Hometown Health Plan, Inc.

Hometown Health states on their phone calls they are Fast and Effective, which are both incorrect statement. They should not be allowed to say this because it is a LIE.I am a Hometown Health member and have met my out of pocket deductible for the year for out of plan providers. My first claim I faxed over 21 pages and they conveniently lost it 2 times. Then they failed to pay me the correct amount so I almost had to appeal it, but when I complaint they did send me more but they still Ripped me off for the right amount I was due. The doctor gave me an itemized bill and they had already subtracted what HH would pay, but then they started to deduct all these other cost which was correct because they were an Out of Plan provider and they didn't have a Contracted Amount with HH.That was my 1st claim, now I have an issue with my 2nd claim, which I sent certified mail and they received on December 14, 2015. I called every week to make sure they had it and where processing it because they are incompetent as an agency. I talked with [redacted] a supervisor who stated she would look into it.However, in the middle of Jan 2016 she called me and said they didn't have all the information they needed and the account number was wrong. HOWEVER, THEY PAID ON THE SAME EXACT PAPER WORK AS I SUBMITTED ON MY 1ST CLAIM BUT NOW THEY HAVE A PROBLEM WITH IT. So I went to my dr. the next day got all the new paper work submitted it on Jan. 22, 2016 and as of today Feb 11,2016 I still have not been paid on my claim. I have called every week and in the beginning of this week a rep said they still had not put it into the system. THEY ARE INCOMPETENT AND SHOULD NOT BE ALLOWED TO TREAT CUSTOMERS THIS WAY. IT HAS BEEN ALMOST 2 MONTHS SINCE I SUBMITTED MY CLAIM. I have called [redacted] and left several messages and she has never returned my Call. When will I get paid and WILL IT BE FOR THE FULL AMOUNT WHICH IS DUE TO ME. I AM FILING A COMPLAINT BECAUSE I BELIEVE THEY WILL TRY TO RIP ME OFF LIKE THEY DID THE FIRST TIME.Account_Number: [redacted]Desired SettlementI would like to be paid, and paid for the Full Amount which I am due. They think they can treat people this way and someone needs to look into how they due business.They are rude and incompetent and shouldn't even be allowed to be in business as all they care about is there money and NOT THEIR CUSTOMERS THAT IS FOR SURE!!!!

I had several strokes and was transferred from Renown Hospital to [redacted] after some time. I was admitted 12/12/2014 and discharged 1/29/2015. Initially I needed more physical help and wanted to get more help but after a point in time I just wanted to be released I went to their Customer Service but was not allowed earlier release by [redacted] no real reason was given ... We had been making payments on the bill and on 7/8/15 our balance was $28.12 per [redacted] invoice. This amount was fully paid on 8/3/15, resulting in a zero balance. Unexpectedly in late Dec 2015 we got a bill from [redacted] with no details claiming we still owed over $900 (around $984, I think). I called, spoke to [redacted] of Collections, and told her we fully paid and owe nothing more. She said that's what she thought also but [redacted] is belatedly claiming that I owe that. No details were given. I called [redacted] Plus, explained the situation, and was told to send a letter of Appeal in late December 2015. I did that, enclosing [redacted] invoice, indicating we were fully paid...and asking why we were being billed again for something that was paid. In January 2016 Madison of [redacted] Plus called me and assured me I had a zero balance and need not worry.I informed [redacted] of this by email. Then in Jan 14, 2016 I got an email form [redacted] stating (again without details) that [redacted] (through a lady named[redacted]) FALSELY CLAIMED that I was contacted on 1/8/16 and told my balance had jumped to over $1400..and that they never got my appeal letter). That call never happened!!! [redacted] then asked if she could bill me for the unsubstantiated amount. OF COURSE NOT!!! Please help me.Desired SettlementReturn my bill to zero balance and eliminated this unexpected belated unsubstantiated bill which zumped from Zero in 8/2015 to $984 in Dec 2015 and over $1400 in jan 2016 (all WITHOUT documentation or proof..!!!!!)Business Response Senior Care Plus Customer Service has had mutliple discussions with this member where it was identified that the claim was initially processed incorrectly. The charges in questions were resolved when the claim was reprocessed to aplly to the correct plan year benefits. Since this was resolved, Senior Care Plus has had mulriple conversations with member in regards to other questions and inquiries.

I have called Senior Care Plus (part of Hometown Health) twice to be removed from their mailing list. This mail is being sent to my maiden name, [redacted]. It has been 2 to 3 months since I called them. Last week I received another ad from them. I called again today. [redacted] told me she could take my info down, which is what they did the first 2 times I called. I tried to speak with someone from marketing (apparently not possible)and to [redacted] supervisor (who is on vacation and who [redacted] assured me would do exactly what she would) This program is for medicare, I am 36. What can I do to end this harassment and total waste of resources? Thank you for your time and help.Desired SettlementThe settlement I desire is to never ever receive mail from hometown health or senior care plus. Business Response [redacted],We apologize for the incorrect fliers you have been receiving in the mail. We have removed all of your information from our mailing lists to remediate this. Please accept our apologies and you should no longer receive any mail from us. Thank you.