Highmark Blue Cross Blue Shield

June 17, 2015Revdex.com Attn: [redacted]Case ID:[redacted] File Number: 15161512628Dear Ms. [redacted]:This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.The member stated in her complaint that she did not agree with the amount that has been posted on her billing account for the policy that became effective January 1, 2015. She stated that based on the previous payment history received from Highmark, four payments are missing.After reviewing the proof of payment submitted by the member with her complaint, four payments were located, and are currently being applied to the correct billing account. Three of the payments were applied to the member’s previous billing account, which is no longer active, and the fourth payment was in an unapplied cash account. Additionally, the member returned the refund of $211.25, and it is currently being posted to the active billing account. When all payments have been moved to the proper account, the member will have a credit balance of $211.29, and a paid to date of July 1, 2015.When members make payments whether through their banks bill payment system or send a check to Highmark, it is very important that their current billing account number be on the payment. If the incorrect account number is placed on the payment, that payment may not be posted to the correct account, and the member could possibly be cancelled for nonpayment.If you have additional questions, please contact me directly.Sincerely,Cassandra M.Appeals Coordinator Phone: [redacted]

Case ID: [redacted]Dear Ms. Gasser:This is in response to your inquiry sent to us on behalf of the member identified by your Case ID [redacted].The member was enrolled in a Preferred Provider Organization (PPO) plan through an employer group from July 1,2005 to March 1,2017. This self-insured...

non-grandfathered group has two levels of appeal to be administered by Highmark with an external available for medical necessity denials only.As the member indicates, she was advised a payment would be issue to her due to incorrect information being provided regarding immunizations. According to our records, a request was forwarded to have the claim’s payment issued to her, but it has not finalized as the initial payment was issued to the provider inadvertently. The payment is being retracted from the provider and will be issued to the member.While I understand that the member is requesting interest, please recognize that we are unable to reimburse a nonmedical expense.If the member has any questions concerning this coverage, please have her contact our Customer Service Department at ###-###-####. If you have additional questions, please contact me directly.Sincerely, Marqueritte M[redacted]-S[redacted]Executive Legislative InquiriesEnclosures

October 16, 2015Revdex.com[redacted]
[redacted]
[redacted]Case ID:[redacted]Dear [redacted]:This is in response to your follow-up inquiry sent to us on behalf of the member identified by case ID [redacted].Our records show this member is enrolled on a Chip Gatekeeper policy effective September 1, 2015.The September 2015, premium payment in the amount of $61.75, was cleared by the bank on September 14, 2015. The paid to date on the account was updated to October 1, 2015, and denied claim number [redacted] was adjusted for payment on September 22, 2015. The Supervisor called the mother on September 15, 2015, and provided an update on the account, and the mother was satisfied with the outcome.Premium payments are due by the 15th of the month, and are applied to the next month’s coverage. The October 2015, premium was due by September 15, 2015, and the November 2015, premium is due by October 15, 2015, making the October 2015, premium past due.The enrollee’s mother called Highmark on October 7, 2015, and requested to speak with the Supervisor, but the Supervisor was out of the office due to a serious illness. The Supervisor has returned to work, and is in the process of placing a return phone call to address any outstanding concerns the mother may have.On behalf of Highmark, please extend my sincere apology to the enrollee’s mother for any frustration, or dissatisfaction she may have experienced in dealing with our Customer Advocates. Be assured we strive to provide efficient, courteous, and quality service, and are concerned when these standards are not met.I trust this addresses the mother’s concerns. If she has any questions, she can contact Customer Service at [redacted]. Should you have additional questions, please contact me directly.Sincerely,Janice M[redacted]Executive/Legislative Inquiries

