Coventry Health Care, Inc.

Review: I believe that my health insurance company (HealthAmericaOne) is not following fair business practices. My wife was recently employed by [redacted] and was able to go under their insurance. As a result, I called HealthAmerica and cancelled our policy. I was told on the phone that the policy would be cancelled and that no other charges would be made. Subsequently, I found out they did charge me another month (~$500) and when calling their customer service was told that the records indicated that I was informed that my wife needed to cancel the policy and that we were sent information. Neither of these statements are true. They claim to have listened to a recording of the call that indicates they did tell me that my wife needed to call and we should receive correspondence to that effect. I have no recollection that that was said. As a result they will not return the money. In addition, they refuse to let us listen to the call. This is the second time this has happened. When my son started his first job, I cancelled the insurance and they charged me anyway. It took about a month to get the money returned. My wife suggested that I write to you and indicate that scrutiny should be given to HealthAmerican in doing business in Western PA. Do you have advice on how to fight this?Desired Settlement: I believe HealthAmerica should credit the monies that they have taken from my checking account.

Business

Response:

Attached please find Coventry Health Care's response to Complaint #[redacted].

Thank you,

August 26, 2013

Dear **. [redacted]:

The Member is participating in the Coventry Health and Life Insurance Company (“CHL”) HealthAmerica One individual PPO health benefit plan.

The Member’s complaint concerns when the request of cancellation of Policy was made by the Member and the request for refund for 1 month premium payment in the amount of $486.00.

Upon review, On July 10, 2013, **. [redacted] called into HealthAmerica One to terminate the policy. The representative informed the Member that the policy can only be terminated if the Primary, ([redacted]) requests it either by phone or by writing. **. [redacted] was also informed that the request to terminate must be in the system atleast 10 days prior to the draft to avoid that month’s draft. The Representative advised that terminations are for the last day of the month. The termination form was emailed to the member at [redacted].

On, August 12, 2013, **. [redacted] called in to advise he requested termination last month but he was still drafted for August premium. The Representative advised that based on the notes, he was sent the termination form for his spouse, the primary, to fill out and submit. Member said the term form was not sent. Representative offered to have supervisor pull the call to confirm the notes from the previous rep.

On August 14, 2013, a representative from the Plan called the Primary member, ([redacted]) back to advise that the phone call was pulled and that her husband was informed that he could not terminate the policy as he was not the primary. [redacted]. [redacted] stated she wanted to hear the call herself. The representative advised that the call is in our systems and she could not open it for the member to hear. Member requested a supervisor to pull the call again and put the phone by the speakers. Representative advised that the policy can be terminated for August 31, 2013. Member wanted it retro terminated to July 31, 2013 and receive a refund for August payment. Representative advised she would send for the supervisor to call her back regarding the retro termination.

On August 15, 2013, Supervisor [redacted], called and left a voicemail for the member. He advised that we cannot playback the call for her but that he did listen to the call and her husband was advised that only the primary member can request a termination. He also advised that the representative and her husband also discussed when the primary should call in to complete the termination. The supervisor also advised that since the member wanted to backdate and refused an August 31, 2013 term date,that the policy was still active at the moment and in order to avoid another draft, she should call in to terminate for August 31, 2013.

On August 19, 2013, [redacted], (Primary Member), called in to terminate her policy. She was advised that we term at the end of each month. Member advised that the policy was supposed to be terminated last month and she wanted it terminated immediately. Member was advised the policy will be terminated and processed the termination for August 31, 2013 at the time of the call.

Please be advised that during the investigation of **. [redacted]’ s complaint, I reviewed the call in question and can confirm that the Member was informed that the Primary Member had to request termination of policy either in writing or by telephone. Further, It is determined that the policy is terminated as of August 31, 2013 as no mis- information has been given to the member by the Plan. I have attached a detailed timeline of events and any documentation pertaining to this complaint.

If you have any questions or concerns regarding this matter I can be reached at ###-###-####.

Sincerely,

Review: This company automatically deducts my monthly insurance premium from my checking account on the first of every month. On September 1, 2014, they deducted TWICE the amount of my premium with no warning or reason. I called customer service on September 2, 2014 (9/1 was a holiday) and spoke with a lady that apologized for the error and assured me that the extra money taken out would be deposited back into my account within 48 hours. She did not offer up a reason as to why they took out too much money. When the money still did not appear in my account after 3 days, I called again. This time the lady I spoke said that she sees my request for my money to be deposited, but the request was not actually submitted AND she told me that it doesn't take 48 hours; that it takes 7-10 days. And it would be 7-10 days from that day (9/5) and not from when I first made the request. They had no right to debit my account for the extra money and they are no making effort to return my money in a timely matter.Desired Settlement: I want my money that they stole returned to my account in a timely matter.

Business

Response:

September 30, 2014To 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

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because:

This was the same time frame I was given initially and it was never followed through. I have since filed a dispute complaint with my bank regarding the amount and the bank refunded my money. This matter has been resolved, but by other means.

