Land of Lincoln Health

Revdex.com Chicago & Northern Illinois [redacted] Chicago, IL RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding two claim issues LLH has reviewed the claims in question: Date of service 9/9/2015, billed charges of $243, claim ending in - [redacted] processed as in-network Date of service 9/23/2015, billed charges of $1,009, claim ending in [redacted] , processed as out-of-network Based on the information submitted by the provider, both claims paid out correctly with the provider’s associated Tax ID and National Provider ID numbers In order for the 9/date of service claim to be paid as preferred, the provider will need to submit an updated claim using his alternate Tax ID number ending in [redacted] In order for the 9/date of service claim to be paid as preferred, the provider will need to submit an updated claim using his alternate Tax ID number ending in [redacted] with provider [redacted] not [redacted] Ltd If the provider is unwilling to make these changes, the member will need to file a verbal appeal by contacting LLH Member Services at [redacted] Best Regards, Land of Lincoln Health

Revdex.com of Chicago & Northern Illinois [redacted] RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding a refund and balance inquiry Please reference the attached payment and invoice history provided by the LLH Finance Department detailing all transactions for this member’s accountInformation is separated into two tabs, “Invoices Due” and “Payments & Tax Credits.” The member’s account has a $balance at this time Best Regards, Land of Lincoln Health

Revdex.com Chicago & Northern Illinois Lower Wabash Ave Chicago, IL RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received Revdex.com case [redacted] regarding claim and pharmacy issues We are able to provide the following update on the claims in question: [redacted] - claim has been reprocessed with $patient responsibility [redacted] - an appeal for this claim has been received and is currently in process, denied because the provider did not pre-certify this procedure [redacted] - claim has been reprocessed with $patient responsibility [redacted] - claim has been reprocessed with $patient responsibility [redacted] - claim has been reprocessed with a $copayment The member also mentioned issues receiving her prescriptionWe have verified that the pharmacy filling her medication incorrectly submitted this claim to our pharmacy benefit manager, CatamaranThe inhaler is for a day supply of medication, but the pharmacy submitted this for a day supply, which caused the rejectionEnsuring that the pharmacy submits claims correctly will ensure that the member does not have any issues moving forward Best Regards, Land of Lincoln Health (Revdex.com Wurster Response.docx)

Revdex.com of Chicago & Northern Illinois N Wabash, SteChicago, IL RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding a member’s missing refund We are unable to directly deposit the refund to the member’s bank account, however, check [redacted] has been mailed to the member in the amount of $This will now clear any remaining credits for insurance coverage during Best Regards, Land of Lincoln Health

I've had this plan for a month and have been unable to talk to the customer service agents over the phoneBecause of the "high volume" of calls, you are asked to leave your phone numberI was never called back after several hours last week and have been waiting for hours todayI need assistance finding a physician because the website is not very helpful and the physician offices are confused about the insuranceI have had so much frustration before even having to deal with billing that I am willing to switch insurance companies before it is too lateI've wasted $on a month's premium and over hours attempting to figure out their systemI can't afford to waste any more time or moneyI hope this helps someone thinking about this insurance company! Hopefully they can get their act together by next year

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 Sincerely, [redacted] ***

Not sure about all the negative reviews, but my experience with this company has all been positiveThis is the second year and signing up and receiving the ID cards went without a hitchClaims have been paid according to the plan

I agree with all of the other reviews thus far There is no EOB information available on their web portal The accumulator information for our account is wrong You can't get anyone on the telephone, you can only leave a message, and no one calls you back They have sent me the exact same letter three times explaining that they would make a claim determination within days The first one arrived over days ago and the most recent one today They have yet to process the hospital claim for a colonoscopy that I had on January 13th with a preferred, in-network hospital The hospital is now dunning me and asking me to get my health insurance company to cooperate in paying the claim They won't allow you to fill generic or other prescriptions that were written by the doctor for a days supply, so each time the pharmacy has to call LOLH to get the claim to go through Worst customer service ever!