Revdex.com Attn: [redacted]Case ID: [redacted] File Number: [redacted]Dear [redacted]:This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.In his complaint, the member states that he has previously been advised by Highmark Customer Service to obtain his vaccinations at [redacted] Pharmacy. He states that he went there and was only approved for his [redacted] vaccine and not for his [redacted]. He further states that he has requested a list of approved pharmacies that are contracted with Highmark for vaccines and has been advised to keep trying different ones.I have reviewed the member’s account, and his claims. I have confirmed in our system that [redacted] pharmacy in [redacted], West Virginia, and [redacted] Pharmacy in [redacted], West Virginia, are both contracted as In Network pharmacies to administer the [redacted] vaccine. I contacted both of these locations and confirmed with the pharmacists that they do in fact submit electronic claims to Highmark for vaccines. Our records indicate that the claims on file for the [redacted] vaccine were submitted by [redacted] Pharmacy on June 3, 2015, and [redacted] Pharmacy on June 5, 2015. Neither of these pharmacies have contracts with Highmark for administration of vaccines. To date, Highmark has not received a claim from [redacted] Pharmacy. The member may go to either of these [redacted] pharmacies and have the vaccine administered, and they will submit the claim to Highmark.Unfortunately, Highmark does not have a printed listing of pharmacies contracted to administer vaccines. Pharmacy participation can change, therefore we recommend that our members call to confirm that the pharmacy they plan to visit is contracted to submit claims for administering the vaccines. Because pharmacy participation for vaccines is a recent change, it is possible that at the time he received his [redacted] vaccine last year that [redacted] was not contracted for vaccines other than the [redacted] vaccine.If you have additional questions, please contact me directly.S[redacted] Appeals Coordinator Phone: [redacted]

May 18, 2016Dear Ms. [redacted],This is the Highmark Blue Cross Blue Shield Delaware response to the customer concern under Revdex.com Case number [redacted].The services the member and his dependent child received on October 16, 2015, were submitted by the network provider as comprehensive...

eye exams, with refractions, and not as routine vision screenings. As indicated on the Summary of Benefits information the member included with his complaint, when received from a network provider, comprehensive eye exams are eligible at eighty percent (80%), after the deductible; routine vision screenings are eligible at one-hundred percent (100%), and the deductible does not apply.The member submitted an appeal related to these allowed charges being applied to his plan deductible and received notification his appeal request was denied, Based upon the procedure codes submitted by the provider, the plan deductible was appropriately applied to these services. The denial letter the member received advised of his Second Level Appeal rights.  However, we have no record of receiving his Second Level Appeal request within the allowed amount of time. Unfortunately, the member has no additional appeal levels available to him related to the processing of these services.Additionally, we are unable to change, alter or delete coding information received from a provider to satisfy individual payment.  According to the claim information submitted by the provider, these services processed correctly according to the terms of the member’s benefit plan. Should our member have any additional questions, a Customer Advocate is available to assist them at [redacted].Sincerely, Ms. L[redacted]Appeals Analyst

April 7, 2017Revdex.com400 Holiday Drive, Suite 220Pittsburgh, PA 15220Attn: [redacted]Case ID: [redacted]Dear Ms. [redacted]This is in response to your inquiry sent to us on behalf of the member identified by Case ID [redacted].Although this member advised she had contacted Highmark West...

Virginia over 25 times to cancel her coverage, please note our records show her first contact to Highmark West Virginia in 2017 was on March 16, 2017. Through investigation, it was determined that she had making her requests to an outside national producer not affiliated with Highmark.Our policy is to cancel coverage the first of the month following notification, which would be April 1, 2017. Currently, our records show an April 1, 2017 cancel date.While I understand she feels she had cancelled her coverage, our records show prescription benefits were utilized in January and February, However, please know that a request to allow a retro cancellation of the policy has been made, but is still pending. The member will be advised once a decision has been made.If the member has any questions concerning this coverage, please have her contact our Customer Service Department at [redacted]. If you have additional questions, please contact me directly. Sincerely, Margueritte M[redacted]Executive Legislative Inquiries

Revdex.com:
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.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]I received a letter asking me to forward the bill to BCBS, which I did.  I will be really happy to close this case as soon as know the bill is paid.
Regards,
[redacted]

The response did not address the concerns for the claim that to date has still not been handled; only spoke about enrollment which had been settled prior to making the complaint. 
Regards,
[redacted]

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. 
Regards,
[redacted]

February 23, 2015[redacted]This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.The member states in his complaint that he contacted the Federally Facilitated Marketplace (FFM) to change his policy for 2015.  Highmark did receive...

