Kentucky Health Cooperative, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***
Kentucky Health Cooperative has not provided any health insurance services to us, has made no payments to our providers, has been unable to resolve the problem of recognizing ONLY my husband as a member, and has improperly terminated us for non-payment per Kynect. Due to these issues we submitted a written request to KYHC, on 6/15/15, for an immediate refund of the $1,premium payment we made on 2/19/15. Our check was cashed by KYHC on 2/25/15.
Once our premium payment is refunded we will consider our complaint resolved

I should have reviewed these guys before signing up They are absolutely worthless Their billing practices are criminal They do not send out bills or notices, but they will jack up prices and terminate you with no warning Their website payment system is a joke Good luck setting up automatic payments; they either lose the paperwork (that you have to submit thru snail mail, not the website) or they simply don't use the information, then cancel your account for non-payment Avoid getting sucked into this scam like I did

The refund is going out as soon as all information with kynect and the federal hub is verified for the funds to be released

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***
Kentucky Health Cooperative has not provided any health insurance services to us, has made no payments to our providers, has been unable to resolve the problem of recognizing ONLY my husband as a member, and has improperly terminated us for non-payment per Kynect. Due to these issues we submitted a written request to KYHC, on 6/15/15, for an immediate refund of the $1,premium payment we made on 2/19/15. Our check was cashed by KYHC on 2/25/15.
Once our premium payment is refunded we will consider our complaint resolved

This is my second complaint with this companyI have several outstanding health insurance claims from last year that are "still being processed" I've called at least 10+ times to have my claims processed and they keep telling me daysWell it's been almost a year for some of my claims and they still haven't picked up their partI have claims in July, August and November that have not been resolvedI also have a claim from October which they billed as out of network, which it was notAnd they only picked up 50% when they should have picked up 90%I called several times regarding this and once again nothing has happenedI'm sick of dealing with this company, it's a continuous headacheI do not wish to deal with this company anymore, but until they do what I paid them to do, I have no choiceI want this resolved and out of my hair!!!
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Desired Resolution / Outcome
Desired Resolution:
Finish the Job
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Desired Outcome:
I want them to process all of my claims from last year and the right waySo that I do not have to deal with them again

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Kentucky Health Cooperative provided lie but nothing elseI started to call them to cancel my insurance in JulyAnd each time when I call to cancel they just tell me it takes days to cancelAlso they didn't send me confirmation on cancelation, just gave me reference numbers what is nothing. Every single time just LIED.I have all confirmation numbers when I called to resolve their issues and lately they were very unpleasant I spoke few times to supervisor Lisa, she knows exactly amount what they own me. Every time they needed to sign something, approve something, again and again days waiting periodThey own me $and I want my money back
Regards,
*** ***

This is the second review I will be posting Stay away from this company, unless it's your only option Your inquiries go unheeded, your appeals are not processed, they repeatedly make the same mistakes in claims over and over You check to make sure you are going to one of their providers and they still don't pay your claim, they will apply it to out of network calendar year deductible or file it as if you had something done in the physicians office that goes toward your out of pocket You go for a routine exam, they process it wrong You can bring a potential problem to their attention, and as is usual , they will ignore it Their any day is days or longer They tell you they will call you back, they don't My opinion is they are trying to wear you down so you don't appeal I have paid doctor's offices so we can keep those doctors simply because this company doesn't pay properly and as we are dealing with the big C, we need these people I have contacted the DOI numerous times, but that gets very old and takes a lot of time I don't have We are going to talk to our doctors who don't take BCBS on our next visit, if they can't give us an idea of when they will accept the new on and off exchange coverage, we will be searching for new physicians, simply to avoid using this company in the future Sadly, this is what is happening everywhere The statement if you like your doctor, you can keep your doctor is a bare faced lie

I had coverage through this company only to be ultimately dropped after not being informed I didn't provide enough information about how much money I madeI paid months of premiums before finding out I was droppedThe company owes me $and some change and I haven't even received a call backThe customer service is very rude and disrespectful and the only reason I applied is because I didn't want to pay the fine for not having insuranceI'd rather have the coverage because I'm currently sick and can't go to a doctor with no insuranceThis issue has been going on for months and all I'm asking for is my money back

A review of the complaint and claim in question show that the claim was processed and paid on 5/6/15.  We apologize for the delay in processing the claim and for the member's inconvenience.

Complainant state that matter has been resolved.