Regards,

My wife and I "chose" Coventry for our child during "open enrollment" because it was the only "in-network" provider accepted by our hospital. In hindsight, we would have gone out of network to avoid abnormal amounts of stress. Upon getting coverage, we submitted our routing and checking account information for automatic withdrawal. Less than a month after scheduled payment did not withdraw, our son's policy was cancelled. After going through reinstatement we checked with our bank to see if the account information was correct, and it was. We also asked if an attempt to withdrawal had been made by Coventry and US Bank had no record of any such attempt. After reinstatement, the exact same thing happened a 2nd time. This time we had to back pay for three months of coverage our son apparently did not have. This time our eyes were very watchful to make sure the money was withdrawn. I called July 1st when no withdraw occurred. They informed me it was scheduled for July 6th. When no withdrawal occurred July 6th I called again. They said to give it 48-72 hours. I called again on July 8th and was assured that payment was showing up on their end. It was not showing on our end. July 16th I called again to find out payment had been rejected and notice of cancellation had been mailed. I offered to pay over the phone by debit card, but it is their company's policy not to accept debit, only checks. I had them clear and re-enter all of our information and submit a payment attempt again. I don't feel confident that it will work. A company that can't accept payment any way other than for you to mail them a check thousands of miles away. We will be switching during "open enrollment" even if we must go out of network.

Review: The company has this as case #[redacted]. This health insurance company accidentally signed me up for 2 policies and charged me twice. Instead of refunding one of the insurance premiu** when the cancelled teh second accidental policy they said they would apply it to a future premium payment. They never did so and cancelled my policy 7 weeks ago without notifying me and continued to take my premium payments every month despite cancelling my policy. I found out last week when I tried to refill a medication. When I contacted the company they easily found their mistake, apologized, and said they would resolve the situation. They never fixed the problem and [redacted] was very rude today to get an update on the situation.Desired Settlement: DesiredSettlementID: Other (requires explanation)

Please reinstate my policy retroactice to the date I started as I have paid every bill on time. I would like a statement from Coventry explaining the company's mistake making it clear that I paid every bill on time and that the company failed to apply it to my insurance premium bill correctly. This statement should include that my policy should have never been cancelled.

Business

Response:

July 17, 2014Dear **. [redacted]:This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to **. [redacted] regarding issues with payment and cancellation of two policies. The request was received by CHC Carolinas from this Revdex.com on June 26, 2014.**. [redacted] claims that Coventry accidentally signed her up for two policies by mistake. In fact, **. [redacted] enrolled in a privately off-exchange policy with CHC Carolinas which was in effect from January 1 - 31, 2014 and then terminated. The payment for this policy was automatically debited from **. [redacted]’s bank account on February 11 for the policy in effect in January.In January **. [redacted] enrolled through the Federally Funded Marketplace exchange in a policy with an effective date of February 1, 2014. **. [redacted] made her initial binder payment on January 16, 2014 for February; she made a credit card payment on February 14 for March; she made a short payment on April 14 for April. On-exchange policies require 100% premium payment by the due date which she did not do and for that reason, **. [redacted]’s policy was cancelled. There were no double payments made. The last short payment **. [redacted] made which caused the cancellation of her policy has been refunded to her.CHC Carolinas has explained in great detail all of the above information in a series of letters with the North Carolina Department of Insurance which we will not repeat here for privacy reasons.I trust that I have addressed this matter sufficiently. However, please contact me if you have any further questions involving this issue. I can be reached at ###-###-####, extension [redacted], Monday through Friday from 8:00 a.m. until 5:00 p.m.Sincerely,

Review: Un able to cancel this insurance over the past 6 months and they have continued to bill my account. I have provided them proof of my new insurance.

I purchased this company's insurance in October of 2013. I was waiting for my new employer's health insurance to begin. The new insurance began on November 1, 2013. I called and asked Coventry to cancel my insurance. This is because I was covered by my new employer's health insurance. Conventry refused. They wanted proof of new insurance faxed. They continued to bill my account to this day(5/16/2014). I am about to put a stop payment order at my bank. This company should not make it so difficult to cancel.Desired Settlement: I would like my past billed amounts refunded. I have no longer relied on Conventry since my new insurance from my employer began on 11/1/2013. I now rely on [redacted] and have send them proof of insurance. They are covering no risk. Why are they billing me still?

Business

Response:

May 22, 2014Dear [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 plan coverage retro termination effective date and refund of premium payments withdrawn by the Plan. The member is requesting a plan coverage retro termination effective date of November 1, 2013 and premium payment refunds for all months since November of 2013.Upon review, as per business rules and the member contract, term requests must be submitted prior to the requested term date. When proof of coverage is received, CHL can retro term back 60 days from receipt of the proof of coverage. This policy has been terminated per business rules for February 28, 2014. A refund has been requested for March through May of 2014 premium payments. The refund will be processed within 3-5 business days and, once processed, will appear back in the member’s account within 1- 5 business days. The total amount of the refund is $169.98.To go any further back with the termination, outside of the established business rules, would require CFO (Chief Financial Officer for the Plan) approval or member validation of prior submission.The Subscriber may terminate Coverage for himself/herself and any enrolled Dependents under the Group Contract for any reason immediately (same day) upon thirty (30) days prior written notice (including facsimile or e-mail) to CHL after the first 30 days of Your Contract. Such terminations will be effective at 11:59 p.m. on the termination date provided by the Subscriber in the notice to CHL. Retroactive termination will be permitted up to a sixty (60) day time frame provided proof in writing is supplied that other insurance was in effect during that time frame.All business rules were followed for this member. CHL received the proof of coverage May 20, 2014 (copy attached). If the member has proof that notice was submitted earlier, he must provide that proof in order for a different determination to be considered.If you have any questions or concerns regarding this matter I can be reached at ###-###-####.Sincerely,

