Eagle Tours, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.My insurer has NO affiliation with this company, as many have suggested this is a fraud and Revdex.com should investigateJust stop the mailings and this goes away for me!
Regards,
*** ***

This is in response to the Complaint ID #*** filed against The
Rawlings Company LLC. Among other
services, Rawlings provides data mining and coordination of benefits services
to health insurance companies and administrators. Cigna is one of our clients and, in our role
as a
business associate of Cigna, we sent the customer letters requesting
information about other insurance coverage that he or his covered dependents
may have.
As part of its work, Rawlings seeks information from its clients’ members
about other insurance coverage that the members’ may have. This information is necessary so that our
clients’ coverage is properly coordinated with any other health coverage that the
members have. Having correct
coordination of benefits information ensures that claims are paid promptly, and
this benefits members, providers, and insurers alike.
We have closed our investigation of other insurance coverage for the
customer and he should expect no further contact with regard to this matter. We have also reached out to our client Cigna
and we understand that Cigna has informed the customer that Rawlings is a business
associate of Cigna’s and that Rawlings’ requests for information are legitimate.
We regret that there was a misunderstanding about our relationship with
Cigna, but we believe the matter has now been resolved. Please contact me with any additional
questions or concerns
*** ***
Associate General Counsel
The Rawlings Group
(502) ***

*** ***This letter is in response to the complaint referenced aboveThe Rawlings Company LLC provides data mining and claims recovery services to health insurance companies, including that of the complainantsAs part of our contract with the complainant’s health insurer, Rawlings Seeks
information pertaining to treatment for which the insurer has paid and which may have resulted due to the fault of another partyTo obtain this information, insureds such as the complainant are sent questionnaires to which to respond.We respectfully disagree with the complainant's characterization of the Rawlings letters as harassing and as “lengthy questionnaires' filled with questions about his healthThe questionnaire is one page long and asks for information regarding the accident, if any, which may have resulted in the treatment referenced in the letterThe complainant has most recently been sent five such letters to which there was no response.Rawlings holds customer Service among our most important valuesWe take seriously any complaints related to our ServicesDue to facts specific to this matter, no additional letters regarding the treatment referenced in the most recent letter and paid by the current insurer will be sent by Rawlings Subrogation Division to the complainantWe regret any inconvenience or concern that this process may have caused the complainant

I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I would like a letter sent to my CURRENT address stating the account is closed and no balance is due. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

Please see attachment for response. This letter is in response to the Complaint filed with your organization bearing # ***Rawlings contracts with the Complainant’s previous health insurer to provide data mining and claims recovery servicesAs part of its work for that insurer, Rawlings'
seeks to recover payments which were made by its client after an individual’s coverage with that insurer has endedThe records of the Complainant's previous insurer reflect that prescriptions were filled by pharmacies after her coverage with that insurer had terminatedHer previous insurer, which is Rawlings’ client, was billed by the pharmacy and paid for the filled prescriptions.Rawlings mailed letters to the Complainant advising of the overpayment and outlining methods by which it could be handledThe Complainant has advised Rawlings that a switch in insurance carriers was not completed in a timely mannerThe Complainant was also advised that Rawlings could assist her in filing a claim with the new insurer, but she stated she would be seeking assistance from another source.We have closed this audit and will not seek any repayment from the ComplainantWe regret any inconvenience this matter has caused her.Sincerely,*** ** ***

Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.Regards,*** ***

SEE ATTACHMENT FOR ORIGINAL DOCUMENT.This letter is in response to the Complaint filed with your organization bearing #***Rawlings contracts with the Complainant’s health insurer to provide data mining and claims recovery servicesAs part of its work for that insurer, Rawlings’ seeks to
recover payments which were made by its client after an individual’s coverage with that insurer has endedThe records of the Complainant’s insurer as provided to Rawlings reflect that a prescription was filled after her coverage with that insurer had terminated, thus giving rise to the balance indicated in the letters sent by Rawlings.We regret that the Complainant was not correctly informed of the relationship between Rawlings and her insurer or of the amount reflected in the lettersBy no means were the letters to the Complainant an “insurance scam”, but rather an attempt to recover payments made in error and in furtherance of the work Rawlings performs for that insurer.Rawlings holds customer service among our most important valuesWe take seriously any complaints related to our servicesWe regret any inconvenience or concern that this process may have caused the ComplainantWe have closed our file on this matter so that the Complainant will not receive any further letters related to the referenced prescription.Sincerely,*** ** ***

