Dear [redacted],
Please see our response below to address [redacted]’s concerns reported in complaint #[redacted] that was received by us on November 19, 2014, regarding overpayment of premiums.
Our records show that no overpayments have occurred.  In reviewing the bank statements sent by [redacted] to the Enrollment department and the premium payment history for her policy, we determined that the debit for $226.96 appearing on her bank statement on September 24, 2014 was actually collected on August 29, 2014, and was posted to her account with us on September 2, 2014, as payment for coverage for the month of September.  The debit for the same amount that appears on her statement on October 1, 2014 was applied toward her premium for coverage for the month of October. 
In reviewing [redacted]’s complete payment history, we show that we have collected seven separate premium payments, each for $226.96, for coverage for the months of May through November 2014.  As the appropriate amounts have been collected, no refund is due at this time.
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 or she have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]@aetna.com.
Regards,
Chris B[redacted]
Executive Resolution Team

February 24, 2014
Dear Sir or Madam:
The Regulatory Compliance Department of Coventry Health Care of Nevada (“Coventry”) writes this letter in response to the consumer complaint filed by [redacted] that his bank account was over charged in the month of...

January 2014 for the amount of $223.28
The refund of the overcharge of $223.28 has been approved. The refund was processed on February 20th and can take 5 days to process into his bank account. If **. [redacted] does not receive the refund within 5 days then he can contact the Billing and Enrollment Department at ###-###-#### for assistance.
Coventry Health Care hopes this explanation 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 ###-###-#### and my email address is [redacted]
Sincerely,

Dear...

[redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on December 30, 2014.
We reached out to our Underwriting department to determine if an exception could be granted to allow [redacted] to be enrolled on his policy with the effective date of January 1, 2015.  The exception was approved.  We have confirmed that the enrollment process was completed on January 13, 2015, and the policy now shows active as of January 1, 2015. 
ID cards will be sent to the address we have on file for [redacted], but they will generally take 7-10 business days to arrive.  He may contact our Customer Service department at [redacted] to request his ID number and to receive instructions on where to get a temporary copy of his ID card if he wishes. 
We apologize for the extra time needed to resolve [redacted]’s complaint.  We appreciate you documenting the extension of the due date that we requested on January 9, 2015.  This extension was needed while the final decision was made in regards to the complaint.
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,
Christopher B[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.
We reviewed the complaint and verified we attempted to send ID cards to [redacted]...

[redacted] but they were being returned to us due to a bad address on file. Unfortunately, we are unable to reimburse [redacted] for May and June premiums that are being requested. We are currently working towards shorter wait times when our members call in. Concerning the customer service you experienced, our goal is o provide exceptional service to our customers, and immediately resolve issues when they do occur, I sincerely apologize for the frustrations and difficulties you experienced and that we did not provide the level of service that you rightfully expect and deserve. These actions are not consistent with our service standards and we appreciate you notifying us of your experience. We have addressed your customer service concerns directly with the representatives who handled your calls.
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],Thank you,
Ashley S.Complaint and Appeal ConsultantExecutive Resolution Team

"Times New Roman";">Dear
[redacted],
Please
see our response to complaint #[redacted]
for [redacted] that was received by us on October 16, 2015.
In
review of [redacted]’s and her husband’s policies, it was noted that several
enrollment issues had occurred surrounding the addition of her newborn twins to
the correct plan.  During the initial
attempt to correct the problem, claims were reprocessed and applied different
amounts towards the deductible than they had initially.  When
considering bills sent by providers at different times prior to and after the
corrections, there was an overage that was applied.  However, [redacted] will only be
responsible for the final amount applied towards the deductible for each
claim.  The current total amount applied
towards her and her sons’ deductibles does not exceed $2500 for any individual person
or $7500 for the family. 
We
were able to contact [redacted] and explain our resolution of the situation
and sent her a report that accurately shows which claims the deductible was
applied on and which amounts she will owe to the different providers.  We have also made all necessary corrections
to the enrollment for her family and gave the correct ID numbers for claim
submission in the future.
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].com.
 
