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Matrix Absence Management

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Reviews Insurance, Insurance Agency Matrix Absence Management

Matrix Absence Management Reviews (53)

Horrible Management of Claims Beware of More Headaches when Dealing with this Company
Matrix Absence Management is your worst nightmare if you are sick injured or needing help getting through STD. My claiment told me on the phone the he and his company work for my employeer. That tells me Matrix cares nothing about my health and my needs. They lie to your face and then once in a while at a rare time they will tell you the truth. They lie and tell you they know nothing about how or when your employer gets payment to you. You think you are getting help but then the person working on your claim goes on a holiday for 5 to 6 days leaving you hanging. You cant call the phone number and ask for the claiments supervisor either because he will not return you calls. No one but your claiment is able to give you any information which even worse when your claiment goes on a holiday. You must remember this is an insurance company that your employer pays. Good luck getting the best care and help from Matrix Absence management for your health needs. This company only makes your health worse by stalling your claim. If you work for a job with the same company for over 38 years like I have and help them become a million dollar making company. It is just sad that I have to be treated this way. I have contributed to my employers wealth and they offer STD so why woould the company you work for let me be treated like this? I will be working with my HR service team where I work to try to help some like me. If they denie me I will appeal and sue Matrix. I am with all of you when it comes time to sue Matrix for non payment.

just to clarify when I said claiment I meant the person at Matrix who files your claim. Not the persom who actually wants to recieve a claim. The person I worked with at matrix left me hanging for five days while he was out of the office. There is no one else to help you with your claim at that point! The guy who works for Matrix work for a muti billion dollar company. Your employeer.

Very Unhappy
I filed a claim for my short term on Feb. 6 2022. I have yet to speak to my claim adjuster, I called her late morning and she had already left for the day. I am returning to work on the 26th and my claim is still pending and have not received anything for them. My claim adjuster is Lisa Veshi. I hope no body else gets her for their adjuster she is unreliable

+1

This company is corrupt
I filed for FMLA on 2 instances. I had one Dr send in paperwork and days had to be added. I was told about this and they advised the days that weren't included would be set as pending status till the amended paper work was received. I got it in and also had to take another day 3 weeks out. All was covered and I was taken care of. The second leave my work had me out on the 6th of December. But the Dr had wrote in the 5th. I was never advised of the dates that had been sent I'm, nothing went into pending, I was just sent a letter from her advising I was denied the days. She advised there was nothing I could do, but yet I had no time ommunication from her at all. She just advised it was closed and that was it. But from the previous leave he was able to go in and a date that wasn't put in for November. He added it in January. I had nothing that I could do She said. Not even get amended paperwork, like I was able to do with a previous rep the month before. My Dr is sending me the paperwork with the correct date and if it isn't covered, I will seek out a lawyer, just do to the fact. She just denies me and didn't even let me appeal it. I have every email and even q message saying there was 2 things I could do bit when I called her there was still nothing I could do. As you can see the first eave I was actually given time and got all paperwork work in and approved. The other I wasn't even asked about the time. But in the email she advises I can't be if go back in and be off again, but she can deny me and give me nothing to send in anything at all. Just DENIED!
This company is corrupt
This company is corrupt
This company is corrupt
This company is corrupt
This company is corrupt
This company is corrupt

+1

Ditto
You can read almost any of the other reviews on this site and that was my experience. Matrix has to be one of the most evil company's in business. I can only hope they get their comeuppance some day.

+2

News Channels
All news channels are interested in my story and others on here let's get this going

+1

Agents
I am working with this company now and the representative I have is horrible and no care for there client at all. He is Anthony G. Schultz Phoenix / Claims Examiner I AMS-M. He will not answer the phone and will not even return an email when you reach out to him. I will be seeking legal service because it should not take 3 months to get paper work in order if so he needs more training. I will not stop until justice is serve. I will be taking this to all news channels.

