Highmark Blue Cross Blue Shield Delaware

Please find the response from Highmark Blue Cross Blue Shield Delaware for Complain #***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear
below.I appreciate your help in trying to resolve this matter. Unfortunately, several items are left out in their response. 1) There were two calls to BC from *** and in both calls they were told that the equipment was covered at 100%.2) While their letter acknowledges one of these calls it seems they will not honor either of the TWO conversations saying that it was covered..3) There were many more than two calls made regarding this issue. *** attempted to appeal but could not as a "non-participating provider". I was not notified of this by BC.4) I made several calls to appeal but had to fax a form from my daughter giving you permission to speak about her account to me. I sent this and had no response so I called again and was told it had not been received.5) I had to re-fax the form and it is now in your office. 6) Perhaps the days have expired but since I was in the middle of working with your company during that day period I would assume you would NOT close the matter and refuse to allow my appeal.7) During this time period I made multiple calls and was promised copies of letters etc that were sent to me. I never received any of them.Please be sure any written correspondence regarding *** *** account is sent to her at *** *** *** *** ** *** That is the address where she and I live

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,

We are very sorry for uploading the incorrect response for this complaint, your case # *** We originally misplaced this complaint and are diligently working to provide a response. Our Member Service management has promised a thorough investigation and response on Friday,
October 16. Thank you for your consideration and again our apologies

Please find Highmark Delaware's response to Case ***. Please forward to our mutual member. Thank you

Attached is Highmark Blue Cross Blue Shield Delaware's response to Complaint ***

Revdex.com:
I have reviewed
the response made by the business in reference to complaint ID ***, and find that this resolution plan sounds satisfactory to me.
However please note- the issue has still not been completely finalized and I am still awaiting the documents I requested The company has reached out to me and explained what their plan is to resolve the issue, but it is still in progress
Regards,

Revdex.com:
I have reviewed the response made by the business in
reference to complaint ID *** and find that this resolution is satisfactory to me.
Regards,

Please find attached our response to the complaitant's rebuttal -- Case ***

RE: Revdex.com of Delaware Response to Complaint # ***Please find attached Highmark Blue Cross Blue Shield of Delaware's response to this complaint.Thank you

Revdex.com:
"line-height: 150%;">I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.I appreciate your help in trying to resolve this matter. Unfortunately, several items are left out in their response.
1) There were two calls to BC from [redacted] and in both calls they were told that the equipment was covered at 100%2) While their letter acknowledges one of these calls it seems they will not honor either of the TWO conversations saying that it was covered3) There were many more than two calls made regarding this issue. [redacted] attempted to appeal but could not as a "non-participating provider". I was not notified of this by BC4) I made several calls to appeal but had to fax a form from my daughter giving you permission to speak about her account to me. I sent this and had no response so I called again and was told it had not been received5) I had to re-fax the form and it is now in your office.
6) Perhaps the days have expired but since I was in the middle of working with your company during that day period I would assume you would NOT close the matter and refuse to allow my appeal7) During this time period I made multiple calls and was promised copies of letters etc that were sent to me. I never received any of themPlease be sure any written correspondence regarding [redacted] account is sent to her at [redacted] That is the address where she and I live

Please refer to the uploaded response in PDF format.

This is a response to the inquiry submitted to your office by [redacted] regarding a claim for hearing aid services rendered by A.I. DuPont Children's Hospital, on date of service 1/14/14 for his daughter.
Highmark Delaware administers the benefits for the FEP plan.  The...

member's benefit plan states benefits are available for hearing aid services as follows :
Covered Hearing Aid Revenue Codes
The Hearing A id Revenue Codes listed in Chart B will process as covered DME services subject to appropriate hearing aid
benefit maximum per ear per time period. Chart B - Hearing Aid Revenue Codes Code Narrative
0470 General
0471 Diagnostic
0472 Treatment
0479 Other Audiology
The Member does have benefits for hearing aid services when billed by the above referenced facility with the revenue codes above. The provider of services has billed with Revenue Code 292, which is not listed as a covered service under the benefit plan. Highmark Del aware h as contacted the provider's billing office on behalf of the member on 4/ 17/ 14 and advised the provider that a corrected claim is needed .
Should you h ave any additional questions or concerns, please do not hesitate to contact me.

There are two attachments which should resolve the member's concerns.

RE:  Final Response to Case #[redacted]   Please find attached our final response for this case.  We had...

initially answered this complaint in your system advising that we needed more time to investigate.   Our investigation is complete and our final response is attached.

Please find the response to Case #[redacted] fro Highmark Blue Cross Blue Shield Delaware.

RE:  Final Response to Case #[redacted]   Please find attached our final response for this case.  We had initially answered this complaint in your system advising that we needed more time to investigate.   Our investigation is complete and our final response is attached.

Please find attached Highmark Delaware's response to the Rebuttal regarding this case #[redacted]

Signed up for coverage 3/22/14.
Didn't hear a word from them until 5/6/14, when I received a bill for the month of April. Called to straighten out, not helpful at all. Just told me all the stuff I had to do. No responsibility no assistance. They are going on the wall of shame in my office so others can be warned.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me.