an enrollment file to enroll the member into a new policy for 2015, however Highmark did not receive a cancellation file for the member’s 2014 policy.  Based on the fact the Highmark did receive the updated enrollment file, Highmark has cancelled the member’s 2014 policy effective January 1, 2015.  On behalf of Highmark, I apologize for any inconvenience or concerns the member may have experienced due to this matter.  If you have additional questions, please contact me directly.If you have additional questions, please contact me directly. Sincerely, [redacted] Executive/Legislative Inquiries Highmark Inc.----------------------------------------------------------------------------...⇄ 11, 2015This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.The member states in her complaint that she experienced problems when utilizing the pediatric dental benefits included in her health insurance policy.  The member states that she was unable to obtain services and had a pediatric dental claim deny due to this issue.  Our research showed that the problem was related to a billing error that prevented the member’s billing account showing the correct paid to date.  That issue has been corrected and the member’s paid to date is now reflecting the correct date.  All claims that were affected by this issue have been reprocessed per the member’s benefits, including the pediatric dental claim for the date of service December 9, 2014.The member states in her complaint that she was promised a return call from the Customer Service supervisor that was researching the issue for the member, and that this return call was not made.  The supervisor did not make the return call as promised, but noted in her inquiry the call was not made because the member had been advised of the resolution to the issue by a Customer Service representative on January 30, 2015.  The supervisor has been coached on the importance of following up on promised calls to members.  On behalf of Highmark, I apologize for any inconvenience or concerns the member may have experienced.  Please be assured we strive to provide efficient, courteous and quality service and are concerned when these standards are not met. If you have additional questions, please contact me directly. Sincerely, [redacted] Executive/Legislative Inquiries

June 4, 2015 Revdex.com Attn: [redacted] Case ID: [redacted] File Number: [redacted] Dear Ms. [redacted]: This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above. The member stated that the previous response submitted to the Revdex.com did not resolve the complaint. They stated they received a refund for over $200.00 that has not been cashed and need to know if it should be cashed and sent back to Highmark. The member also stated they would like a complete break-down in payments for the entire year. The member also requested information regarding past refund requests that might possibly be pending. According to Highmark’s records, the invoice for June shows a balance due of $510.60. There was a payment applied to the account in the amount of $127.66, after the invoice was generated, bringing the current balance due down to $382.94. If the refund check in the amount of $211.25 is mailed back to Highmark, the total amount due on the account for the June 2015 benefit period is $171.69. The enclosed payment chart is a break-down of all payments received and/or applied to the current policy. The member had a total of three requested refunds on the billing account. Two of the requests were cancelled and the moneys were reapplied to the member’s billing account. The third request was approved and the money mailed to the member in the amount of $211.25. If you have additional questions, please contact me directly. Sincerely, Cassandra M. Appeals Coordinator Phone: [redacted] Enclosures: Payment chart

Dear Mr. [redacted]This letter is in response to your inquiry dated February 18,2015 concerning the delays in claim processing.The expenses in question were initially submitted to us by the customer and were received November 7,2014. On November 22,2014 two claims were processed and denied with an...

explanation of benefit notice (EOB) advising the customer; we are unable to verify that the services were performed by an eligible licensed provider, please have your provider contact Highmark’s Provider Data Service, [redacted], [redacted], phone ###-###-####.On January 6,2015 and February 13, 2015 the expenses in question were submitted to us by the provider’s local Blue Cross Blue Shield Plan of Tennessee. Two claims were processed and paid to the customer on February 13,2015 and February 17,2015,If the customer has any additional questions or concerns about this matter, a Customer Advocate is available to assist them at ###-###-####.If the Revdex.com has any questions or needs additional information, please contactme directly.

June 19, 2015 Revdex.com Attn: [redacted]...

