Land of Lincoln Health

Revdex.com Chicago & Northern Illinois
Lower Wabash Ave
Chicago, IL
RE: Case ***
To Whom It May Concern:
Land of Lincoln Health received Revdex.com case *** regarding claim and pharmacy issues
We are able to provide the following update on the claims in
question:
2*** - claim has been reprocessed with $patient responsibility
*** - an appeal for this claim has been received and is currently in process, denied because the provider did not pre-certify this procedure
2*** - claim has been reprocessed with $patient responsibility
*** - claim has been reprocessed with $patient responsibility
*** - 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)

There has been nothing done or said to correct this POOR process and excessive time needed for precertification They sent me the approval after weeks of asking for it They have not even attempted to justify there process or lack of dutie to the contract I have to pay monthly to a company that has no reason to fullfill there end of the contract. Allow me and people everywhere to move from an inferior health service provider AT ANY TIME the provider is: said by health professionals, "this is a terrible company", or refuse to respond to medical precertifcation requests for weeks, or require the patient and the medical provider to call and beg and plead to have the test or treatment done for weeks before someone even looks at the the request. The company should and probably will have a class action law suit against them

Revdex.com of Chicago & Northern Illinois *** * *** *** ***
*** ** *** RE: Case *** To Whom It May Concern: Land of Lincoln Health received case *** regarding medical claim issuesWe were
able to contact the member and explain the copayments associated with office visits and laboratory services under his planIn addition, there was a medical claim denied for a physical therapy procedure because the provider did not contact LLH and obtain precertification for the serviceWe advised the member that the provider should appeal this claim with LLH and we will then consider the claim for paymentBest Regards, Land of Lincoln Health

Initial Business Response /* (1000, 8, 2015/03/06) */
Land of Lincoln Health received case XXXXXXXX regarding an issue with a member and her provider having difficulty getting in contact with our Member Services Team
Land of Lincoln Health's Issue Resolution Team spoke to the member on
February 17th and to the provider on February 18th on behalf of the memberWe followed up with the member again on February 24th to confirm the issue had been resolved

Initial Business Response /* (1000, 5, 2015/03/26) */
Land of Lincoln Health (LLH) received Revdex.com Case ***, which concerns verification of coverage for pediatric dental benefitsThe members are father and daughter, and the dental visit applies to the daughter
Upon
researching the aforementioned issue, LLH confirmed the daughter's enrollment with Land of Lincoln Health as a dependent under the father's coverageLLH then contacted the dental office and spoke to the office managerLLH was able to confirm pediatric dental coverage, provided benefits to the provider, and advised the provider on where to submit the claim(s)
Land of Lincoln Health left a voice message informing the member that we have resolved the issue and we apologize for any inconvenience this has caused

Revdex.com of Chicago & Northern Illinois N Wabash, SteChicago, IL RE: Case *** To Whom It May Concern: Land of Lincoln Health received case *** regarding a member’s missing refund We are unable to directly deposit the refund to the member’s bank account, however, check
*** 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

Revdex.com of Chicago & Northern Illinois *** * *** *** *** Chicago, IL RE: Case *** To Whom It May Concern: Land of Lincoln Health received case *** regarding a member’s transition of care requestThe member’s request was received but cannot be approved because additional
information is neededLLH mailed a request for relevant medical records related to the member’s treatment and diagnosis on February 22, 2016, however, we have not received any correspondence back since that dateWe have mailed out an additional copy of letter requesting this documentationOnce provided to LLH, we will be able to review the member's requestBest Regards, Land of Lincoln Health

Revdex.com Chicago & Northern Illinois *** * *** *** *** Chicago, IL RE: Case *** To Whom It May Concern: Land of Lincoln Health received case *** regarding two claim
issues LLH has reviewed the claims in question: 1. Date of service 9/9/2015, billed charges of $243, claim ending in -*** processed as in-network 2. Date of service 9/23/2015, billed charges of $1,009, claim ending in ***, 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 *** 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 *** with provider *** *** not *** 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 *** Best Regards, Land of Lincoln Health

Please don't buy this insurance, you are going to regret itWorse insurance on the market!!!!

Initial Business Response /* (1000, 5, 2015/02/13) */
Land of Lincoln Health received case XXXXXXXX regarding an issue involving member ID cards and issues with making a payment for her health insurance plan
Our records indicate that the member's welcome kit, including ID cards, was
ordered on December 30, and mailed on January 5thSince then Land of Lincoln Health has mailed two additional welcome kits to the member on February 3rd and February 10thTo our knowledge, the address we have on file is correct so we are unsure why the member she has not received any information
Additionally, Land of Lincoln Health offers the ability to print a temporary ID card through our secure Member Portal as well as a mobile application for smartphones that allows members to access their ID cardThis information is located on our website along with instructions on registering for the Member PortalIt appears the member was able to access the temporary ID card from the Member Portal but had issues printing the temporary ID cardThis could have been attributed to the page layout of the printer as we have not had any other issues with the printing functionality
Lastly, the member requested additional options for making a payment other than by phoneIn addition to the ability to make a payment over the phone, Land of Lincoln Health offers the ability to pay online through the Member Portal as well as the ability to mail in a check or money orderThese instructions are located on the invoice mailed to the member as well as our websiteOur records do indicate the member was able to make a payment so we hope the issue has been resolved

Revdex.com of Chicago & Northern Illinois *** * *** *** ***
*** ** *** RE: Case *** To Whom It May Concern: Land of Lincoln Health received case *** regarding medical claim issuesWe were able to contact the member and explain the copayments associated with office
visits and laboratory services under his planIn addition, there was a medical claim denied for a physical therapy procedure because the provider did not contact LLH and obtain precertification for the serviceWe advised the member that the provider should appeal this claim with LLH and we will then consider the claim for paymentBest Regards, Land of Lincoln Health