Ms. [redacted] claim was originally denied due to a COB record that came over from kynect on her original enrollment file indicating she had other insurance coverage. We have since verified she does not and a claims supervisor was instructed on June 17, 2015 to reprocess the claim. However, that claim...

will be processed using the diagnosis code that was submitted on the claim by her provider. That diagnosis code does not reflect a procedure that should have been processed as preventive and paid at 100% as mandated by the Affordable Care Act. Ms. [redacted] was advised of the incorrect coding for this claim when she contacted N. Hicks of our call center at 8:47 a.m. on April 24, 2015. She was informed of the miscoding of the claim at that time as well as the fact that the miscoding was the reason why the claim was adjudicated in the manner it was. Ms. [redacted] was also advised during the same call that she could contact the provider and ask that they resubmit the claim with the correct code. As of today, no resubmitted claim has been received from her provider.

This "business" cancelled my insurance at the end of 2014 for no reason. I started talking with them in late December to get January insurance, after a week of hemming and hawing, they said they could not give me insurance until February, 2015. I paid for Feb insurance in early January and waited. In early February, they said my insurance was good. On Feb 16th, I tried to get a prescription filled and was told the insurance wasn't active. This company said that I owed additional money - they had billed me for 2 months of insurance and said insurance wasn't good until it all was paid. They refused to give me a refund on the time that they had not given me insurance. Their policies and customer service are ridiculous.

I purchased insurance through this company through KYNECT in October 2014. I went through a nightmare. Coverage, no coverage, picked one plan got another due to false information on website, which KYNECT & KHCC would not take responsibility for. Even though it was not my fault they would not go back to January 1 with the correction (maybe because of an expensive test my husband had to have). Because one of our doctors we HAVE to see doesn't take BCBS unless it's a grandfathered plan, we had to go with this company again. First it was no access to our files on their website, then wrong date of birth on my husband when picking up prescriptions, Pro-Care (the pharmacy side of this plan are totally useless) it's always someone at the pharmacy putting in wrong info, my husbands file has another person of the same name attached to our plan in the "system" they won't approve a very much needed test without paperwork being filed which can take 14 days. They file claims in duplicate, they file claims wrong, you make calls and nothing happens. Stay away from this insurance company unless it's your last resort. File a report with the Department of Insurance each and every time they make a mistake. (My agent advised me to do this on each complaint separately) Revdex.com cannot help with this. Contact DOI first, you can file the complaint online. KYNECT is useless as well, get them involved and you will find yourself in a huge mess. They can screw things up but somehow only a "supervisor" can fix it, and good luck with that! Follow the directives of the DOI, they at least do an excellent job in assisting with problems. Be mindful they can't do anything with KYNECT, only our governor has control over them. (Very scary, as he's touting what a great job KYNECT does)

Revdex.com:
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.Kentucky Health Cooperative provided lie but nothing else. I started to call them to cancel my insurance in July. And each time when I call to cancel they just tell me it takes 28 days to cancel. Also they didn't send me confirmation on cancelation, just gave me reference numbers what is nothing. Every single time just LIED.I have all confirmation numbers when I called to resolve their issues and lately they were very unpleasant . I spoke few times to supervisor Lisa, she knows exactly amount what they own me. Every time they needed to sign something, approve something, again and again 28 days waiting period. They own me $430.08 and I want my money back.
Regards,
[redacted]

Revdex.com:
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.
[Yes I would like my money back, but telling me that it would be mailed out soon has no meaning whatsoever to me. I've been told since the beginning of March that the money will be mailed to me any day now. Well, it's been over a month and I am tired of hearing any day now. If I had submitted a late insurance payment to your company, I would have already been canceled. What I want to hear is, I am so sorry for your inconvenience, the payment is being sent in the mail TODAY (4/16/15). ]
Regards,
[redacted]
 
 
 
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My best advice, simply put, read the reviews- these people are practically criminals. I have never heard of company with such poor ethics and policies. It is true, this "cooperative" should not even be an option in the health insurance marketplace and its practices are more than disgraceful.

I did check to see if we had followed up and we had.  We believe Ms. [redacted]' complaint to be resolved at this time.

KYHC Response to complaint from Mr. [redacted]:
 
KYHC agreed that the dependent could be added back to the date...

of birth based on meeting special enrollment provisions, however, Kynect needed to generate a transaction and send to KYHC to make the member retroactively eligible for coverage.  While KYHC approved the policy, limitations in Kynect would not allow them to send the appropriate transaction to add the dependent to the KYHC policy with a retroactive effective date all the way back to May 28, 2014 (according to Kynect).  According to Kynect, system changes were held during the period of passive enrollment.  Subsequently, the system fix was made and KYHC received the needed transaction from Kynect.  The dependent is now showing effective retroactive to May 28, 2014.

Re: [redacted], complaint #[redacted] - requested refund of $125.16 was processed as paid on 7/15/2015.

Thanks
Revdex.com:
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 for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
 
 
 
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