Health Net Of Arizona Inc.

Review: My former insurance company continues to reject my medical claims from October, 2013. It was a routine annual physical exam which should be paid in full by HealthNet. The first time I called they said it was rejected because the Dr. office billing department did not enter in the correct billing codes. Now the insurance company states that this exam is not covered. Every time I call this insurance company I get a different answer. All I want is for Health Net to pay the claim in full.Desired Settlement: Pay the claim!

Business

Response:

The member's appeal has been submitted the the Commercial A&G Department for processing. The standard timeframe for processing a post service appeal is 30 days. Health Net will respond directly to the member with the review outcome.Thank You.

Consumer

Response:

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 until for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Review: We have been trying since November to get information and help with our health plans. after waiting 1-1/2 hours today, he put me back on hold and then disconnected me a few minutes later, this is the second time this has happened. there are issues that need to be dealt with and questions that need to be answered.Desired Settlement: set up the new health plan perhaps change to a better plan.

Business

Response:

The member's complaint will be processed through our standand grievance process and we will respond directly with the member within 30 days following receipt of the member's complanit.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted]. I will wait for the business to perform this action within 30 days or less.Regards,

Review: I applied for a Healthnet HMO plan through the EHealthinsurance website. I found out that I would not be able to keep my physician with this plan and cancelled it before it was ever supposed to take effect. I was still charged for the plan after the request for cancellation was submitted and they have not issued a refund despite many requests. I have called Healthnet multiple times and keep getting put on hold and either disconnected or transferred to the wrong person that tells me they can't help me. The agents I speak with keep telling me that a refund should have been processed but hasn't been. I am unable to get any answers or my money back. I have been trying to get a refund for 22 days now.Desired Settlement: I want the money back that they should never have charged me for in the first place.

Business

Response:

The member's complaint will be reviewed through our formal grievance process and a written response will be sent directly to the member within 30 days.

Review: I signed up for HealthNet via the Health MarketPlace. I sent in the first month's payment and HealthNet cashed the check on Feb 4, 2014 for $448.41. I was given a subscriber ID no. by a customer service representative and the number was not listed on the payment coupon as the instructions said. When I did not receive my ID card, I called several times. Each time I was told they did not know why I showed up in one computer and not the other more important one but no one offered to send me an ID card. I tried to register online but the site will not accept the ID no and has no record of me. I cannot go to a doctor without an ID card I don't care what HealthNet says on the phone, you cannot go to a health care provider without a card to prove your coverage. I also do not want to keep paying for health insurance without being fully accepted into the computer system which will accept my check but not give me an ID card or take note that I do not show up in the system. I have spent hours on the phone getting nowhere and always always being pawned off to someone else.Desired Settlement: Get the computer problem straightened out or return my money. Make it so I can go online without a problem and print out an ID card or send me an ID card and acknowledge that the problem is fixed permanently. Do this by the end of the week or my next complaint will be with the State Board of Insurance in several states.

Business

Response:

Health Net will investigate the member's complaint and respond directly to the member within our grievance timeframe of 30 days.

Consumer

Response:

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 ONLY IF THEY DO IT BEFORE 30 DAYS. I will wait for the business to perform this action but am speaking to my insurance broker tomorrow who also found that there were problems with this transaction with HealthNet. At the moment, I am contemplating writing to the State Board of Insurance and contacting consumer reporters at television stations in Phoenix. I have a canceled check with me yet everyone I talk to at HealthNet says I have not paid. Healthnet representatives have pawned me off each time I call with no one taking charge and fixing the situation. The longer they keep my money and say they don't have it, the more stressed I am.

Regards,

Review: Healthnet of Arizona has denied benifits to me that should be paid based on their stated policy. I have called several times to try an resolve the issue but I am always put on hold and told to wait...wait..wait... and never a response.Desired Settlement: I would like a representative to call me at [redacted] and or email me at [redacted].com

Business

Response:

The member's complaint has been submitted into our formal grievance process. We will correspond directly with the member regarding the review outcome.

Review: I started a plan in Healthnet in January of 2013. After the first month I found out they raised my rates without letting me know. I tried to file a complaint with the [redacted] for this issue. But after two weeks of not hearing back from Healthnet, I decided to cancel my policy effective February 1. I contacted[redacted].[redacted] as they instructed me to do and filled out a form to have my policy cancelled. As of today I am still receiving bills monthly and now show a late balance of over $1,000. I called them last week and they told me my policy was still active even though they showed that I had sent in cancellation notices. They told me they would have to file a report and would let me know. I haven't heard anything since then, and I don't want to continue waiting for this to be resolved. I want my policy canceled retroactive back to February 1. I filed the correct paperwork, contacted all the responsible parties, and nothing has been done to cancel my policy.Desired Settlement: I would like my policy cancelled retroactive to February 1, and ALL outstanding balances credited as these balances are building up because they have not cancelled my policy. I have not used my policy at all.