+4

We are in receipt of the consumer complaint submitted thru the Arizona Revdex.com (ID # [redacted] ) size="3"> Matrix Absence Management is a third party administrator of benefits offered by employers and/or insurance companies, and as such is bound to policy limits, documentation, and conditions dictated by our clients What’s more, we are unable to disclose confidential information relating to any claimant’s health condition, employment or coverageWe have completed our review of this particular case and can only offer assurances that it was thoroughly and promptly processed in compliance with the appropriate policy concerns Under no circumstances does Matrix deliberately delay or impede benefits, and makes every effort to expedite required documentation and available benefitsWhile we recognize all claimants – especially those facing severe health issues - are anxious to have benefits approved promptly, we are equally determined to ensure such benefits are administered accurately, fully, and in accordance with the underlying policiesMatrix Absence Management

+1

That is what Matrix will tell you. Why then are there so many complaints about Matrix company stalling on payments? Sounds to me the people have spoken and Matrix Absence Management need to get their head out of thier you know what and become a better management team for the sick and injured not just the employer with whom you work for. My HR team at work with become advised of the situation. These hurt or injured people desive care and respect from the employeer and Matrix an insurance comapny who only works for your employer not the sick and injured! So sad this company cant understand that!

I think owners should know how there clients are being treated This is my 3rd medical claim with this company the intake representative are great but the claims adjusters are horrible they lie to me and don't calls back This last claim took a whole month and I sti have not been paid [redacted] sent my check to a wrong address he wasn't sympathics I asked to speak with his manager he transferred me to another agents name issueShe said she would overnight the check to me on FridayI called back and spoke with [redacted] she was helpful but she could not give me a tracking number She states she had to email the audit dept and she would call me back Then I call back and was transferred to [redacted] who said she was the operation manager and she would get a tracking number an call me back No one called me back and I st don't have a checkI would like my check a nd would like upper management to review all calls concerning my issueMy sickness was in January and I still don't have a checkI don't appreciate the run aroundThis is ridiculous and this is poor business practiceI asked to speak with upper management but no one would transfer me or call me back

+2

I have had the same experience. This company only works for your employeer. My claiment told me on the phone that his company works for your employeer. They are an insurance company who loves to get paid but when it comes time to pay up...Sorry...Sos sad for the sick and injured. They dont deserve to be treated this way.

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 until for the business to perform this action and, if it does, will consider this complaint resolved Regards, [redacted] ***

On September 15, we responded to a Revdex.com complaint, however on October 10, we received a follow up request which indicated [redacted] was not satisfied with resolution response to her initial complaint [redacted] maintains that Matrix’ response which states we attempted to contact her on multiple occasions unsuccessfully is untrue and that her claim was rejected The file documentation shows that [redacted] called in a claim on August 12, with a *ate of *isability of August 6, *ue to a motor vehicle accident A medical request for information was sent to [redacted] ***’s physician [redacted] on August 13, [redacted] ***'s medical certification was received on August 19, from [redacted] and indicated that [redacted] would be released to return to work as of August 28, An email was sent to [redacted] on August 19, by the claims examiner indicating that Matrix had received the medical certification but it was insufficient and we needed additional medical documentation to support her claim for disability At that time we also sent a request to [redacted] ***’s physician [redacted] requesting medical records containing treatment and treatment plan notes In follow up, the examiner emailed [redacted] on August 25, and informed her that a medical request was sent to [redacted] on August 19, but we had not received a response from her physician On August 27, a second request was sent to [redacted] as well as an email to [redacted] informing her of the second request that was sent to her physician [redacted] for medical records On September 2, we received a phone call from [redacted] indicating that she was returning to work on September 2, We sent her an email in response, confirming we received her voicemail regarding her return to work and we also informed her that we were still waiting for records from her physician On September 5, 2015, [redacted] provided the medical records that were requested and the file was sent to our medical staff to be reviewed The medical review concluded that the claim was medically supported from August 6, through August 29, 2014, the *ate [redacted] stated she could return to work The policy of [redacted] ***'s employer states: ?WEEKLY INCOME BENEFIT DAY BENEFITS BEGIN: Benefits, for one period of disability, will be paid as follows: INJURY AND SICKNESS: We will pay benefits from the greater of: (1) the thirty-first consecutive day of disability; or (2) the day immediately following exhaustion of the Insured’s EIB (Extended Illness Bank) hours available on the date disability occurs We sent an email to [redacted] on September 10, indicating that the medical review had been completed We advised her that since she had not been out of work for more than *ays, per the policy provision above, no benefits would be payable and her claim would be *enied We finalized the determination on September 15, and mailed [redacted] denial letter on September 25, While there was a delay in sending out the denial letter, we provided [redacted] with our determination via email on September 10,