Regards,
Chris
B[redacted]
Complaints
and Appeals Consultant
Executive
Resolution Team

[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 me through this process. 
Regards,
[redacted]

May 8, 2014
Dear Sir or Madam:The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter in response to the consumer complaint filed by [redacted] regarding a billing issue and question of refund.[redacted]’s policy was effective 6/1/13 and has been terminated per her request as of 5/31/14.Initial payments are drafted upon case issuance. In this instance, **. [redacted] paid her initial payment for the month of June 2013 when underwriting issued the policy. The payment was drafted on 5/9/13 for June 2013 premium. **. [redacted] is paid through her termination date. Each month’s billing was as follows:
06/01/2013 - $197.94
07/01/2013 - $197.94
08/01/2013 - $197.94
09/01/2013 - $197.94
10/01/2013 - $197.94
11/01/2013 - $197.94
12/01/2013 - $197.94
01/01/2014 - $197.94
02/01/2014 - $197.94
03/01/2014 - $197.94
04/01/2014 - $197.94
05/01/2014 - $197.94
TOTAL BILLED TO MEMBER = $2,375.2805/09/2013 - $197.94
07/05/2013 - $197.94
08/05/2013 - $197.94
09/05/2013 - $197.94 
10/07/2013 - $197.94
11/05/2013 - $197.94
12/05/2013 - $197.94
01/06/2014 - $197.94 
02/04/2014 - $197.94
03/05/2014 - $197.94
04/07/2014 - $197.94
05/05/2014 - $197.94TOTAL PAID BY MEMBER = $2,375.28
Please note that the first month’s payment was paid on May 9, 2013. The next payment was not made until July 5, 2013 – no money was paid in June 2013. In other words, the payment at the beginning of each month was made for the instant month, not the upcoming month. Therefore, there is no refund due. Once a policy is terminated, the home office sends a certificate of credible coverage. This is generated once the termination date passes. The member’s account will not be drafting any further payments as the policy has been terminated per her request.The calls that are on file are as follows:6/12/13 – Member called to update her address on file.6/18/13 – Member called to confirm address because she received an email for returned mail. The representative confirmed the address of record was correct.6/28/13 – Member called to get information about her plan and seeing a physician the previous day. The representative transferred the member to claims and benefits.5/6/14 – Member called to advise that she received a letter that her policy would be terminated in February and she noticed the May draft. The representative searched the system and did not locate this letter and advised the member she can terminate for the end of May. The member wanted the termination processed for 5/31/2014 and the representative did so during the call.5/6/14 – Member called back to advise that she is due a refund. The representative explained that the member was terminated for her paid-through date and there was no refund due. The member advised she will contact the Revdex.com.That was the last call on file.Coventry Health Care hopes this explanation 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 ###-###-####, extension [redacted]. My fax number is ###-###-####, and my e-mail address is [redacted]Very truly yours,