Review: I signed up for health insurance with the marketplace though [redacted] hospital in [redacted] IA. and was given Coventry One which is Coventry health care. I had to call 3 different phone numbers in order to find out where to send my payment. After talking to someone in [redacted], Fl. at Coventry health care and was informed I had to send my payment to Coventry one [redacted], Fl. [redacted]. I purchased a [redacted] money order on 3/31/2014 and mailed it that same day. After hearing not hearing back from them. I started calling them on (4/18/2014) and have gotten nothing but the run around. Claiming that my payment didn't get there in time but yet they cashed my money order. I've talked to over 8 different people at Coventry Health care over two different days and some at first said I had health Insurance, but then when I asked if they were going to mail me my information they stated I didn't have insurance due to the payment not getting there in time. We all know it doesn't take more then 4- 5 days for may to get to Florida from Iowa. To take my money and them claim it didn't there in time is called Fraud. I paid for my insurance and they should honor my payment and stop lying to me and other people who are having to go through this same ordeal I'm having to go through. I'm also writing my state Senators Tom Harkin and Chuck Grassley about this ordeal.

Product_Or_Service: health insurance

Account_Number: App ID [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I want Coventry heath care ( Coventry One )insurance to reinstated my insurance back to when it was suppose to start 94/7/2014 and a formal apology and all the paperwork I'm suppose to have proving I have insurance sent to me stating it started April 7th 2014.

Business

Response:

April 29, 2014Dear [redacted]:Your letter of April 25, 2014 to Coventry Health Care of Nebraska, Inc. (Coventry) was received in our office, and referred to my attention for review and response. [redacted] is covered under Coventry effective April 1, 2014.On April 28, 2014, Coventry confirmed [redacted]’s $21.46 initial binder payment was received. [redacted]’s policy effective date is April 1, 2014. Her next premium payment of $21.46 is due on May 1, 2014. An extension has been granted for [redacted] to mail in her May premium payment. Additionally, she may make a payment over the phone by calling ###-###-####.On April 28, 2014 and April 29, 2014, Coventry contacted [redacted] and advised of the circumstances surrounding her policy issuance. [redacted] was provided with my direct contact information in case she experienced any additional issues in the process. [redacted] was provided with her policy identification number and how to obtain member materials online prior to receipt via mail. Coventry apologized for the inconvenience this has caused [redacted].If I may be of any further assistance, please feel free to contact me at ###-###-#### or toll-free at ###-###-####, ext. [redacted].Sincerely,

Review: On November 5th I filled my prescription at an out-of-network pharmacy, because, 5 in network pharmacies refused to help me, returned my prescription to me, and refused to order the medication I required, dye-free. I have a severe allergy to red dye and required the dye-free version of my medication. [redacted], on [redacted], in [redacted], PA, was the only pharmacy that would take the time needed to look into and order the correct medication for me. When I phoned [redacted] pharmacy customer service at ###-###-####, and asked if they would please fill my medication and charge me the $19 in-network pharmacy co-pay, rather than $33 for out-of-network, they hung up on me, twice. The third call they recorded my complaint. I received a call from someone a week later stating they were from [redacted]. When I answered the phone, they told me I had the wrong department and asked me to hold. I held for 50 minutes, the phone then cut out. When I called back I was passed around between departments and found myself holding the line for another 25 minutes.Desired Settlement: I want a phone call from someone that will assist me in my dispute of the $33 copay amount and charge me going forward the in-network pharmacy copay of $19 since I cannot find an in-network pharmacy that will assist me.

Business

Response:

11/21/2014Dear [redacted]:This letter is in response to your grievance (complaint) that you filed with us on 11/19/2014.Based upon our review, we received your written grievance expressing your dissatisfaction with the customer service you received. Please accept our apologies about the service you received. Coventry expects that our members are given accurate information in a professional, friendly and timely manner. Please be assured that feedback and coaching have been provided and leadership has been made aware of this incident.On 11/03/2014 you paid $33 for [redacted] 10mg because the preferred pharmacies in your area did not have your medication in stock. You may go to any of our network pharmacies. However, your cost may be less for your covered drugs if you use a preferred network pharmacy. When requesting an adjustment you can send us your request for payment along with your bill and documentation of any payment you have made. It is a good idea to make a copy of your bill and receipts for your records. To make sure you are giving us all the information we need to make a decision, you can fill out our claim form.We are including a claim form with this letter. You do not have to use the form, but it will help us process the information faster. Keep in mind that you must submit your claim to us within 36 months of the date you received the service, item, or drug.We apologize for any inconvenience that you have experienced. Please be assured that this was filed as a grievance and all grievances are reviewed by upper management for future plan process improvements.If you have any questions, please feel free to contact Customer Service at ###-###-####, 24 hours a day, seven (7) days a week. You can request language translation services when you call. TTY/TDD users please call 711 Telecommunications Relay Services.Once again, we apologize for any inconvenience.Sincerely, Advantra Silver (HMO)

Review: Failure to issue refund after cancellation of policy.

After I signed up for a new insurance policy with Coventry through the affordable care act I cancelled my original Coventry policy. Coventry continued to bill me for the original policy for 2 months after it was cancelled. I called Coventry and 4 times since July they have told me that the refund has been approved and that I would receive a refund of $528.12 within 10-14 days but I have never received it. They tell me that they are waiting for accounting to mail the check and that they do not have a way to contact them directly.Desired Settlement: I just want the refund of $528.12 that was promised.