Business

Response:

The member's complaint will be submitted through our formal grievance process and we will respond directly to the member within 30 days with the resolution.

Go far far away from this company. They took my payments but dropped me for non payment. It took me calling 10 times for anyone to even tell me this. All the other reps had just said they would resubmit the claim that was being denied. So now my son and I do not have heath insurance, but they have thousands of dollars of my money that they billed to my credit card every month as the premiums.

Now I am waiting for documents to sign for them to consider reinstating our policy but no one can tell me how long that will take and until then they are keeping my money.

Review: I purchased medical insurance through[redacted].[redacted] and selected HealthNet as my insurance company in December 2013. My first billing cycle was January. I paid by check for Jan, Feb and March. In April and May I used the bill pay of my checking account, echecks were sent. On April 22nd I received a letter that my health insurance was suspended. I called and told the customer service rep. that I paid using my checking account. I was told I would here back from them in 7 to 10 days. After 10 days I called again. Same issue, I was told I would hear back in 7 to 10 days. I called again after 10 days, I faxed copies of my canceled checks for the April and May payments. I was again told the billing issue would be resolved and my coverage would be re-instated in 7 to 10 days. I called again with no satisfaction however HeathNet now shows I am in arrears of $357.80. I owe not a penny and have copies of all 5 canceled checks for payments submitted for January through May 2014. My insurance is still suspended.Desired Settlement: I want the billing issue resolved immediately and want credit for every day my service was suspended, They had my payments but did not provide the coverage I paid for not to mention the 6 to 8 hours I spent on hold and in conversation with their customer service representives

Business

Response:

This complaint is a duplicate of #[redacted], which I responded that the member's complaint will be submitted through our formal grievance process and we will respond directly to the member within 30 days with the resolution.

Review: On Feb., I called Health Net to cancel policy. They said I had to cancel with the Affordable Health care people so I did that same day. Because of all the trouble and problems it was to get the insurance I figured there may be a problem canceling it. So after canceling the insurance I called back Health Net and withdrew my authorization to auto withdraw from my checking account.

I figured if worst came to worst I would be canceled for non payment. They took out $326.55 for March anyway. [redacted], Health Net, and I had a conference call and it seemed that it was all settled and was told by Health Net that I would get a refund for March. After no refund I called and was told that they can't refund on a phone call and that it must be in writing. Well, turns out that [redacted] people don't have the technical ability to change the cancel date of March 14th in writing. [redacted] people said although I canceled the policy in Feb. it took a couple of weeks, due to red tape, to notify Health Net.

All this, including the conference call and my ACTUAL cancel date is in Health Net's notes. I have proof that I was already insured with [redacted] and could not use Health Net since Jan., 1st 2014 but I'm only asking for the months premium that was canceled.Desired Settlement: Refund for canceled month of March for $326.55.

Business

Response:

The member's complaint will be reviewed through our standard grievance process. A written response will be sent to the member within the next 30 days.

Consumer

Response:

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.

This complaint has not been resolved. Health Net withdrew unauthorized money from my checking account.

Regards,

Review: I had been sent a bill from Healthnet of Arizona regarding my son's new premium in late October informing me it would be going from $125.00 to $221.00. At that point I began the process of finding a new policy for him. I paid his new Insurance in December with another company. I then received a bill from Health Net of AZ indicating that the new premium was $140.92. I called them on 01-06-15 and spoke with [redacted] in the sales department, gave him my son's name DOB and HN id #. I questioned as to why the policy quote had changed. I spent 45 minutes on hold with him and another rep from the member services department. At which point I was told that they didn't know why the change but it was correct and I should go ahead and pay for the month of January. I explained that I had already chosen another insurance policy with another company and had paid, and If I could start the policy on 02-0-15. I was told no that it would then be$225.00, but if I started the policy on on 01-06-15 I would be locked into the $140.92 price for the entire year. I paid it with my debit card, and was told by [redacted] at HN that to contact the other insurance and cancel that policy. I was then informed by my broker when I told her what had happened that she contacted HN and they told her oh that was a mistake and would be paying $225.00 a month. I immediately contacted [redacted] at HN and explained what was going on and that I wanted my refund of $140.92 because they had given me fals information, after I had specifically called and questioned it. I waited 72 hours with no response. I am still waiting for a supervisor to contact me regarding this and where my refund is. I have now been send another bill for over $300.00 for an 80.00 due from January and then the current policy. I cancelled this policy. This is considered fraud and I have also reported this to the OIG.Desired Settlement: I would like my refund for the cancelled policy in the full amount of $140.92.