Dear Ms. [redacted],
Please see our response below to the additional concerns reported in complaint # [redacted] for [redacted] that were received by us on March 10, 2015.
In reviewing the screenshots attached to the rejection message, it was noted that they only show one payment being made and that the payment was subsequently refunded.  The reason the payment was refunded was because the electronic check that was sent did not include a case number that indicated to whose policy the payment should be applied. 
We did find that Ms. [redacted] sent additional screenshots to our Billing and Enrollment department that were not included with the rejection message.  Those screenshots showed a second payment being made and did not show any refund being received. Our Premium Accounting department reviewed those screenshots and determined that they need the complete electronic check information in order to attempt to locate that payment.  Ms. [redacted] may be able to request that information from her bank and can send it in to the Billing and Enrollment department as she did with the previous screenshots. 
At this time, while Ms. [redacted] may have attempted to make payments for her coverage, no payments have been posted to he policy in Coventry’s system for her coverage for February or March.  In order for her policy to remain active, those payments still need to be submitted.  As stated in our initial response, Ms. [redacted] is in the second month of the grace period that is allowed for people who qualify for an Advance Premium Tax Credit.  Any claims received by Coventry for services performed or medications received in March will be denied until the policy is brought back current. 
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 you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Sincerely,
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:
I feel that the Coventry
One company did not provide me any kind of service and they just
stole $651.20 from me. I tried to obey the federal law and tried to avoid the
fee that will be imposed by government to uninsured people. Otherwise, I would
never have a deal with such dishonest company like Coventry One which dares to deceive
and rob the poorest people.
Coventry One is a monopoly health insurance company in Iowa that represent Federal
Healthmarket  and you have no choice just
deal with them if you buy a Health Insurance via Government Market Place.
According the Law and Affordable Care Act it is mandatory for anyone living in
the US to have a medical insurance and I applied for the insurance for my wife
and myself via www.healthcare.gov in March 2014. At that time my income was
unstable and it was near $1800. The healthcare.gov officer assured me I have to
pay just initial payment $325.60 and the next premiums will be paid by
Government till my financial situation would be improved. Also I was assured
that my wife and I will be covered till the end of the year 2014. I believed
them and applied for the Bronze plan as they advised. Again, at that period of
time we rented an apartment which cost us $1025/month and it would be a suicide
action for me to have in addition such unbearable burden like $325.60/month of
premium for the med. insurance. First couple months my account was not charged
by Coventry and everything worked as I was promised. Unexpectedly, in June 30,
without my authorization Coventry One charged my account for $325.60 which was
also against the federal low that states that premiums cannot exceed the up to
9% of total household income. I found the way to delete my bank account
information from Coventry One. I submitted several complains to Coventry and
Helthmarket about the situation. For me it is unclear why the rules were changed
and why Coventry One started to charge me $325.60 each month. Anyway, the
Healthmarket representatives suggested me to continue have deal with Coventry
One and take a tax credit of $264.00 as a financial support from the Government.
Therefore, our monthly premiums should be $61.60 per month, which was fair and
reasonable for Bronze plan. 
Unfortunately, Coventry
One demanded to pay $387.20 which I cannot give them since it was not
affordable for me. Therefore, I sent them $61.60 for Septmeber 2014 and via
phone conversation to Coventry One representative I requested to cancel service
for the August. By the way, I don't understand how could Coventry one charge
people in full if it is against the law? Why the Coventry One agreed to become
a Government Healthmarket provider and not follow the Affordable Care act
rules?
I think that Coventry
One just takes money and do nothing for people. They tell you that you are
insured, but we have to pay $12000 for med. service ourselves during a year (in addition to monthly
premiums $325.60), before the Coventry One will start to provide their real insurance
service. If you call them or send them letters they just redirect you to
healthmarket. In my opinion the Coventry One company just uses the "great opportunity" to rob poor
people and grab easy money almost for nothing. 
I don’t believe them anymore and just want my money
back.
Respectfully yours,
[redacted]