[redacted]
[redacted]  [redacted]                                         ...⇄                                         ...⇄ Case ID: [redacted]                                         ...⇄ File Number: [redacted]     Dear [redacted]: This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above. In the complaint, the member’s husband states that she did not receive a benefit book for her policy after enrolling in the Balance Blue PPO 1000 on April 10, 2015.  He states that they called and requested the books, and were advised she would receive them within a couple of weeks, but they were never received.  Upon review of the account, there was a request made on April 30, 2015 for the Enrollment packet.  However, this request was cancelled in error on May 5, 2015.  I placed a new request in the system today and she should receive the packet within seven to ten business days.  I will follow up with the member to confirm of receipt of the enrollment packet. If you have additional questions, please contact me directly.                                           ...⇄ Sincerely,                                             ...⇄ Linda S[redacted]                                         ...⇄ Appeals Coordinator                                         ...⇄ Phone: [redacted]

Revdex.comAttn: [redacted]Case ID: [redacted]File Number: [redacted]Dear [redacted]:This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.In his complaint, the member states that...

he had made a premium payment in the amount of $302.45 at the end of June, for the July coverage period. He states that he was advised by Highmark that the payment was never received and that his policy was in danger of cancelling. The member would like assurance that the payment has been applied to his policy.I have reviewed the member’s account and have located the payment he made on June 25, 2015, via telephone. There was an error in the processing of the payment, and it was not posted to his policy. The payment has been posted, and the member is now paid to August 1, 2015.There was also a discrepancy in the amount he was being invoiced. The member is eligible for an Advance Premium Tax Credit (APTC) in the amount of $112.00 per month. His invoices for July and August did not include this APTC. This has now been corrected and there will be an adjustment of $224.00 on his next invoice which will generate around August 8, 2015.If you have additional questions, please contact me directly.Linda S[redacted]Appeals CoordinatorPhone: [redacted]

December 31,2015Revdex.com[redacted]Attn: [redacted]Case ID: [redacted]Dear [redacted]:This is in response to your inquiry sent to us on behalf of the member identified in your inquiry by Case ID [redacted] .Our records show a call was place by the...

member’s mother, (herein referred to as the member) on December 16, 2015. Our advocate advised she would have the dedicated advocate assigned to this member return her callThe dedicate advocate was not in the office con December 16, 2015, but attempted to call the member back on December 17, 2015. The advocate left a message that she would try to call her again on Monday, Dec 21 , 2015. During the call between the member and the advocate, it was determined that the member’s check had not cleared her bank, and she was concerned about sending another payment. She wanted the advocated to investigate where the missing payment was, but the member was advised we were unable to investigate the missing check since it had not cleared her bank. She was advised of the Walk-In Center in her area should she decide to make the payment.Please note that the member’s account was place on a hold so it would not terminate. The member is currently paid to December 1,2015; however, once she makes a payment in the amount of $209.00, the account will be paid to March 1, 2016.If the member has any questions concerning this coverage, please have the member contact our Customer Service Department at [redacted] If you have additional questions, please contact me directly.Sincerely, Margueritte M[redacted]Executive/Legislative Inquiries

March 12, 2015Revdex.comAttn: David Baker400 Holiday Drive, Suite 220Pittsburgh, PA  15220 Case ID: [redacted] File Number: [redacted]  Dear Mr. [redacted]This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.This member...

stated in her complaint she enrolled in a health care plan with the Federally Facilitated Marketplace (FFM) in December 2014.  She said that she has had numerous problems since she enrolled, including the inability to receive identification cards and invoices, problems with her billing account, and a misplaced payment.  She stated she has called in repeatedly to address these issues. The member also stated that she has a difficult time reaching Highmark’s Customer Service Department due to long hold times.The member made her initial payment on December 29, 2014, but due to a data entry error the payment did not apply to her account.  Unfortunately, the Social Security Number was entered incorrectly and the payment went into an account for unapplied cash.  Because the payment was not immediately applied to the member’s account, the plan was not able to be activated and since it was not activated the identification cards were not generated.  Subsequently, the misapplied payment caused the account to be cancelled (the binding or initial payment was not applied by the due date).  The member called in January 29, 2015, to verify her payment for January.  The Customer Service Representative (CSR) told the member that her initial payment was not on her account.  The member called back in later that same day and paid the premium for February and she was advised by the CSR that her initial payment was being moved to her account.On February 26, 2015, the member called Highmark Customer Service and questioned why she could not make payments through the member portal website.  The CSR advised the member her account had been cancelled due to the missing payment.  At that time, the CSR requested a reinstatement of the account due to the account being cancelled because of Highmark error.Re: Case ID: [redacted]Page 2On March 3, 2015, the member called Highmark Customer Service questioning the status of her account.  The CSR advised the member they were in the process of having the account reinstated due to issue with the initial (binding) payment.  The member’s policy is currently active, the payment was applied to the member’s account on March 2, 2015, and the paid to date is April 1, 2015.  Our records show she has been sent identification cards and her invoices are being mailed.  Additionally her prescription drug coverage is active.  She was also concerned about the long hold times she has experienced when trying to contact Highmark Customer Service.  Highmark realized that prompt service is important to our customers and while we experienced longer than normal hold times due to the Open Enrollment Period, measures have been taken to provide the prompt, courteous service our customers deserve.  Customer Service lines are open Monday through Friday 8am until 8pm. On behalf of Highmark, I do apologize for the inconvenience the member may have experienced in the enrollment process.  If you have additional questions, please contact me directly. Sincerely, [redacted] Executive/Legislative Inquiries

