Independence Blue Cross

December 9, [redacted] Revdex.com Metro Washington, DC and Eastern Pennsylvania K StNW, 10th Floor Washington, DC 20005- Re: [redacted] Complaint ID#: [redacted] Dear [redacted] : I am writing in response to your follinquiry regarding [redacted] The purpose of this letter is to inform your office that we have applied the payment in the amount of $1,to [redacted] ’s account The matter at hand In his original complaint to your office, [redacted] stated that, “Independence Blue Cross has failed to credit my account in the amount of $1,since July 2014.Although the company has received the above funds, they posted it to someone else’s accountI have sent them proof of payment times, and it still is not being resolvedMy most recent inquiry did not result in the credit being appliedI have been told a supervisor will call me but they do notI receive late notices and letters saying my account may be cancelledThe level of incompetence there is alarming.” In our November 7, response, we indicated that our records did not reflect that he was entitled to a premium credit of $1, Due to your most recent inquiry, we took a second look at [redacted] ’s concern about his account and discovered that we did in fact receive his check, number for $1, 132.82; however, we applied it to an incorrect accountWe transferred the payment from the erroneous account and applied it to [redacted] ’s account on November 5, As of today, [redacted] ’s balance is $1,132.82, which represents the December monthly premium [redacted] , we appreciate the opportunity to address [redacted] ’s concernIf you have additional concerns regarding this matter, please feel free to contact me via email at [redacted] .I will be pleased to assist you Sincerely, Rafael *D***, Specialist Executive Inquiries Department

December 4, Dear [redacted] ***Our Supervisor of the Executive Inquiries Department, Detra D [redacted] , has requested that l acknowledge your recent correspondence regarding [redacted] The purpose of this letter is to provide your office with an authorization form.The federal Health Insurance Portability and Accountability Act, known as the HIPA Privacy rule requires that we obtain an individual's written approval before using or disclosing his her protected health information (PHI) for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable lawThe written approval, called an authorization must contain certain required elements for us to consider it valid under the HIPAA Privacy ruleAs such, we have enclosed an authorization form so that [redacted] could complete the form naming you and your office as an authorized recipient of her PHI so that we can provide your office with our response upon the conclusion of our investigation [redacted] ***, should you have any additional questions, regarding this matter, please contact me at ###-###-#### and I will be glad to assist youSincerely , Rafael DLead Client Services Representative Executive Inquiries Department

Dear Ms***, I am writing in receipt of Mr [redacted] 's complaintIn order to provide your office with a copy of our findings a completed HIPAA authorization form is required Please provide our office with the completed authorization formOnce received we will be able to share our findings with your office If you have any questions, please feel free to contact me at ###-###-####I will be happy to assist you Sincerely, Sylvia B***, Specialist Executive Inquiries

[redacted] -- Attached is an authorization for you to provide to the member so that we can share our findings with your offcieIf we don not receive it, we will respond directly to the member [redacted] Executive Inquiries Specialist [redacted] ***Philadelphia, PA 19103P ###-###-#### x*** | F ###-###-####

I am writing in response to the May 2, 2016, letter to Detra Davidson-Stewart on behalf of Mr [redacted] Your complaint was received in our office on May 9, 2016, and concerns his enrollment and billing activity for the January, February, and March coverage periods.As you are aware, the federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information or PHIWhile our records indicate that there is no authorization for you to receive this member's PHI, we want you to know that we have reviewed Mr [redacted] 's March 18, 2016, complaint to your officeIt was identified that we previously resolved this matter on March 22, 2016, and currently consider it closed.Ms***, we appreciate your bringing Mr [redacted] 's matter to our attentionIf you have any additional questions, please do not hesitate to contact me at ###-###-####I will be glad to assist you.Sincerely,Tedra F [redacted] Lead Client Services Representative Executive Inquiries