Dear [redacted],
Please see our response below to the additional concerns reported in complaint #[redacted] for [redacted] that were received by us on January 16, 2015.
It may be possible for [redacted] to receive reimbursement for expenses that she paid for out of pocket.  Unfortunately, the Executive Resolution Team is not able to send reimbursements directly.  In order to review to determine what Coventry would have initially been responsible for, a claim must be filed.  If the provider of services is not in network with the plan, she may file it herself as a request for member reimbursement.  In order to properly process the claim, we will need the provider’s Tax Identification Number, the procedure codes for any services that were rendered, and the diagnosis codes that indicate what condition was being diagnosed or treated.  Most providers are willing to send statements reflecting this information even after an account has been sent to collections.
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].
Sincerely,
Chris B[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.
Upon receipt of the complaint we immediately reached out to Coventry to request a payment history and to review to see if [redacted] was due a refund. Based on our review; [redacted] is not due a refund of $123.99. We did confirm that on three separate occasions [redacted]'s payments were returned for the months of June, July and December 2014. We also show that [redacted] did contact Coventry Customer Service and Billing departments on numerous occasions starting in January 2015 and was advised that she was currently paid through November 30, 2014. She was also advised during these phone conversations that the premiums for December 2014 and January 2015 must be paid by January 2015 or her policy would terminate. The representative further advised [redacted] that we show that the payment for December 2014 was made from a savings account and therefore was returned as EFT to the member's account on December 24, 2014.
On January 27, 2015, a customer service representative followed back up with [redacted] per her request and she was advised that again the December 2014 payment had been returned to her and that the premium payment s for December 2014 and January and February 2015 in the amount of $451.67 must be paid to keep her policy active. This was also reiterating to [redacted] again on February 03, 2015, February 06, 2015, and February 17, 2015. We further show that in December 2014 and January 2015 we sent letters to [redacted] stating the amount due amount was $451.67 or her coverage would terminate.
On March 11, 2015 the policy was retro-terminated to December 31, 2014 since the total amount of $451.67 was not paid in full by the end of the grace period (February 28, 2015). We applied $123.99 of the payment received February 10, 2015 toward her past due premium amount for December 2014. The member was refunded the amount of $203.69 which was the remainder of the funds.
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].com.
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 January 7, 2015.
The policy in question showed [redacted] as the policyholder.  We reached out to [redacted] to request authorization to respond to [redacted].  This request was granted. 
Our research determined that [redacted] had contacted Coventry on January 2, 2014 to request termination of his policy.  Unfortunately, that did not allow Coventry enough time to prevent the premium draft from occurring on January 5, 2014.  We withdrew $399.78 at that time.  A refund was issued by Coventry for that amount on January 13, 2015.  Depending on the processing time his bank requires to post the refund to his account, the amount should be reflected on his balance within 1-5 business days from that date. 
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

[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.  The deposit posted to my account today (2/11/15).  Thank you for your assistance in getting this matter settled.
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 original form to remove my daughter from the policy was sent to Coventry on 8/7/2014. After following up several times via telephone, I got in touch with Tanisha G[redacted], a supervisor at Coventry, who asked me to send proof that the form was sent and proof of my daughter's new insurance.  I sent this information to her and she confirmed receipt of the same. She promised that the form would be processed immediately so that I could make payment for the adjusted amount for my premium without my daughter. My premium should be for $265.37 and I am missing to pay for August and September. See attached emails to and from Tanisha G[redacted], Coventry change form to remove my daughter from the policy as well as proof of my daughter's new insurance. As I stated in the attached email to Ms. G[redacted], I am not refusing to pay; however, I am not going to pay the incorrect amount just because Coventry did not process the original request efficiently and timely. Please advise.
Regards,
[redacted]

May 21, 2014Dear [redacted]:The Member is participating in the Coventry Health and Life Insurance Company (“CHL”) HealthAmerica One individual PPO Exchange health benefit plan.[redacted], (the “member”) has filed a complaint. The Member’s complaint concerns termination of...

coverage effective date. The member is requesting reimbursement of premium payment in the amount of $588.69.Below is a timeline of events leading up to the resolution of the member’s complaint.February 20, 2013 – Member contacted Billing & Enrollment because her daughter had a doctor’s appointment and she didn’t have a card yet. She was advised that she can print a temporary card off of the member portal.February 25, 2013 – Member contacted Billing & Enrollment because she wanted to know when the member would be billed. She was advised that she will be billed the 5th of every month.March 1, 2013 – Member contacted Billing & Enrollment called to ask why the next draft will be April 5, 2013 and not in March. She was advised that it was too close to the new bill, and she is going to be drafted for two months.February 18, 2014 – Member contacted Billing & Enrollment because she wanted to terminate her coverage. She was advised that her policy would terminate for February 28, 2014, and once the plan receives proof of other coverage the plan will be able to retro-terminate the member’s policy and issue a refund for February.February 27, 2014 – Member contacted Billing & Enrollment because she wanted to terminate her coverage. She was advised that her policy was terminated effective February 28, 2014 and we could not issue a refund until the plan receives proof of other coverage.April 21, 2014 – Member contacted Billing & Enrollment to check to status of her refund.May 7, 2014 – Member contacted Billing & Enrollment and spoke to a supervisor. The member called requesting a refund for the month of January. The member was advised that we need proof of coverage with the new policy’s effective date. The member was also advised that we can only retro-terminate a policy back to 60 days.ROOT CAUSE:The member requested to terminate the coverage effective January 31, 2014. There is no refund due.RESOLUTION:The member’s policy has been terminated effective January 31, 2014. There is no refund due because the member placed a stop payment for February’s draft, making the member paid through January 31, 2014.If you have any questions or concerns regarding this matter I can be reached at ###-###-####.Sincerely,