I am new the Land of Lincoln as Jan 1, Today Jan I'm trying to find out why a medication listed on the formulary is not being coveredI placed a call at 4pm CT and stayed on hold until 5:STILL NO ONE PICKED UP The estimated wait time was - min which is still TOO LONG
So I hung up and called back, which originally I thought that means I'll lose my spot, but I didn't, someone picked up after being on hold for minsI've never had to to wait like that to speak to a representativeJust hate I have to wait a whole before I change nowMy time in valuable

Initial Business Response /* (1000, 5, 2015/02/13) */
Land of Lincoln Health received case XXXXXXXX regarding an issue involving eligibility for the member's health insurance plan
Due to an error with the enrollment file from the Marketplace, it appeared the member's insurance coverage
had been terminatedThis was brought to the attention of Land of Lincoln Health on January 29thAfter researching the issue further, a manual update was implemented through the system on February 2nd to reinstate the member's account which was then reflected in the system on February 3rdAfter this was completed, the member was notified of the correction
The member also requested to verify the dependents had continuous coverage and Land of Lincoln Health is able to provide such confirmationAdditional ID cards with the members' dependents have been reordered and mailed to the member
We apologize for the inconvenience this caused to the member and do not expect such issues to occur in the futureWe hope this issue has been resolved to the member's satisfaction
Initial Consumer Rebuttal /* (3000, 7, 2015/02/16) */
(The consumer indicated he/she DID NOT accept the response from the business.)
To Whom It May Concern:
Yes, my coverage was reinstated, however, for the record please note:
1) The Company never contacted me as they stated, I found out about my reinstatement by constantly calling them
2) I have no or never had any dependents, this does NOT make any senseWhat is the Company talking about?
3) No new cards were ever received by meWhy would I need any?
4) There was no enrollment error from the MarketplaceIn fact, a Land of Lincoln supervisor admitted the problem was on their side
Bottom line, there was nothing factual in their response
Thank you for your concern

Initial Business Response /* (1000, 8, 2015/03/26) */
Land of Lincoln Mutual Health Insurance Company (LLH) is in receipt of case XXXXXXXX; this letter is in response to said complaint
In December, the member requested that healthcare.gov cancel her first enrollment that was to be
effective January 1, The termination was made on December 31, At the time she requested the termination, she requested reenrollment for an effective date of February 1, However, that enrollment file was never sent to LLH from healthcare.govThe member sent her premium payment with the invoice from the January policy which had been termed
The LLH Call Center Manager spoke to the member and suggested she contact healthcare.gov and file an escalated case to request a new effective date of March 1, On March 14th, LLH received the new enrollment file from healthcare.govThe member's payment from January was credited to March and she is now an active member of Land of Lincoln Health
When the Call Center Manager spoke to the member, she acknowledged that the error was made by healthcare.gov and she was happy that everything was resolved

Revdex.com of Chicago and Northern Illinois N Wabash Ave *** Chicago, IL RE: Complaint *** To Whom It May Concern, Land of Lincoln Health (LLH) received complaint number *** regarding a pre-certification issueWe have attempted to reach the member on three separate occasions
and left a detailed voice mail for a return call so that we can further assist herAt this time we have not heard back from the member and are not able to have our Medical Management Department reach out to her provider to further assistWe would ask that the member contact our Member Service Department at *** Best Regards, Land of Lincoln Health

Revdex.com Chicago & Northern Illinois
Lower Wabash Ave
0in 0in 0pt;">Chicago, IL RE: Case ***
To Whom It May Concern:
Land of Lincoln Mutual Health Insurance Company (LLH) is in receipt of case *** related to a termination and refund issueWe 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

Revdex.com of Chicago and Northern Illinois N Wabash Ave *** Chicago, IL RE: Complaint *** To Whom It May Concern,
11pt">Land of Lincoln Health (LLH) received complaint number *** regarding a pre-certification issueWe have attempted to reach the member on three separate occasions and left a detailed voice mail for a return call so that we can further assist herAt this time we have not heard back from the member and are not able to have our Medical Management Department reach out to her provider to further assistWe would ask that the member contact our Member Service Department at *** Best Regards, Land of Lincoln Health

Revdex.com of Chicago & Northern Illinois *** * *** *** ***
*** ** ***RE: Case *** To Whom It May Concern: Land of Lincoln Health received case *** regarding a precertification for a medical procedureThe member’s procedure was reviewed for medical necessity and was
approved on 4/8/under authorization number ***A copy of the authorization letter has been sent to the member and providerBest Regards, Land of Lincoln Health

Initial Business Response /* (1000, 5, 2014/09/04) */
Revdex.com CASE#: XXXXXXXX- Complaint Resolved
message
*** *** Thu, Sep 4, at 2:PM
To: "***@chicago.Revdex.com.org"
Hi ***,
I hope this email finds you
well
A few days ago we spoke on the phone concerning the Revdex.com CASE#: XXXXXXXX- complaint against Land of Lincoln HealthI called the Revdex.com office and they instructed me to email you the resolution of the complaint
The member ( consumer) has been contacted directly by Land of Lincoln Health Member Services and all coverage has been reinstated as of 9/4/At this time, please consider this complaint to be resolved
Since this is our first time dealing with a complaint via the Revdex.com, can you please advise on next steps? Also, please confirm receipt of this email so that we are able to comply within our day window to respond to this type of case
Thanks in advance for your time!
Best, ***
**
C: XXX-XXX-XXXX
O: XXX-XXX-XXXX

This is the worst company I've dealt with in a very long time! Customer service is a total joke.Each person that i've talked to told me different liesdifferent claims and none of them were processed correctly.It has been more than months and still waiting for those claims to be reprocessed