Thank you for contacting Matrix regarding this matter While we are never pleased to see that a claimant is unhappy with our services, we do greatly appreciate a chance to clarify this matter for our claimants Ms [redacted] originally filed a claim for leave of absence for the period of 02/19/14-04/01/ As part of this claim she was required to provide Matrix with the necessary paperwork for her claim to be approved This paperwork was received on 03/13/and her FMLA claim was approved the very same day In addition to filing an FMLA claim, Ms [redacted] is also eligible to apply for short-term disability benefits These benefits would begin after she has been out of work for continuous days In order to receive short-term disability benefits, the claimant must provide the necessary medical documentation to support their claim for benefits In this case, the medical certification form which was provided was not sufficient to approve her claim for benefits A letter informing Ms [redacted] of the need for more medical information was mailed to her on 03/20/ We have also been in repeated contact with her physician's office in an attempt to clarify her physical restrictions as well as medical findings to support her claim for benefits Please note that we are working diligently to resolve this claim and once the medical information is received from the provider's office we will be reviewing the claim in an expeditious manner to make a decision on this claim We encourage Ms [redacted] to continue to work with her provider's office to ensure that her most updated medical information is sent to our attention Sincerely, [redacted] Senior Director Of Operations Matrix Absence Management ###-###-####

I have filed for short term disability at end of sept 2016, it is now mid November-I have made repeated calls to MATRIX with no call backs-they have lied and said they have been calling me consistently with no answer-but on the two occasions they called and I was immediately available I CALLED them right back -yet they don't document this,they are constantly saying they don't hav e enough documentation from my doctors-I see a doctor once a week who has been sending records-yet they claim they haven't received thework place changed absent management companies on nov 1st but since initial claim started with Matrix the new company will not handle my claim saying Martix must handle this since it was initiated with them- I am so frustrated I could scream-poor customer service- dishonesty on their part- they claim they are trying to help me but at this point all I want is a yes or no to my short term disability claim

+2

There is nothing positive to say about my two claims I've had to open with this company, they have been rude, uncompassionate, told untruths to my family, and forced us to wait more than a month to being receiving payments after having lost a child at weeks pregnantThis was the worst experience of my life outside of thatNow that I am pregnant again, they've denied my claim again, saying that they faxed the doctor info and the doctor didn't fax it back...but I had them send me the confirmation so I KNOW they did I am just fed up with them altogether, I don't understand how they are in the business of helping people who are disable and this is how they treat them, its sad and VERY discouraging

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
The assertions made by Matrix contain both misleading statements and outright falsehoods The assertion that Matrix attempted to contact me repeatedly and unsuccessfully are untrue I called the agents daily and repeatedly These calls went unanswered I eventually received a few emails containing very little information and *id not answer the questions I asked In fact, I was told that the clinic was not sending information (an allegation Matrix see** to be back tracking upon) It is true that they rejected my claim, but they could have been honest and forthright (eg, professional)
Regards,
*** ***

Good afternoon, My name is *** *** and I am the Senior Director of Operations for Matrix Absence Management. First and foremost, we want to apologize to Mr*** for his experience to date and we hope that we can rectify this situation so that he can focus on his health, and not
worry about his insurance benefits from Matrix Absence Management. I have reviewed his concerns and as of yesterday, his claim has been approved and a check has been sent to his attention. A check in the amount of $5,has been sent to his attention for the period of 2/7/14-05/01/2014. A second check will be released on 05/22/for the period of 05/02/14-06/01/in the amount of $2166.78. We did call and speak with Mr***’s wife on 05/06/and explained that this claim has been approved and we have drafted an approval letter to that effect as well. We do hope that this rectifies this situation for Mr*** and moving forward, should he experience any delays in the processing of his claim, we encourage him to communicate with his claims examiner and escalate any issues if he is not seeing a response time within hours of his initial inquiry. Again, we apologize for his experience to date and we will take every measure to ensure that his experience is much more meaningful as we continue our partnership with Mr***. ?Sincerely, *** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait until for the business to perform this action and, if it does, will consider this
complaint resolved
Regards,
*** ***