Revdex.com: 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.Ms. [redacted],  Here are the
documents that I told you that I would send. I am sending you a copy of the
most recent bill in which they tell me I owe $638.27 before 4/30/2015, although I just recently received a check in
the mail (that I have NOT cashed) from them for $211.25 that is dated for
4/17/2015 (the same day that they responded to my complaint). I have also sent
a copy of the payment I made in December that would have made my account
current for January after my overpayment of the old account and the $88.21 payment.
You will see a copy of all the payments that were made this year along with the
extra payment that I made on 1/16/2015 of $83.51 that they told me I had to
make so my account wouldn't be shut off but it was anyways (account has been
shut off twice now). If you need anymore from me let me know. Thank you.Sincerely,[redacted]Ms [redacted],The resolution that I am wanting from this is to make sure
my account is "right". My account has been shut off twice now for
"non-payment" when it was Highmarks mistake but they want me to wait
weeks for them to fix it while I have to pay out of pocket for things like
prescriptions and then I have to go back through everything to rebill it once
they do have it "fixed".This $211.25 check that was sent to me should never have
been sent out. That money should have been taken from the old account and been
moved to the new one.The refund that I was requesting was the $83.51 payment
that I made on 1-16-2015 that one of their representatives told me I
"had" to make that day in order to make my account current because my
money wasn't all moved from the old account and my new account would be shut
off if I didn't make it. The new account was shut off anyways. So this $83.51
was an extra payment that was made for really no reason since my account was
shut off anyways.I make two payments to Highmark a month to pay the premium,
one on the 13th and one on the 27th. January payments pays February premium,
February payments pays March premium and so on. These payments come out of my
banking account via automatic electronic transfer to Highmark. When I call to
talk to a representative and they tell me that I owe money for May's premium
but it isn't even April yet then that concerns me, because obviously I will
always owe money. As far as I know you don't pay two months in advance.I really don't think that since I am a paying customer that
is in good paying history that I should have to go through all this grief or
hassle. I pay these premiums, not the company I work for or even my husband.
This company that I am paying to provide me a service can't even get the
billing straight. Thank you for your time.Sincerely,[redacted]

June 13, 2016Revdex.comAttn: [redacted]Case ID: [redacted]File Number: [redacted]Dear Ms. [redacted]:This is in response to your inquiry sent to us bn behalf of member identified by the Case ID number noted above.In her complaint, the...