Dear [redacted] : I am writing in response to case number [redacted] , for [redacted] *** We spoke with [redacted] on August 5, 2014, about her concernsShe has decided to remain in the plan she chose with usShe is aware that once her payment is applied to her account, her identification card will be issued to her Thank you for bring [redacted] ***' concern to our attentionif you have any questions, please contact me at ###-###-####I willbe glad to assist you sincerely, Scott Y [redacted] Executive Inquiries

[redacted] , size="3"> Per our email exchange on yesterday We do not have a HIPAA authorization on file from [redacted] (file# [redacted] ) to release the details to you about her concernsHowever, I can tell you that my team member, [redacted] , spoke with ** [redacted] on 4/11/** [redacted] is in an appeal process with our organization about the service she has requestedIn fact, it is at the third level appeal review with an external review organization, which should be completed around 4/23/** [redacted] has advised that she does not want us to send her anything in writing until that review is completed Let me know if you have any questions [redacted] Manager Customer ServiceMarket Street, Mails SG2Philadelphia, PA 19103P ###-###-#### x [redacted] | F ###-###-#### [redacted]

To: [redacted] Helvetica;">The Revdex.comMy complaint has been resolved We received the refund owed to us I wish the company would see my complaint and perhaps realize that returning customers call would allay frustrations Thank you for your help[redacted] Sent from [redacted] Mobile App

Great, you got insurance, and now you want to use it, right? WrongUnless you are looking for a general practitioner, you will have to call around blindly hoping to find the specialist that will accept your insuranceIndependence Blue Cross's website is awful, every specialist I was trying to get "could not be found" in either of the zip codes I triedI tried to submit a help request to me, and got a shady email asking for personal information without any links or contact information (so for all I knew it could very well be a scammer)There was no recourse for contacting themI've given up using their serviceLuckily I am changing jobs soon who will have a different provider, because I was getting absolutely nothing from IBXConstant back pain and digestive problems and no specialists within their networkIt is absolutely ridiculousThey even consider a molar implant to be "cosmetic", so now I can't chew food on the right side of my mouth without destroying my gumsIf you were unlucky enough to get IBX as your insurance provider, be prepared to work extra hard to find doctors, and be prepared for them to shaft you on any care you need with the exception of regular checkupsWorst insurance company ever

Complaint ID: [redacted] Complainant: [redacted] Dear Sir/Madame, We are in receipt of your July 9, 2014, communication that includes ***'s rejection of your response and additional comments about his past experience with us We acknowledge that we could have handled ***'s past inquiries in a timelier manner and are truly sorry for the fustration we caused himPlease be assured that we have addressed his previous inquiries mentioned in his comments As part of our investigation(s) we troubleshoot any identifiable system errors, determine the root cause and remedy itWe review the telephone calls for quality assurance and training purposes, and if warranted, we coach/educate our representatives to ensure that they are consistently providing quality customer service to our members Lastly, ** [redacted] can be assured that key members of our leadership team are aware of his experience with us Still, I am closely monitoring the progress of his initial filing and will contact him once it has been resolved I hope that this information helpful Sincerely, [redacted] SpecialistExecutive Inquiries

Good Morning: I am issuing a response directly to [redacted] , in this case as we do not have authorization to disclose his protected health information to your officeIf you have any questions, please contact me at ###-###-####I will be glad to assist you sincerely, Scott Y***, Specialist Executive Inquiries

I am writing to acknowledge and respond to your February 16, 2016, email to Detra D [redacted] , Supervisor of the Executive Inquiries Department You contacted MsD [redacted] , on behalf of [redacted] , who contacted the Revdex.com (Revdex.com) regarding a copayment amount we applied to her son’s claimWe received the Authorization to Release Information form that accompanied your inquiryUnfortunately, upon review, we determined that the form has not been completed correctly [redacted] signed under both the Member Signature and the Personal Representative Information fieldsSince the Personal Representative Information field should only be signed when an individual has been designated by the member to be their personal representative, [redacted] only needed to sign under the Member Signature fieldHaving signed both fields has rendered the document invalid, and we are unable to disclose the member’s protected health information to you under the federal Health Insurance Portability and Accountability Act, known as HIPAA I can tell you that prior to receiving your inquiry, this matter was presented to our plan by the Pennsylvania Insurance Department, and has been reviewed and resolvedRather than delay our reply, please be advised that we have corresponded our findings directly to [redacted] [redacted] ***, we thank you for bringing this matter to our attentionSincerely, Yvonne P [redacted] , Lead Client Services RepresentativeExecutive Inquiries