Business

Response:

Dear

Review: I have carried Coventry Health Care of Iowa insurance since January 1 2014. On May 22, 2014 I called the Marketplace to update my account as my husband was no longer working. The agent confirmed that I would be eligible for a new premium starting July 1 for $100.67. I was previously paying $439.23 a month for coverage of my husband and myself.I was surprised when my premium came out July 1 for $439.23 again. I called Coventry 07/01/2014 and spoke with a rep. who connected and confirmed with the Marketplace that the change should have gone into effect 07/01 for the 100.67. She stated she would expedite a request for a refund and I should see $338 credited back to my account in 3-5 business days. Skip ahead to 07/08/2014- no credit at this point- I called again as no credit to my account, and the agent stated would actually take 10 business days. Now it is 07/17/2014 (12 business days) and spoke with supervisor Matthew who stated the request for a credit was not initiated, and is now submitted it so another 3-5 business days I can see a credit on my account for $338.70.

Account_Number: [redacted]Desired Settlement: Would like my refund of $338.70, as I was not expecting such a high amount to be deducted I have now incurred 2 over-draft charges from other checks that were out - those charges were each $35.00. Would like the credit to my account from the overage and a courtesy of $70.00 as this process has hurt my standing with my bank account and each call placed was well over 20 minutes spent explaining my situation. Thank you.[redacted]

Business

Response:

October 6, 2014Dear [redacted]:Your letter of September 24, 2014 to Coventry Health Care of Iowa, Inc. (Coventry) was received in our office, and referred to my attention for review and response. [redacted] is on a CoventryOne Individual Silver $10 Copay Point of Service (POS) UnityPoint Health-[redacted] policy, with a January 1, 2014 effective date. [redacted] enrolled for coverage through the Health Insurance Exchange (Marketplace).In her complaint to the Revdex.com, [redacted] advised that the incorrect monthly premium amount was withdrawn from her bank account on July 1, 2014. [redacted] requested a refund of $408.70; $338.70 for the amount over her monthly premium payment and $70.00 for the bank overdraft fees she incurred because of the error.On December 14, 2014, [redacted] applied for health coverage through the Marketplace for an effective date of January 1, 2014. The monthly premium payment for the policy was $439.23. On May 22, 2014, Coventry received an updated enrollment file for [redacted] from the Marketplace reporting a decrease in premium payment to $100.53 effective July 1, 2014. However, [redacted]’ bank account was drafted the premium of $439.23 for July 2014 because the enrollment update was not processed in Coventry’s system until July 11, 2014. This caused a credit in the amount of $338.70 on [redacted]’ account.[redacted]’ premium payment for August 2014 was due on July 31, 2014 in the amount of $100.53. This amount was satisfied by the credit balance of $338.70 on [redacted]’ account. On August 7, 2014, Coventry issued a refund to [redacted] in the amount of $238.17 for the remaining credit via Electronic Funds Transfer (EFT). [redacted]’ policy is current and paid through October 31, 2014.[redacted]’ request for a refund in the amount of $70.00 for the overdraft fees she incurred is currently under review. Coventry will contact [redacted] with the determination concerning an additional refund within 5-7 business days.If I may be of any further assistance, please feel free to contact me at ###-###-#### or toll-free at ###-###-####, ext. [redacted].Sincerely,Shawn MComplaint and Appeal Analyst

Business

Response:

October 7, 2014Dear [redacted];This letter is a follow up to the letter filed with your office on October 6, 2014 regarding the above-referenced member, [redacted] had requested a refund in the amount of $70.00 for the overdraft fees she incurred. In order to refund the money, we will need proof from [redacted] that she was assessed overdraft fees. The bank statement can be faxed to Member Services at ###-###-#### with Case #[redacted] notated on it. Once that has been received and approved, we will be able to issue a refund.If I may be of any further assistance, please feel free to contact me at [redacted] or toll-free at [redacted], ext, [redacted].Sincerely,Shawn MComplaint and Appeal Analyst

Review: On February 14, 2014, CoventryOne, after I filed a rate appeal, approved coverage for me effective 12/15/13 (my anniversity date) at a monthly rate of $316.14. Prior to receiving my retroactive approval, I paid $526.90 and $594.89. These monies (as well as each months premium) are being directly withdrawn from my checking account. It has been agreed that I am due a billing credit in the amount of $489.51 which was to be directly deposited to my checking account. I have called on 3/10/14, 4/15/14, 5/7/14 and 5/27/14, each time speaking to a different representative of the billing department. Besides being on hold for way too long (45 minutes on 5/27), I have been told that a supervisor will be calling me back and have been given a confirmation number as to such. Absolutely no follow up. I have repeatedly asked for a direct number as to someone who would be accountable and can provide me with detail if there is, in fact a discrepancy. I have backup to all. It probably would be easier to just drop this matter, however, as a matter of principal, I feel that I am being extremely mistreated. And I am quite sure that I am not the only one. I am also a CPA by trade and am of the habit as to keeping comprehensive notes and records.Desired Settlement: Direct deposit of any monies due me. If I am not accurate as to my figure, an accounting as to how my monies have been applied. Would like the ability to have direct access to someone in charge as compared to repeatedly stating my specifics and not getting a professional response.

Business

Response:

June 23, 2014Dear [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,

Review: Business drafting excess amount from checking account.

Business was authorized to draft monthly premium from my account. Has been fine for over a year. This month they drafted more than 250% my normal premium. Have tried to call multiple times. Can not speak to individual. Get put in hold que with nobody ever answering.Desired Settlement: Want refund and no future access to my account. Will pay future bills by mail as they have proven the**elves incompetent.