Business

Response:

The member's compliant will be submitted into our formal grievance process and a written response will be sent to the member within 30 calendar days.Thanks You.

Review: My Health care policy has a deductible of $5000.00 and a Co-Insurance of $1350.00. This has been met. As of today, 12/9/2014, going by Health Net's account on their web site, I have paid $5485.00 towards deductible, 3715.84 towards Co-Insurance and $446.00 in Co-pays. This totals $9646.84 out of pocket expenses. The total out of pocket expense for my policy is $6350.00, which includes the deductible and co-insurance.

I am unable to finish my required follow up appointments and procedures due to [redacted] continuing to charge the Co-Insurance. The agent has contacted them and they have agreed on numerous occasins that I have over paid. They will not, however, correct it. The bills keep mounting and I no longer can afford to manage my health care as prescribed by the physicians.Desired Settlement: I am unable to finish my required follow up appointments and procedures due to [redacted] continuing to charge the Co-insurance. One of those follow ups being with a cardiologist which is important due to my daughter having passed away earlier in the year due to a genetic heart disease. I would like this situation remedied so I can continue my health care as prescribed by the physicians and complete the prescribed procedures. I would like the outstanding bills that need paid taken car of and any reimbursement to me taken care of.

Business

Response:

The member's complaint will be submitted into our grievance process and we will provide a written response to the member within 30 days.

Consumer

Response:

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.

They have spoken to the agent and stated that they have made a mistake on numerous occasions. This is interrupting my prescribed health care and a new deductible year starts January 1, 2015. 30 days is unacceptable as I will not be able to obtain my health care as prescribed by the physician by the end of this deductible year. This is a great injustice and health wise very risky for an insurance agency to operate this way. The deductible and co-insurance has been met and I have been over charged. This is proved through the EOBs submitted with the original complaint. There is no grievance process needed. It is in black and white, it needs corrected immediately as they have stated in order for me to obtain my prescribed treatments and procedures as prescribed by my physicians.

Regards,

Business

Response:

I have forwarded the add'l comments to the appropriate department responsible for processing the member's grievance.Thank You.

Review: I got health insurance with is company through the health exchange to start 01/01/2014. I paid for the first month (January). I called Health Net and the government health exchange to cancel the insurance on 01/15/2014. I keep getting bills for 415.80.Desired Settlement: Stop sending me bills for health insurance I paid for and cancelled after 15 days.

Business

Response:

The member's complaint will be submitted through our formal grievance process and we will correspond directly with the member regarding our review outcome within the next 30 days.

Consumer

Response:

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.

The response of the business is to deal directly with them in the next 30 days. I have been dealing directly with them for over 4 months by phone and letter without success. They have refused to respond to all my telephone and letter requests.

Regards,

Business

Response:

A written response will be provided to the member by Health Net's Appeals and Grievances Department within 30 days from receipt of his original complaint with the Revdex.com on 5/24/2014.

Consumer

Response:

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.Heath net has had another 30 days (over 180 days in total). I have not received any response from my Revdex.com complaint. I would like the complaint reopened. Thank you.[redacted]Regards,[redacted]

Business

Response:

Hi [redacted], Health Net sent a written grievance response letter to Mr. [redacted] on 6/23/14 providing him with direction on how to resolve his issue. Please let me know if you need further information. Thank you.

