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 do not accept Univera's standard template response to my issue. The letter received states "Benefits will be provided in accordance with the contract in effect at the time services were rendered." This is incorrect. Had the Univera "Advocacy Associate" looked into my records, it would have been evident that I was given incorrect information regarding my benefits on separate occasions, and that Univera has since admitted their fault in this and has agreed to pay the out of network charges for the Mayo Clinic as in-network since this is what I was told on multiple calls to confirm coverage It took Univera over a month to review those calls and admit that it is their responsibility to pay those charges based on the incorrect information given by their associates. It has been months now of Univera continuing to process these claims incorrectly, and of me having to follow up with HOURS of phone calls to Univera to correct this. On top of this, Mayo Clinic confirmed to me that they had not heard from Univera since June, although I was promised by multiple associates that Mayo Clinic would be contacted to advise that the account billing be put on hold while they resolved the claim processing issue. Recently I was advised that Univera contacted Mayo Clinic possibly late last week, but I have yet to confirm this with the Clinic.This is not only extremely stressful, but time consuming, and potentially harmful to my credit as well. The absolute lack of any type of ownership on the part of the Univera representatives I have spoken with over the last months, and the template response which shows that even Univera's "Advocacy Associate" can't be bothered to take charge of resolving this issue is astounding. Never have I had such blatant disregard directed at me as a "valued" client
Regards,
*** ***
Dear Ms. [redacted]Point of Service (POS)[redacted]April 13, 2015 to April 24, 2015Out of Network ProviderThis letter is in response to your inquiry concerning the above referenced service. Upon researching this case it was found that the claims in question are...
being adjusted to pay the provider at charge. Benefits will be provided in accordance with the contract in effect at the time services were rendered. Therefore, there is no need for a grievance at this time. We are sorry that you had such problems with this and we are glad that it has now been resolved in your favor. Should you have any further questions please contact Customer Service at [redacted]
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 do not accept Univera's standard template response to my issue. The letter received states "Benefits will be provided in accordance with the contract in effect at the time services were rendered." This is incorrect. Had the Univera "Advocacy Associate" looked into my records, it would have been evident that I was given incorrect information regarding my benefits on separate occasions, and that Univera has since admitted their fault in this and has agreed to pay the out of network charges for the Mayo Clinic as in-network since this is what I was told on multiple calls to confirm coverage It took Univera over a month to review those calls and admit that it is their responsibility to pay those charges based on the incorrect information given by their associates. It has been months now of Univera continuing to process these claims incorrectly, and of me having to follow up with HOURS of phone calls to Univera to correct this. On top of this, Mayo Clinic confirmed to me that they had not heard from Univera since June, although I was promised by multiple associates that Mayo Clinic would be contacted to advise that the account billing be put on hold while they resolved the claim processing issue. Recently I was advised that Univera contacted Mayo Clinic possibly late last week, but I have yet to confirm this with the Clinic.This is not only extremely stressful, but time consuming, and potentially harmful to my credit as well. The absolute lack of any type of ownership on the part of the Univera representatives I have spoken with over the last months, and the template response which shows that even Univera's "Advocacy Associate" can't be bothered to take charge of resolving this issue is astounding. Never have I had such blatant disregard directed at me as a "valued" client
Regards,
*** ***
Dear Ms. [redacted]Point of Service (POS)[redacted]April 13, 2015 to April 24, 2015Out of Network ProviderThis letter is in response to your inquiry concerning the above referenced service. Upon researching this case it was found that the claims in question are...
being adjusted to pay the provider at charge. Benefits will be provided in accordance with the contract in effect at the time services were rendered. Therefore, there is no need for a grievance at this time. We are sorry that you had such problems with this and we are glad that it has now been resolved in your favor. Should you have any further questions please contact Customer Service at [redacted]