This letter is in response to the complaint referenced aboveThe Rawlings Company LLC provides data mining and claims recovery services pursuant to contract with health insurance companies, including that of the complainant’sAs part of our contract with the complainant’s health insurer,
Rawlings seeks information pertaining to medical treatment for which the insurer has paid and which may have resulted due to the fault of another partyTo obtain this information, insureds such as the complainant are sent questionnaires to which to respondThe complainant has received such letters from Rawlings
These letters are neither advertisements nor solicitationsThey do not ask the complainant to make a claim against his provider or employerRather, Rawlings seeks information regarding a health claim that has already been paid by his insurerThis inquiry is being made on behalf of his insurer
Rawlings holds customer service among our most important valuesWe take seriously any complaints related to our servicesWe regret any inconvenience or concern that this process may have caused the complainantWe have closed our record on this matter so that the complainant will not receive any further letters related to the referenced treatment
Sincerely,*** ** ***

This letter is in response to the Complaint filed with your organization bearing #*** Rawlings provides claims recovery services to health insurance companies and administrators, including the complainant's insurerRawlings did in fact have a potential claim regarding the complaint's
accidentAs per her letter, the complainant did previously advise Rawlings that claims paid by her insurer were not related to the accident, Rawlings file was noted and subsequently closed
Rawlings received a call from the complainant on 10/21/The complaint states that her
attorney had tried to contact Rawlings without successWe have no record of any messages or
correspondence from him until October 22, 2015.
Rawlings is not pursuing any recovery regarding the complainant’s accident of 2/14/We have so notified the complainant's attorney and the insurer for the at-fault party in writingWe trust that this will resolve the complainant's concernsWe certainly regret any inconvenience that this process may have caused her.
*** ** ***
Deputy General Counsel to The Rawlings Group

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to *** ** *** and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
This does not solve the problem of their repeated harassment For the record, they can disagree with me all they want - the questionnaires are written in an invasive and threatening manner Again - I will NOT be satisfied until they take my households' address OFF their mailing list I DO NOT want to hear from them again
Regards,
*** ***

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.I would like a copy of what gives this party the right to my private information and where it states that I must comply in providing any information the Rawlings Company requests from me and what legal recourse I have to refuse to answer thier questionairres. How is my private healthcare the business of a 3rd party company in Kentucky?   My Dr visit had nothing to do with a 3rd party or any injury relating to any 3rd party. This is an intrusion of my rights to privacy by a big government entity clearly seeking to data mine healthcare customers of [redacted] for a purpose not related to my welfare.
[redacted]

This letter is in response to the Complaint filed with your organization bearing #[redacted]. Rawlings provides Services to health insurance companies and administrators, including the Complainant's,Summarily, the Complainant cites issues regarding Rawlings delay in responding to communications and...

requests for information, as well as her dealings with Rawlings’ employees. Rawlings employees are trained to promptly respond to all such communications. Rawlings also expects its employees to communicate with others with the highest level of respect, professionalism and courtesy. We do note that the Complainant had telephone conversations with two different Rawlings individuals. After the Complainant's calls, her concerns were escalated to the proper individuals. We apologize that the Complainants concerns were not properly addressed.The President of The Rawlings Group is writing to the Complainant in separate correspondence. Our file regarding her motor vehicle accident has been closed. We certainly regret any concern and inconvenience that this matter may have caused the Complainant.