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

Conventry has yet to initiate any contact with me. I have since contacted them again and they did not file some paperwork correctly and promised the money would be refunded in 2-3 business days. I have yet to see any action from them. I also called the number on the letter and eventually spoke with someone that said that was not the correct number. They routed me to [redacted] voice mail. Please send me a "signed authorization form" that they claim they do not have. I am about a week away from contacting a lawyer to file suit against them. I recorded the phone calls I have made with them. They admitted they messed this up. I am fed up with their stupidity.

Review: I have had a insurance policy with Coventry One for me and my daughter since year 2008. My payment has been drafted from my bank account since this time. I cancelled my policy with Coventry One in October when my current job offered me insurance coverage. Since October Coventry One has taken the full amount out of my bank account since October. I have emailed, mailed, had my daughter call and my broker call to get the draft stopped and they are still taking monies from my account. I have called anywhere from one to three times a day trying to get this handled and each call after waiting for 30 to 60 minutes each time the customer service person has hung the phone up. At this point my only option is to close my bank account and this would cause distress due to drafts coming out of my account and direct deposit for payroll. I feel this company has stolen 3 months of premiu** and no one will take my call and take accountability for the charges on my account. I would NEVER do business with Coventry One or [redacted] Insurance again and would not recommed using this company.

Product_Or_Service: Year 2008

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Refund

I would like my money refunded to me for the months of October, November and December.

Business

Response:

January 24, 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 the termination date of his individual CoventryOne policy and **. [redacted]. [redacted]’s termination of her individual CoventryOne. The request was received by CHC Carolinas on January 14, 2014.

CHC Carolinas responded on January 6, 2014 to **. [redacted]’s complaint received on December 30, 2013 for this same issue. CHC Carolinas requested additional information from **. [redacted] in order to resolve his complaint. **. [redacted] has not responded to date with the requested additional information needed to complete the review of his complaint.

Lastly, CHC Carolinas does not have a signed authorization release form from **. [redacted] or **. [redacted]. [redacted] indicating that the Revdex.com is representing them in this matter.

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,

Review: Have attempted to correct billing issue since October 2012

Coventry completd a billing proces conversion in October 2012. Since then they have been crediting monthly premium payments for my husbands account into my account. We have attempted no less than 5 times to have this issue corrected on their end and each time we speak to a customer service representative we are assured the issue has been resolved. The we receive billing statements that are still incorrect. I asked to speak to a supervisor on March 29, 2013 and was told it would take 24-48 hours for a supervisor to call me back. Today is April 11, 2013 and I still have not heard back. I called the customer service again today, they still do not have the accounts corrected. I requested again to speak with a supervisor and was told I would get a call back in 24-48 hours. I also requested to make an appointment to come in and sit with a representative to show physical proof of my payment history and was told that it is not possible.Desired Settlement: I want Coventry to correct our accounts and correct their procedure for speaking with a supervisor.

Business

Response:

Good afternoon,

We are in reciept the complaint [redacted]; however, we do not have record of an existing policy for the complainant, [redacted]. In reading her statement, she talks about Coventry . Is it possible that she is speaking of Conventry [redacted]? Please advise.

Thank you.

Review: Unauthorized debit from my checking account on a policy that was cancelled.

My son and I had a health insurance policy with Coventryone, identification #'s [redacted]01/[redacted], and I was sent a letter stating that I need to either cancel my existing policy by September 1, 2014 or keep the policy and my premium would increase from $205.00 to $411.39. I was told that my current policy did not meet the new standards because of the health insurance changes. In july 2014, I called and to try and cancel my policy because I was in the market to find a new one. I was told then to call back in August so my policy would not lap and my effective date would be Sept. 1, 2014. Per these conversations, I called back in August and cancelled my policy with Coventryone and proceeded to the market place, as Coventry calls it, to purchase a new policy. I completed the process, picked my new health insurance, and paid the premium by the end of August 2014. During the month of August, I had conversations with 2 people at Coventryone to verify the above policy was cancelled because it was set up automatic payments from my checking account each month and I did not want to be charged the $411.39. I was assured by both employees that the above policy was cancelled. Well on Sept 5, 2014 I noticed a return fee on my checking account for $36.00. I called my bank and I was informed that Coventry tried to debit the premium in the amount of $411.39. Luckily I did not have that much in the account so they did not get the money. I called Coventryone back on Sept. 5, 2014 to make them aware of the situation and that the above mentioned policy was suppose to be cancelled and that I was assured by their employees it wsa cancelled. I spoke to a lady named Mercedes and she told me that she would send a request for the refund in the amount of $36.00 to accounting and I should see the refund within 7-10 business days and she gave me a confirmation #[redacted]. Well it's now Sept 24, 2014 and I still have not received that refund. Speaking with Mercedes I was again assured that the above policy was cancelled, well on Sept 17, 2014, the company debited my account again and was able to get the premium amount $411.39. I called back to Coventryone I was told that they would refund the premium amount but that it would take 3-5 business days and that a supervisor would call me within 24-48hrs. Well again it's Sept 24, 14 and no refund. I had to call back in the 48 hours because no supervisor had called me and I tried to explain to her (Linda the supervisor)that their mistake has caused me not to pay other bills that have been due during this time. We are a one income household and we do not have the money to just throw away like this. All she could tell me was the same thing I have already heard, that the refund for the premium is being processed. I hung up on her because I did not want to hear this, this was not helping me pay my other bills or get my money back in my account because of their error. I understand that there is a process to do things but I have also worked in enough customer service places to know that a phone call could have been made back on Sept 5 and again on the 17 to get my refunds. I did voice this to the supervisor before I hung up on her. I have a letter that was sent to my by Coventryone showing that my above policies were infact cancelled on August 31, 2014.Desired Settlement: I am seeking a refund in the amounts of $36.00 for the return fee when Coventryone originally tried to debit my account on Sept 5, 2014 and a refund in the amount of $411.39 for a premium on a policy that was cancelled.