Thank you for your response, enclosed is an attachment with the completed HIPPA formPlease let me know if there is anything else you need to resolve this issueThanks Best Regards, [redacted]

[redacted] ***, Good afternoon I am writing to acknowledge our receipt of the concerns for [redacted] under complaint # [redacted] I will be handling the review and response to the concerns presentedIn accordance with the Health Information Portability and Accountability Act (HIPAA), we can not release protected health information (PHI) to any recipient without the member's consent/authorizationI will fax the HIPAA Authorization Form to your attention so that [redacted] can complete and return to my attention naming you and the Revdex.com of PA/DC as authorized recipient of his PHI in this matter Regards, Rafael *D [redacted] Specialist, Executive Inquiries Department Independence Blue Cross ###-###-####

Dear ** [redacted] , Thank you for contacting our office on behalf of ** [redacted] ***We checked our records and we were unable to identify him as one of our membersPlease contact ** [redacted] to verify his coverageIt is possible that he is enrolled in another plan If you find that this information is incorrect please provide his member identification numberOnce received we can investigate his concerns Thank you for contacting our office Sincerey, [redacted] ***, Specialist Executive Inquiries

Good afternoon I am writing to acknowledge the complaint under file # [redacted] We have commenced a review into the matter presented and will present our response upon the conclusion of our review Regards, Rafael *D [redacted] Specialist, Executive Inquiries Department Independence Blue Cross

Good Morning, Member's account is reinstated and he was able to obtain his prescripton drug purhaseI am waiting for information from our Billing Department to complete my response letter If you have any questions, please contact me at ###-###-#### Sincereley, Sylvia B***, Specialist Executive Inquiries

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted] I am rejecting this response because: Again, I do not have [redacted] insurance (I am not sure why this error has been so persistent)My claim was submitted under the [redacted] PPO (ID [redacted] ), for which the copy for a [redacted] provider should be $As IBX repeatedly has pointed out, [redacted] Hospital is a [redacted] providerTherefore my copay should be $once IBX understands that I have a [redacted] PPO plan and DO NOT have [redacted] as my primary insurance In addition, MrY [redacted] continues to fail to return any of my calls regarding this issue to try to resolve the matter outside of the Revdex.com, which I find to be disappointing and unprofessional behavior Regards, [redacted]

Re: [redacted] Dear [redacted] : I am writing to acknowledge our receipt of your June 26, 2014, correspondence to Detra D [redacted] , Manager of the Executive Inquiries DepartmentWe appreciate your writing to alert us to your concern(s) In order to fully address the concerns you have presented, additional research is necessaryI have forwarded your correspondence to the appropriate liaison for further review However, as you may be aware, the federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable lawThe written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule Our records indicate that there is no authorization for you to receive this member’s PHIAs a result, we cannot disclose any information regarding our memberWe ask that you have [redacted] complete the attached Authorization to Release Information formIn order for the form to be considered valid, all sections of the document must be completedShould [redacted] require assistance, instructions for the completion of the form are located on the back of the documentPlease return the completed document to us via email as a PDF [redacted] , should we complete our review before the completed form is received, we will be required to correspond our findings directly to [redacted] Thank you for bringing this matter to our attention and for the opportunity to address her concerns Sincerely, Yvonne *P [redacted] , Specialist Executive Inquiries Attachment

[A default letter is provided here which indicates your acceptance of the business's response If you wish, you may update it before sending it.] 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 Providing that they actually follow through with the refund Time will tell Regards, Shannon Y [redacted] Specialist Executive Inquiries