This letter is in response to the Complaint filed with your organization bearing [redacted]. Rawlings provides data mining and claims recovery services to health insurance companies and administrators. As part of its work, Rawlings seeks to recover payments which were made by its clients after an...

individuals coverage with that insurer or plan has ended. The records of [redacted] ([redacted]) reflect that a prescription was filled for the complainant on 15/15 after his coverage with [redacted] had terminated. [redacted] was billed by the pharmacy and paid for that prescription.
To assist in facilitating the billing of this expense to the proper coverage, Rawlings can work with the complainant at his request to complete the necessary forms and file them on his behalf with his current carrier after he reviews and signs them. This may require additional time on the complainants part. Rawlings cannot guarantee the outcome of this process. Please note that Rawlings will not be reporting this matter to any credit reporting agency.
We will contact the complainant regarding the completion of the forms referred to above. We regret the difficulties this matter has caused him.
[redacted]
###-###-#### 
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. While it's odd that on one hand the business admits it is doing data mining & in same letter claims it's trying to protect the privacy rights of [redacted] clients, I accept the fact they will no longer contact me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.Regards,[redacted]

This letter is in response to the complaint referenced above. The Rawlings Company LLC provides data mining and claims recovery services pursuant to contract with health insurance companies, including that of the complainant's. As part of our contract with the complainant's health insurer,...

Rawlings seeks information pertaining to medical treatment for which the insurer has paid and which may have resulted due to the fault of another party. To obtain this information, insureds such as the complainant are sent questionnaires to which to respond. The complainant received 2 such letters to which no response has been received. Unfortunately, when the complainant called his insurer, he was given incorrect information about Rawlings.
Rawlings holds customer service among our most important values. We any complaints related to our services. While we do not believe any of our correspondence was harassing, we regret any inconvenience or concern that this process may have caused the complainant. We request that the complainant complete the questionnaire and return it to Rawlings with any questions using the phone number indicated in the letters.
Sincerely,
[redacted]
Deputy General Counsel
The Rawlings Group

See attachment for originalThis letter is in response to the complaint referenced above. The Rawlings Company LLC provides services pursuant to contracts with health insurance companies, including that of the complainant’s. Pursuant to our contract with the complainant’s health insurer, Rawlings...

sent to him letters requesting information about other insurance coverage he may have and his employment status. Having this information helps to ensure that the claims are paid properly.The letters are neither advertisements nor fraudulent. The inquiry was made on behalf of and authorized by his insurer. We regret that the Complainant was not correctly informed of the relationship between Rawlings and his insurer when he called his carrier. So that Rawlings can fulfill its obligations to its client, we respectfully request that the Complainant complete the questionnaire and return it to Rawlings or call us at the toll-free number indicated in the letter if he has any further questions about Rawlings or the questionnaire.Rawlings holds customer service among our most important values. We regret any inconvenience or concern that this process may have caused the Complainant.Sincerely,[redacted] Deputy General Counsel -The Rawlings Group

This letter is in response to the Complaint filed with your organization bearing #[redacted]. Rawlings provides data mining and claims recovery services to health insurance companies, including the Complainant's. As part of its work, Rawlings seeks information from insureds pertaining to medical...

treatment which may have resulted due to the fault of another party. To obtain this information, individuals who have received treatment, such as the complainant, are mailed questionnaires to which to respond. The complainant's health plan is seeking information to determine if the treatment is the responsibility of another person, organization or insurer. The member’s health plan requires full cooperation with such efforts.
Rawlings holds customer service among our most important values. We take seriously any complaints related to our services. We strive to ensure that our processes provide high value to our clients and are as seamless as possible to their members. While the correspondence addressed to the complainant is authorized by the health plan, we regret any inconvenience or concern that this process may have caused the complainant. We have closed our record on this matter so that no additional letters will be sent to the complainant.
Please contact me if you have any further questions.
Sincerely,
[redacted]

This letter follows the response of the complainant to the submission of The Rawlings Company LLC dated November 17, 2015. 
As stated previously, the complainant's health insurer contracts with Rawlings to provide data mining and claims recovery services. Rawlings receives from the insurer paid claims information in order to perform its services. Rawlings is considered under federal privacy laws, specifically HIPAA, to be a “business associate” of the insurer. As required by HIPAA, Rawlings has entered into a Business Associate Agreement with the insurer to provide reasonable assurance that the health information of insurer's members is adequately protected. Rawlings also commits that the information is utilized in a manner appropriate to its services and as permitted by law.
In her most recent submission, the complainant advises that the treatment referenced in the letter from Rawlings, “had nothing to do with a 3" party or any injury relating to any 3" party.” Based on this response, Rawlings will note its records accordingly and not send any additional questionnaires regarding this treatment. We hope that this will resolve the matter to the complainant’s satisfaction. 
Sincerely,
[redacted]