Business

Response:

October 10, 2014Dear Sir or Madam:This letter is written in response to the consumer complaint filed with the Revdex.com by [redacted] regarding a refund of her CoventryOne policy which was terminated by her on August 31, 2014.[redacted] received her refund on October 2, 2014. It was credited back to her card in the amount of $411.39. Regarding the $35 NSF, if [redacted] would submit a rolling bank statement to reflect her balance before and after the transaction that resulted in the $35 NSF, we would be happy to handle that for her.I trust that I have addressed this matter sufficiently. However, please contact me if you have any further questions involving this issue. I can be reached at ###-###-####, extension [redacted], Monday through Friday from 8:00 a.m. until 5:00 p.m.Sincerely,Melody CComplaint and Appeal Analyst

Review: Coventry One said that I would receive a refund because I had gotten a policy with a new health insurance company. Over two months later - no refund.

I received a letter (dated 1/13/14) from Coventry One stating that our policy would be terminating on 1/31/14. After receiving this letter I began looking for a new insurance policy for myself and my 3 daughters. Close to the end of Jan I received new insurance cards in the mail for Coventry One. I also received a letter stating that my insurance policy renewed but instead of $588.69 a month it would be $684.56 a month. Since the $588.69 was already very expensive I continued to check with other insurance companies. I was approved for a policy through another insurance company on 2/1/14. Knowing that my premium for Coventry One would be automatically deducted from my checking account on 2/5/14, I called Coventry One to cancel my policy. When I called the woman I spoke to told me to fax a letter asap, she told me to back date it to 1/31/14, she told me what info to include in the letter and gave me the fax number. On 2/4/14 I faxed my letter to the provided fax number. On 2/18/14 I called Coventry and the woman I spoke to said that it wasn't showing my policy as cancelled. She said that she would cancel my policy for me and gave me a confirmation number. She also told me to fax proof of my new insurance policy and that I would be reimbursed for my any premium paid during the time I was covered under my new insurance policy. I waited until 3/10/14 and called Coventry back to check the status of my refund and they said it was processing. I called on 3/19/14 to check the status of my refund. The woman I spoke with said that it was still processing, she gave me a confirmation number and said I should see the money within 5-10 business days. I called Coventry on 4/2/14 and was told that my refund was in processing. On 4/21/14 I called in and spoke with a man. He told me that all these people that I had spoken with previously were not taking the complete steps to issue my refund and that was why it was continually showing as "processing". I expressed to him my frustration with all the hoops I had to jump through and that I couldn't understand why it was taking so long. He agreed that I had waited long enough and he said he had expedited my refund and that I should see it within 3-5 business days. I called on 4/28/14 and spoke with another man. He said that he showed in the system where I had spoken to the last guy and that today was the 5th business day. He said it should be in my account by the following day (4/29/14). I didn't call back in until 5/7/14. This time the woman I spoke to tried to tell me that I had already received my refund in the amount of $684.56 on 2/10/14. I explained to her that I did not receive a refund. The amount and the date she was referring to was when Coventry tried to withdraw another payment from my bank account and my bank denied it because I had put a stop payment on the account. There was no reason for them to try to withdraw another months premium from my account because I had already cancelled my policy with them. I have a letter from Coventry telling me they tried to withdraw payment on 2/10/14 in the amount of $684.56 and that it was unsuccessful so they added on a $20 fee. After going in circles with this woman I asked to speak to a manager or supervisor. After a lengthy hold I finally got to speak with a "supervisor". She told me that they didn't have any record of where I faxed over proof of my new insurance policy and that she could no longer do anything for me because it was past the 60 period for them to give a refund. Are you freaking serious?! I told her that I had jumped through all their hoops and did everything that they had asked me to. Why wouldn't I? I have almost $600 on the line. I told her that none of the other people I had spoken with in the last 3 months had mentioned this to me and that it wDesired Settlement: I am only seeking what is owed to me. I followed all the steps that I was given to get my refund and yet I still do not have it. I was told that I would receive a refund for the period of time when I was double insured. That would be for the month of February in the amount of $588.69. If they would just pay me the money I am owed and stop wasting my time this could all be done and over with. I am seeking for payment in the amount of $588.69.

Business

Response:

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,

Review: I have my premium setup on auto-pay to come out of my account every month. My wife realized that the payment hadn't come out and we were wondering why. I called in (waited for about 40 minutes before I got through) and spoke to a representative. I told them the issue and they told me that my account had been terminated by mistake. I told them that I never asked for it to be terminated. She told me to hold on. While on hold... I noticed that the same advertisements were playing as before. I waited another 30 minutes and finally someone came to the phone. It was a different person. They didn't know anything about my issue. The first person that put me on hold basically hung up on me and someone else took the call. So this person tells me the same thing and then puts me on hold. I hear the same hold music so I hang up. I call back a third time and ask to speak to a manager. They were all "busy" so the representative told me that he was going to see what was going on and call me back. I never received a call back. I just want my insurance back.... Please help.Desired Settlement: I just want my insurance back and maybe a lower premium.