I am rejecting this because the problem has not been resolved. I did not receive ID Cards/policy from Coventry Health Care in a timely manner and no longer need their services. I applied for coverage in November 2013 and requested coverage beginning on Dec. 1, 2013. I received a email from them on Dec. 9, 2013 stating that I had been accepted. I made several phone calls to Coventry Health Care and was told something different each time. Then on Jan. 28, 2014 I contacted the Revdex.com of NC and also the NC Department of Insurance. I am now covered with another insurance company and would like a full refund of $869.62. Tried to contact the person on this email letter on 02/05/14 and this is a call center. Requested her phone number ([redacted])and left a message. I have had no response from her. Also called back the NC Department of Insurance on 02/05/14 and I was told there was no mention of a refund. In a letter he received it said that a policy had been issued. I have not received anything from Coventry at this time nor do I want to. The money I am requesting to be refunded was for the Dec. 2013 & January 2014 premiums. Checks were mailed to Coventry Health Care P.O. Box [redacted] on 1/3/14 and cleared our bank on 1/8/14.
[redacted]. [redacted]
[redacted] ###-###-####
E-mail: [redacted]
02/06/14
Complaint ID [redacted]

mso-bidi-font-family: "Times New Roman";">Dear
[redacted],
Please see our response to complaint
#[redacted] for [redacted] that was received by us on January 20, 2016.
In reviewing [redacted]’s policy, we
found that an issue with our systems had caused the policy to be terminated as
never in force back on December 31, 2015. 
While correcting that issue, her spouse was inadvertently left off of
the reactivated policy.  He has been
added back to the policy effective January 1, 2016.  The process of adding him to the policy and
assigning an ID number was completed on January 22, 2016. 
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].com.
Regards,
Chris B[redacted]
Complaints and Appeals Consultant
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:I understand how pre authorization works and the entire process.   In this case my company had switch insurance carriers from [redacted] to coventry.   I, as well as my wife, had already gone thru the entire per authorization process with the previous insurance company and have been on the medications for years prior to coventry.
Coventry apparently does not want to take that into consideration as it is related to this issue.   In fact, the doctors had numerous calls with coventry and coventry insists on a hard line stance.   The point being the medications that are being referred to in this complaint, [redacted] and [redacted], are ones that both my wife and I have been on for years.   In my case, as a long term diabetic, I have tried all the appropriate pills prior to [redacted] and upon my doctor(s) recommendation have moved to [redacted]--with prior authorization from previous insurance companies.
My wife takes [redacted], prescribed by a leading eye physician, who performed eye surgery on her as well as other doctors recommendations.  She has been taking [redacted], that was pre authorized by prior insurance company's.   
Coventry has not, and will not take that into consideration, in its evaluation of allowing the prescriptions.   Instead coventry insists they know best and want my wife to go backwards in our treatments, versus continuing with treatments that are currently working.    Yes, in my case [redacted] was approved--however it was approved after many heated discussions with their staff--who are not doctors by the way--
In my wife's case they insist on not approving her medication.    Unfortunately my wife is at high risk of losing her sight and coventry, who are not trained in the type of problems my wife has, or will not consult with her doctor believe they know best.   
What has been written in their letter is verbiage from their handbook--which I have and understand completely.   Unfortunately their concern is all about cost, not patient care.    If my wife has an issue as a result of not being able to take the appropriate medication I wonder how much money it will cost them for a lawsuit that I am not afraid to pursue.
Please advise as I am more than willing to discuss with coventry--an appropriate representative I may add--thos issue
Regards,
[redacted]