Revdex.com Chicago & Northern Illinois Lower Wabash Ave Chicago, IL RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding a plan termination LLH receives enrollment information from the Health Insurance Marketplace, and in this particular case we received an automatic re-enrollment for her for The Marketplace is the “source of truth” for eligibility and we cannot override their enrollment dataTherefore, the member will need to contact them at [redacted] and request to open a HICS (health insurance casework system) caseWe will then be notified of the termination and will reach out to confirm this Alternatively, the member has the option of not paying her invoices and she would then be cancelled for non-paymentWe would terminate the policy as of 1/LLH does not report to collections agency or credit bureaus and this would in no way affect the member negatively Best Regards, Land of Lincoln Health

Complaint: [redacted] I am rejecting this response because: Sincerely, [redacted] The Market Place I called in January and again on today knew that I have a totally new plan Not Land of LincolnThank you, Revdex.com

Revdex.com Chicago & Northern Illinois Lower Wabash Ave Chicago, IL RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding the timeliness of medical claims payment Effective 1/1/2016, LLH pended all claims while we conducted an audit to ensure accurate processingThe audit was completed on 2/28/and we lifted the claims hold on 2/29/The member has a total of nine claims on file, five of which were successfully paid out on the 29th through checks [redacted] which have been mailed to the appropriate providerThe member’s additional claims are currently in process and will be paid shortly Best Regards, Land of Lincoln Health

Revdex.com of Chicago & Northern Illinois Wabash, SteChicago, IL RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding a claim appealWe have verified that the appeal for services on the date of service 7/16/has been approvedThe member will be receiving a formalized letter shortly with additional details related to this claim and paymentBest Regards, Land of Lincoln Health

Complaint: [redacted] I am rejecting this response because: Each time I have called this business I have received a different responseNow I'm told the the specific test I originally called about is not classified as a test, but in the same category as outpatient surgery with the attendant higher costs yet to be clarified Part of my complaint was that my health providers were given the wrong information by Land of LincolnThey have now given the correct information regarding this specific matter only after several weeks and this complaint being filedHowever there is no system in place to suggest that Land of Lincoln will give the correct information in a timely manner in the future Sincerely, [redacted] ***

Revdex.com Chicago & Northern IllinoisLower Wabash AveChicago, IL 60611RE: Case [redacted] To Whom It May Concern:Land of Lincoln Mutual Health Insurance Company (LLH) is in receipt of case [redacted] related to a termination and refund issue.We are able to verify the member terminated his plan, and the LLH finance department has confirmed that a refund was issued to the member on 2/19/Best Regards,Land of Lincoln Health

Initial Business Response / [redacted] (1000, 5, 2015/02/20) */ Land of Lincoln Health received case XXXXXXXX regarding an issue involving payment of medical claims for a member The member was treated for a medical situation and incurred hospital, physician and laboratory charges during this episode of careThe hospital and doctor utilized were considered in-network providers; however, the laboratory was not a contracted provider with Land of Lincoln HealthAs such, the laboratory services were originally processed accordingly Upon receiving a verbal complaint from the member in January, Land of Lincoln Health did review and reprocess the claims in questionThe member has since requested additional review of claims incurred for a second episode of care which is currently under review We apologize for any inconvenience the member has experienced in receiving service from Land of Lincoln Health and are committed to resolving the member's issue

RepJan [redacted] s staff suggested LoL when my experience with [redacted] was so terrible, Granted, I have---thankfully---never needed to actually use the insurance---but the past several months & I've had trouble paying the premium by phone (no excuse for an over minute wa8it time), and an employee told me they've sold their websites, So that's why I got a 'Secure Connection Faild' notice I am mailing in my payment----but it got me thinking...what if I actually needed to use my insurance? What ** We really need single payer

I made a payment and they cashed the check and I was told my policy is now canceled because I missed the dateThey would not even listen to why I was late and I have not received my money backSo now I have no insurance and I have to pay cash for all medical visits and medicines and at the end of the year I will be the one paying for it with our taxes not Land of Lincoln How is this fair?????