Business

Response:

May 12, 2014Dear [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 March 1, 2012 – February 28, 2014. **. [redacted] is also requesting a information regarding the termination of his policy.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,

Review: I was overcharged in January and promised a credit on my next month's premium which is auto drafted from my checking account. I was not credited on the payment that is withdrawn this month (February).Desired Settlement: I want a immediate refund of the overcharged amount plus any overdraft fees incurred until I receive their refund because I do not have the money to cover their mistake for 2 months in a row. I also want a credit on next month's bill for a day's lost wages and tips. This morning were calls 6-10 on the same issue, dealing with the same run around from billing department employees and after being disconnected on for the 4th time without a representative bothering to call me back (even though they ask for a call back number). I was too frustrated and upset by the lack of professionalism by Coventry One employees and worried about the overdraft fees I was going to incur to perform my job and was sent home for the day to get this matter resolved so that is yet another cost for me caused by their delay in crediting my account properly.

Business

Response:

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,

Review: I tried to cancel my insurance in September. I called the helpline and was told that, due to recent legislation, I had to cancel my insurance in writing and provide proof of my new insurance policy. I waited to receive my insurance card for my new policy, then sent the cancellation letter along with a photocopy sometime in early October. In November I was billed again and called to ask why my policy still hasn't been cancelled. The customer service agent I talked to in November said I could cancel my policy over the phone. If their policy is that I can cancel my policy over the phone, the agent should've done so in September. I shouldn't have been billed for October or November.Desired Settlement: I desire a refund for the charges billed to me in October and November.

Business

Response:

Dear [redacted],

Review: I contacted Coventry Healthcare toward the end of July. I was wanting information about terminating my daughters insurance policy because she became eligible for medicaid, after her father lost his job. They informed me that I could terminate the policy and get refunded as long as medicaid agree to cover her before or by August 1st. Medicaid agreed to cover her from July 1st. Coventry promised me the refund for July & August. I ask to stop the August payment since it wasn't due yet, and they told me the payment was already processing and they could not stop payment but would refund me. I sent in all the required documents for termination and refund within a few days. I contacted them again August 4th and was told the request was put in for refund, and I would have the money within 14 days. I never got the refund so I called back August 20th and was told the refund was never sent in because they did not have proof of medicaid. Which they did have, they just didn't realize what the form was suppose to look like according to a supervisor. I spoke with a supervisor name Jasmine and she promised to get the refund expedited because of the wait and the frustration. She said I would have the refund within 14 days. I called back again September 4th and was told it was put in for refund, but was canceled for an unknown reason. Then again, I was told they would put in the refund, it would be approved within 48 hours and I would have my money within 7 days. That did not happen. I called back Thursday Sept 18th and was told it was approved, processed and would be in my account by Friday or Monday Sept 22nd. It has now been 13 business days and I called back today and was told it has not been processed and they do not know why, therefore it will not be in my account anytime soon. They told me they could not contact the accounting company that deals with refunds so they could not help me. I was hung up on the first time I called by a man who seem very frustrated with dealing with my situation. I talk to a lady who put me on hold for a supervisor. The supervisor was busy, so she told me she would call right back. She never called so I called back 5 hours later and was told it could take 48 hours for a call back and that I needed to wait. I told her I was highly upset with the service and wanted to speak to a supervisor now. She put me on hold a few minutes, came back and told me her supervisor approved the refund. I will have it in my bank account within 3-5 business days. I have been told this before, and nothing has happened. I have waited since the beginning of August. Every time I call and ask about the refund, I am literally pushed onto another person, or I am told exactly what I want to hear but it never gets done. I have talked to so many people who are not on the same page. I just feel like this company needs some organization and knowledge, instead of always telling customers what SHOULD happen, but does not actually happen.Desired Settlement: I would like my refund back in my banking account preferably within 5 business days as I was told. I just want the right thing actually done this time instead of being told what will be done.

Business

Response:

It appears from the Complaint that [redacted] is the mother of, not one of, our insureds. In order to investigate this matter, Coventry Health Care would need the daughter’s information and a HIPAA authorization form signed by our insured. If the daughter is a minor, we would still need the daughter's information and a signed form from whomever has the authorization to do so.

Thank you,

Review: I tried changing my address on Coventry's website a few months ago and was unable to. So I wrote to them using the "Contact Us" form and asked them to change my address. I never received a response at all. I was like FLAT-OUT IGNORED! So I called a few months ago and asked Coventry to change my address from [redacted] (in [redacted]) to [redacted] (in [redacted], MO). They told me my address was changed. A few days ago I received a letter in the mail that still had the INCORRECT ADDRESS of [redacted] on it. I don't live at [redacted] any more!!! The letter was forwarded to me by USPS but that forwarding expires in a year. I CAN'T HAVE YOUR COMPANY CONTINUING TO SEND MAIL TO AN ADDRESS I DON'T LIVE AT ANY MORE because the [redacted] who live at [redacted] won't be telling me I have mail at their address. So I picked up the phone a day or two ago and called Coventry, and once again, asked them to change my address (just like I did months ago). They said "I see two addresses on file, one is billing and one is shipping." I told them that they should only see ONE address for both billing and shipping, and thats the [redacted] address. Do not send any more mail to the [redacted] address. Please remove that address altogether from your system!! They said it's been changed. Then I logged onto website a day or two later AND IT STILL LISTS THE INCORRECT ADDRESS! (which tells me your company didn't change it at all). It says [redacted] IL [redacted]. I DO NOT WANT TO SEE that address ever again on your website (when I log into my account). I DONT LIVE THERE. PLEASE KINDLY CHANGE MY ADDRESS ALREADY TO: [redacted], [redacted] MO [redacted]. Let me rephrase my issue. I called months ago and asked your company to change my address. They claimed they did, but they did not, as evidenced by this "New Policy Confirmation" letter you just sent me in the mail. I called again to change it a day or two ago, and I'm still not convinced that my address has been changed on your records.Desired Settlement: PLEASE KINDLY CHANGE MY ADDRESS ALREADY TO: [redacted], [redacted] MO [redacted]. I want to see the changes reflected in your website the next time I login. I DO NOT WANT TO SEE THAT [redacted] ADDRESS on file with my name ever again.