Review: I signed up for this health insurance in January of this year. I paid my premium and immediately went to find a primary care doctor. I used the Health Net search form with my insurance information and found a provider. I called to verify that this provider was in network. While waiting for this appointment I was experiencing additional pain, called a few specialists to find someone who was in network and made an appointment. After arriving, I was told that they actually were not in network for my specific specialist need, after calling to find a doctor and speaking with the insurance company I was told that there is a SINGLE practice that accepts my insurance (they had a three month wait to get in). I decided to just wait for my PCP appointment. Knowing that my insurance had issues, I called the PCP office (Nancy S[redacted]) to verify that they were in-network. Yes, they were. Arriving at my appointment, I asked AGAIN and paid my co-pay. Fast forward two weeks, and I now have a bill for OUT OF NETWORK services from both my insurance and provider. I called my insurance only to be told that the number for "current members" is no longer in service. The only way I could talk to a human being was if I called the sales number and demanded to be connected with someone else. After FINALLY getting on the phone they told me that they would look into it and call me back. I also complained about not being able to reach anyone and he said he would look into it. Two weeks later, I still haven't heard anything. When I called, I was sent to the SAME place that is no longer in service and again spend over 45 minutes just pushing buttons trying to talk to a human being. This is absolutely ridiculous, and not only do I want this resolved, but I will be sending a bill to Health Net Corporate for MY time that it has taken in resolving this.Desired Settlement: A. My billing issue resolved and my provider paid.

B. The bill I am sending should also be PAID.

C. Health Net quits misrepresenting their provider availability in Tucson.

Business

Response:

Health Net will submit the member's request through our formal grievance process and will provide a response to the member with 30 calendar days.

Review: I signed up for insurance through the market place because my [redacted] was running out. I picked a plan through Healthnet. In May I called both Healthnet and the Market Place stating that my new employer is offering me insurance and if I could cancel my Healthnet insurance. Healthnet refused to help and said I had to go through the market place. The market place said I could cancel at anytime. I waited patiently for my employer to tell me I can sign up there was an issue on what was the new policy due to healthcare reform. After they got the final answer, I was told my effective date would be August 1st. I rushed to sign up because I was going into surgery on the 24th of July and they didn't tell me about the August start date until 7/22/14. I would miss open enrollment if I did not sign up that day because I was scheduled to be off of work for 2 weeks. After surgery and I was well enough, I called the market place to cancel. All of a sudden they told me I had to wait until they completed their paper work and it would take 14 days. I already had my payroll deductions for my new insurance. I told Healthnet and the market place I could not afford two premiums during August. The market place basically told me tough luck and wait for a prorated bill from Healthnet. The bill arrived electronically and it was not prorated. It was for the entire month of August. I called Healthet and was told my cancellation date is 9/1/14. I asked for a supervisor and was told they could only change it if the market place completed form 834. The market place said they had no such form and didn't know why Healthnet's records were incorrect. I was told a supervisor would call me back. The supervisor left a message on my voicemail with no direct contact and stated I should call the general number for help. This is ridiculous. I have been trying to resolve this issue since the beginning of August. I shouldn't be punished for the market place giving me the incorrect information and not informing me in May about the 14 day period for them to process the paper work.Desired Settlement: I want Healthnet to credit my account and not charge me for August 2014. I understand that two of my doctors made a mistake and accidentally billed them for visits in August. I will follow up with those doctors and correct the problem. I gave them my new insurance and paid the copays.

Business

Response:

The member's complaint will be processed through our standard grievance process and we will respond directly with the member within 30 days.

Extremely difficult to reach someone in claims. April 1st I was on hold 33minutes. April 2 on hold 58 minutes. Recording only says we value your time we will be with you shortly. No estimate of wait time given. Another 1hr and 38 minutes spent, on top of the 58 minute hold time, to find out they had processed the claim incorrectly. Mistakes are made but the hold time to talk about the claim is unreasonable.

Review: there have been several issues ranging from waiting over an hour on several occasions to be serviced by associates to calls being dropped when being transferred but nothing compares to the fact that my wife called to cancel service at the beginning of November 2014, was told by the associate we would be reimbursed only to find out 3 weeks later (3 days prior to Decembers billing) that they never processed the request.

This was strike 3 in our issues which started from day one when they attempted to deny coverage to my infant because their website was allegedly broken the day we did the online application despite sales associates on the phone verbally confirming the online application we had started being reviewed.

strike 2 occurred when we told them insurance was not needed to date back for our son since he was covered and we would prefer it to start on the month of application. instead 2 months into the policy 3 months were pulled out in one billing. once that was resolved they forgot to bill us the following month and ended up pulling out 2 payments from Novembers bill.

The service delivered was terrible by their representatives and their billing was terrible. I would say I have lost over 2000 to health net.Desired Settlement: I just want my wifes policy cancelled and our bank account refunded. Ideally I would want them out of my state so no one else has to deal with them. on a side note, I was told waiting 15 minutes on a slow day isn't long to wait to speak with someone. Between myself and my wife we have lost over 60 hours on the phone with Health Net.

Business

Response:

The member complaint has been submitted into our formal grievance process. A written response will be sent directly to the member within 30 days.