I've been a customer since January 1st, We signed up because we wanted to support the [redacted] we thought the idea of a nonprofit was a good idea, and the prices we got for premiums were better than I could get through my employer sponsored coverageUnfortunately, this has been the WORST health insurance and customer service experience we've ever encountered Obviously, Land of Lincoln is a new companyThey're trying to figure things outBut, that does not excuse them for their poor customer service, and slow processing of claimsAt this point we can only recommend that people STAY AWAY from them Here are some examples: When you call customer service, you are actually speaking to the company [redacted] Land of Lincoln contracts out to them for the actual benefits adminstrationThese customer service people, while nice, are not well informed as to the policies, and how the system worksIf you have a question, you are often put on hold while they talk to a different departmentYou often have more information and knowledge than the [redacted] which is a problem Their website often doesn't work, and trying to pay online is a big problemIf your payment fails, you have to call customer service, and pay with your credit card over the phoneThey have acknolwledged that it is a problem, but there is no fix in sightEven after paying my premium on time, for about months, I would receive a letter postmarked the 10th of the month, saying I hadn't paid my premiumI'd have to call to confirm they received itFeatures of the website (accumulator, messaging, etc.) have been non-functional, or are just poorly designed [redacted] (the company that handles the benefits website) doesn't use technology well, and therefore the experience is poor for customers When they say they will mail you something, it often takes about weeks to leave their system and arrive at your door stepPostal service isn't that slow, their systems for automating mailings, EOB's, and pre-certification letters are just slow ClaimsWe used an in-network hospitals service for a test in Feburary of 2014, they've only now figured out how to actually PAY the claim properly this last week (October 2014)My EOB has changed or times as they make payments, rescind payments, have write-offs, and correct thingsYou can never tell when your claim will be paid, or if it will be paid correctly Our Out of Pocket remaining value was unknown to the Customer Service teamThey thought it was one number, the next day it changed, and pharmacies when calling to check how to bill, get a different numberWe literally spent hours over a few weeks calling, calling back, speaking to managers, and escalating, including way calls with the pharmacy, to try and figure out how to bill thingsTheir system had marked our prescriptions as PAID even though they hadn't been, and that caused our Out Of Pocket remaning value to be wrongWe actually figured it out and had to explain it to them The website to determine if a doctor is in-network is confusingOften when calling a doctor, they'll tell me that they AREN'T an in-network physcianI've had to make calls to the billing offices of doctors to confirm with TAX ID numbers to figure out if they're part of the newtorkPart of the problem is that they use [redacted] as their network system, and some physicans are unclear on what this isIt's often a roll-of-the-dice when starting to use a new provider Trying to speak to a person from Land of Lincoln is difficultIf you navigate the phone-system correctly, you will be put into a voice mail system, where you can leave a messageThat is the only way to get an actual Land of Lincoln employee on the phoneI've had to send blind emails to people, leave voice mails for the [redacted] (he never called back) and just generally be a pain-in-the- [redacted] to get someone to respond Overall, it has been a horrible experience, and we are counting the days until we can CANCEL our policy and move onto my employer sponsored insuranceThat being said, we have found a couple of the employees ( [redacted] - the new VP of Member Services, and [redacted] - supervisor at [redacted] to be nice and work hard to resolve our problemsBut, we shouldn't have to actually spend this much time to get the basics of our insurance company to work I think they honestly want things to workThey want to helpBut, until they bring their benefits adminstration in-house, or add more customer service people that work for Land of Lincoln, we can't recommend them as an insurance companyThe third party benefits admistration company [redacted] that they use is NOT a good company to work with, and the fact that they have no real stake in the success of Land of Lincoln, makes the whole experience very negative Stay away, unless you want a hair-pulling experienceSomething else I dislike, is that their company motto is: "Life is Complicated, Your Health Insurance Shouldn't Be"The fact that I've spent so much time trying to figure out my insurance company, and the amount of times my wife has cried out in frustration, tells me that their motto is wishful thinking

THIS IS THE WORST COMPANY IN THE HISTORY OF TIMEI had to go to the ER April of and before I went, I checked to see if the nearest hospital was in networkIt wasThey doctor wasn't apparently which isn't something you think about when you are in and IN NETWORK facilityI was seen and then for a year afterwards, I was being bill by the doctor for $At least people that I had talked to at LOL assured me that they will resubmit this claim and I shouldnt have to pay this and they will contact meThen I got my FIRST collections letterI called LOL and waited for days, literally days, to hear back from someoneThey called the collections company and said they were still looking into itI just got another collections letterNEVER HEARD FROM LOL AGAINI am a single mother with a very limited income and can't afford thisI could have been making small payments and been done with this nightmare by now but the principle of the matter is, this insurance company SHOULD PAY for some of this claim.This company is a JOKE and has treated me worse than any business I have ever dealt withI'm not expecting them to pay all of it but they owe more than $Total **

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 Sincerely, [redacted]