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EBSO, Inc

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Reviews EBSO, Inc

EBSO, Inc Reviews (2)

What are the plan docs, what's covered
Calls are disconnected or they just don't answer.
We received cards that's it!
I WORK for a fortune 500 insurance co we are 2nd in the country.
I HAVE NO IDEA WHAT GOING IN WORK THIS CO.
Look like
Bad coverage
Bad customer service
Bad communication no letter.
What are my copy
Do I have a deductable
Who is in network
Are you going to refund our weekly insur PMT?
Big co... Bad coverage for employees... Sad

Review: From 5/1/13 until 4/30/13, we had EBSO insurance thru my husbands employer, [redacted]. I am diabetic and wear an insulin pump which requires infusion sets and reservoirs. I have ordered these items from [redacted] since early 1999 and never had any problem with other insurance carriers covering this. EBSO said it would be handled out of network, but my insurance agent and I called numerous times to fight this because there was a clause in EBSOs insurance contract that if I could not get these supplies within a 50 mile radius of my home, [redacted] would be covered as in network. There was no where within this radius for me to get my supplies,so they agreed to cover them in network, which my order on 7/22/2013 from [redacted] for $698.80 was indeed covered by them in network. Since at this time I had met my deductible, this amount was paid in full by EBSO to [redacted]. I then had 2 more orders to [redacted] on 10/24/13 for $698.80 and another on 11/05/13 for $1419.00. These should have been covered in network like the July order was, but EBSO incorrectly processed them out of network and paid nothing on them because while my in network deductible had been met, my out of network deductible had not. I also had two shipments from [redacted] on 2/13/14 for $1419.00 and another on 4/22/14 for $698.80, both of which were processed out of network again. I received a bill from [redacted] mid November of this year stating that I owed $4235.60 for the four dates and shipments listed above. [redacted] said they did not get the EBSO denial of benefits until now and that's why it took so long to send me a bill. I then got EBSO's explanation of benefits right after that and realized they had processed all these claims out of network. Ebso is not denying they processed them wrong. They are denying coverage because we had 6 mths after 4/30/14 when we switched companies to process claims and it was 7 months. My dispute is that they had all this information prior and processed it wrong.Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like EBSO to pay [redacted] for my pump infusion sets and reservoirs. $2117.80 for the 10/24/13 and the 11/05/13 bills which is what they would have paid had they filed them correctly in network. I would also like EBSO to refigure the 2/13/14 and the 4/22/14 [redacted] bills totaling $2117.80 as in network instead of out of network and resubmit these to our current insurance carrier, [redacted], so they have the correct in networ

Business

Response:

In response to your letter of December 23rd regarding the above matter.The Plan under which the benefits claim is being made is governed by [redacted]. Strict HIPAA Privacy guidelines guidehow we can communicate information on Plan activities to the Revdex.com. That said, within an [redacted] Plan the memberhas the right to appeal any claim determination in writing to the Plan Sponsor and/or EBSO. To my knowledge, wehave not received in writing any appeal to the claim made in this complaint.At this time our claims department is reviewing the claims in question. If in fact additional payment is due we willcommunicate with the member directly.If you have any additional questions, please feel free to contact me at ###-###-####.

Consumer

Response:

Ebso did contact me and has since paid me the $2117 and also sent me corrected in network amounts for 2014. I am completely happy with the results from them. Thank you for your help.[redacted]

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Description: Insurance Agency, Consultant - Employee Benefit Plans, Insurance - Health, Insurance - Dental, Insurance - Disability, Insurance Claim Processing Services, Insurance Services, Insurance - Employee Benefits, Human Resources Consulting Services (NAICS: 541612)

Address: 7020 N Port Washington Rd Ste 206, Glendale, Wisconsin, United States, 53217

Phone:

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Web:

www.ebctpa.com

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Shady, yet now dead: once upon a time this website was reported to be associated with EBSO, Inc, but after several inspections we’ve come to the conclusion that this domain is no longer active.



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