member stated Highmark has not made it easy for her to make the monthly premium payments on time. She stated that Highmark did not send her invoices for the first three months of 2016. The member stated she has called Highmark every month to make her payments. In April 2016. her policy was cancelled due to a Highmark system error and it took Highmark three weeks to reinstate the policy. The member stated she set up automatic payments and was over charged in June. She stated Highmark cancelled the overpayment without asking her and she does not know if her family has insurance coverage now. The member stated she was advised by Highmark that she cannot make another payment until an invoice has generated, which will not be until the end of June. She stated they cannot get their prescriptions and that they will how be going another month wondering if they have insurance or not.The member has active coverage with an effective date of January 1, 2016. Highmark has sent out invoices to the member each month. She made her May premium and then set op the reoccurring payments through the Highmark member portal. When members set up reoccurring payments the payment that is taken reflects the amount on the invoice. The double payment of $1,166.42 was taken because her May premium payment posted to her account one day after the invoice for June was generated. Therefore, the amount due on her invoice showed a total of $1,166.42 due for May and June.On May 31, 2016, the member contacted Highmark to find out why there was a double payment taken and if anything needed to be done so this would not happen again. The Customer Service Advocate (CSA) advised the member why the double payment was taken and the best way to correct the overpayment would be to refund the payment of $1,166.42. Once the refund was requested she was advised to make a payment of $583.21 for June. She stated she did not want to be refunded. However, the CSA requested the refund before confirming this. The CSA advised the member the refund had already been submitted and could not be reversed.The member agreed to continue with what she had been advised and was willing to make the payment for June. The CSA did not verify if there was a payable invoice to take a payment and she was not able to make the payment. The CSA advised her that she does have a 90 day grace period, so her claims will still pay and she will still be able to pick up her prescriptions. Staff education has been provided to the CSA.The member’s credit card has been refunded. However, the invoice for July does not show this. The invoices should show the update with the next billing cycle, but this can take up to two billing cycles to reflect the corrected amounts. I will continue to monitor the member’s account to verify no other issue arise. She currently is paid to June 1, 2016, and owes $583.12 for June.On behalf of Highmark, I apologize for any anxiety or inconvenience this issue may have caused. If you have additional questions, please contact me directly.Sincerely,Michelle D[redacted]Appeals CoordinatorPhone: [redacted]

Member: [redacted]Group Number: [redacted]Revdex.com of Western Pennsylvania[redacted]Dear Ms. [redacted]:This letter is in response to your inquiry that was received at Freedom Blue PPO on February 18, 2016 regarding complaint ID #[redacted].Ms. [redacted]...

[redacted] is filing a complaint against Freedom Blue PPO regarding her premium payments. She states she sent in a payment for January that was never applied to her account, and her invoicing indicates she is one month in arrears.I have investigated this issue and found that there was a payment received on December 11, 2015 via check # [redacted] in the amount of $279.50 that was misapplied to another member’s account. This other member did not have an active policy, and so the payment was refunded to that member in error. The amount of $279.50 in lieu of this payment has been removed from the balance of Ms. [redacted]’s account on February 25, 2016. Her account now reflects credit for this payment as well as two additional payments: one in the amount of $559.00 received February 5, 2016 and one in the amount of $279.50 received February 23, 2016. Ms. [redacted]’s account is paid through March 31, 2016 as of the writing of this response.I apologize for any confusion this issue has caused. If Ms. [redacted] has any additional questions or concerns, she may contact a Freedom Blue PPO Customer Service Representative at [redacted] Monday through Sunday 8:00 a.m. to 8:00 p.m.Sincerely,Jennifer B.CMS Complaint Specialist

January 21, 2016Revdex.comAttn: [redacted] Case ID: [redacted] File Number: [redacted]  Dear [redacted]:This is in response to your inquiry sent to us on behalf of member identified by the Case ID number noted above.In his...

complaint, the member states that his wife’s health insurer is not allowing her to pick up her prescription.  He states that she is out of medication, and needs the prescription badly.  He states that his wife has been on this medication for several years and wants the prescription filled now. Upon review of the member’s account, the Highmark policy ended effective January 1, 2016.  Highmark contacted the member via telephone on January 8, 2016, and the member stated she enrolled in coverage through [redacted] Health plan for the 2016 benefit period.  Member was advised that if she is having difficulty filling her prescription at this time, they will need to contact the new health insurer.  The member and her husband explained that they had filed the complaint due to the difficulty in filling her medication during the month of December.  The medication that the member was prescribed, required a prior authorization.  She attempted to fill the medication on December 22, 2015, at which time she was advised the physician would need to submit a request for authorization.  The request was received on December 23, 2015.  On December 28, 2015, a call was placed to the physician to obtain additional information pertaining to the request.  Once this was received, the authorization was approved on December 30, 2015.  The member received her medication, delivered via FedEx on December 31, 2015. If you have additional questions, please contact me directly. Sincerely, Linda S[redacted]. Executive/Legislative Inquiries Phone: [redacted]