Business

Response:

Attached please find Coventry Health Care's response to Complaint #[redacted]. I understand that a copy of this response was also sent to fax number ###-###-####.

Thank you,

[redacted]. [redacted]

November 6, 2013

Dear Sir or Madam:

The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter in response to your request dated 10-30-13 and received at our office on 10-30-13. This letter is in response to the consumer complaint filed by **. [redacted] regarding her change of address.

The member complains she is unable to change her address with our company. Any member may contact the number on the back of her ID card to reach our customer service organization to change an address associated with her policy. After receiving this complaint, we did forward this information to our customer

service organization who updated her information. Attached hereto as Exhibit A, please find a screenshot showing this information

Please also note the following:

No appeal was filed by the provider or member on this matter. No medical records were obtained or utilized. There was no U&C determination.

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 1917. My fax number is

###-###-####, and my e-mail address is [redacted]

Very truly yours,

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because: This screenshot does me no good. It does not reflect the webpage that I'm usually able to view. I wanted to log in to the MEMBER website to see if you guys actually did fix it, but I'M LOCKED OUT! I'VE BEEN LOCKED OUT OF MY ACCOUNT FOR A FEW DAYS NOW for no reason. Normally, when you get locked out of any other website, they ask you to answer the secret question, and if you get it right, they send a link to your email to manually reset the password yourself. Your website didn't even give me that option. I know I typed in the right password and some red text came up saying call Net Support. I don't have time to call net support. I'm swamped at my office during the day! I don't understand why your website isn't issuing me an email to reset my password and let me back in. So I received a call today from [redacted], concerning who knows what. I'm not sure if was about my previous issue, or what, but she told me I'm locked out. I said I don't have time to deal with this, I'm swamped at work, CAN YOU PLEASE JUST GET THIS FIXED FOR ME SO I CAN GET BACK INTO MY ACCOUNT? She told me I would have to call you guys. So work ends today around 5:30pm CST and I call the number that [redacted] gave me and OF COURSE IT SAYS YOU GUYS ARE CLOSED! I don't have time to call during work hours! I have to work during work hours! Not talk on the phone with you guys! Every time I call you guys, I'm on the phone with you guys for over an hour being transferred to 20 different departments because no one knows what the [redacted] is going on, and that hour on the phone is an hour of pay that I lose at my job (when I'm spending time on the phone with you guys). So I've rambled here a bit, so I'll try to get to the point. YOUR WEBSITE SAYS "UPDATE ADDRESS" BUT THERE IS NO OPTION TO MANUALLY UPDATE IT YOURSELF. That's frustrating! I feel like I've had to make MANY phone calls with your company just to get something really small and simple resolved. And then just to further complicate the situation, you've locked me out of my account. Now I feel like I have two issues pending. You guys haven't fixed any problem yet in my eyes. You've just made it more difficult. Because I can't get into the members website, and because I can't get in, I can't see if my address has officially been fixed or not, and I can't get a hold of anyone during hours that work for me because you guys are closed! So when I was calling web (or net??) support tonight around 5:30pm CST, it says if you want to leave a message Press 1. So I press 1 and the phone call disconnects! I call back again, and the same thing happens! I call back again and I push no number and the call disconnects. YOU'VE RIGGED YOUR PHONE TO AUTOMATICALLY HANG UP AND NOT LET ANTONE LEAVE A MESSAGE EVEN THOUGH THE VOICEMAIL SAYS YOU CAN LEAVE A MESSAGE BY PRESSING 1. THATS A LIE! This whole entire process has been extremely frustrating, and tiring. I've spent a lot of time on the phone trying to get this resolved for many weeks now and for all I know this still isn't resolved, and I'm locked out, and I'm tired and I'm frustrated, AND I JUST WANT THIS RESOLVED IMMEDIATELY. AS IN...RIGHT NOW! PLEASE LET ME BACK INTO MY ACCOUNT. That [redacted] woman today on the phone told me that someone at your company reset my password. WHY!?!?! I NEVER AUTHORIZED ANYONE TO DO THAT!!! I don't really have much more time to give to this issue during work hours without losing money. PLEASE LET ME BACK INTO MY ACCOUNT ALREADY and PLEASE RE-INSTATE MY ORIGINAL PASSWORD SO I CAN GET IN TO THE SECTION OF THE WEBSITE THAT SAYS "UPDATE ADDRESS" TO SEE IF YOU GUYS HAVE ENTERED the correct address. I DONT HAVE TIME TO SIT ON THE PHONE WHILE YOU GUYS FIGURE THIS OUT. JUST REINSTATE MY ORIGINAL PASSWORD SO I CAN GET IN. PLEASE!

Regards,