April15, 2016UPLOADED TO Revdex.com.org website Revdex.com Phoenix, ArizonaRE: Complaint ID#*** ("Complaint") To Whom It May Concern:This letter shall serve as a response on behalf of Matrix
Absence Management, Inc("Matrix")to the above-referenced Complaint filed by *** *** ***'.Matrix is the third-party administrator for the short-term disability benefits plan offered to employees of *** * *** (the "*** STD Plan" or the "Plan") This means that Matrix is charged with handling requests for benefits under the plans, including ensuring that employee/claimants submit required medical and other support for their initial eligibility for benefits.Our records show that on or about October 7, 2015, Ms*** filed a claim to extend the benefits she was receiving since May under the *** STD Plan Shortly, and on many occasions, thereafter, representatives of Matrix informed Ms*** that, in order to evaluate her claim for continued benefits under the Plan, we would need to receive supporting medical documentation and that, while Matrix would endeavor to request those records on her behalf, it was ultimately her responsibility as the claimant to provide the necessary supportOur records show Matrix also made three separate attempts to contact the physician we understood to be her treating physician to obtain the required medical certification, without success.After not receiving the required supporting objective medical certification to justify benefits under the Plan beyond October 6, 2015, Matrix denied Ms***'s claim and sent her a letter dated November 12, 2015, explaining the bases for the denial decision in great detail and providing her with notice of her appeal rights under the PlanThis is the avenue for a claimant under the Plan to request reconsideration of a decision As of this date, she has not done so.We trust that this information resolves this Complaint as to Matrix

In response to the Revdex.com Complaint#***, I asked Matrix staff to prepare a summary of the actions taken to *ate, pasted below, having redacted claimant names. In all regards, it appears we processed this claim in a timely manner, and with the interests of both the claimant and her
employer being appropriately addressed
*** ***’s claim was filed on August 12, 2014. We received a medical certification from her physician
on August 15, at which time the claim was forwarded to our medical *epartment to review
This review was completed on August 18, 2014.
Based on this review and the facts of the claim, we *etermined that *** ***'s restrictions would prevent
her from working for the period from August 5, to August 14,
However, the policy under which *** *** is insured indicates that she would have to be out of work and *isabled per
the contract for *ays before Short Term *isability payments are to begin
Since the above stated period is for less than *ays, *** ***’s examiner requested additional medical
information on August 19, to see if there was more medical information that may support a longer *uration
We received an invoice from *** ***’s physician on August 22, requesting an amount of $be paid as
pre-payment for the additional records requested
This invoice was paid. We received the records on September 5,
Therefore, *** ***’s physician has been corresponding with us. There *oes not appear to be
any evidence of non-receipt of records. In the instances where *** *** called and we had not yet received a responset this was communicated to
her. However, her *octor responded to us initially, and then again once the pre-payment was received for records
Currently, *** ***’s claim is being reviewed for a final *etermination regarding her claim. Once this
determination has been made, it will be communicated to *** *** *irectly

After reviewing the response submitted by Ms. [redacted], it is unclear what additional response she or the Revdex.com is seeking.  While the parties appear to continue to disagree about how and whether the records Matrix received were timely submitted or received to support her claim (please see initial response submitted by Matrix for more details on our position), she indicates she is "happy" because she received the STD benefits she was seeking and is back at work, so we see no further need to respond or any additional complaint lodged that requires us to do so.
Sincerely, Gail C[redacted], Director of Employment Law & Compliance

We are in receipt of the consumer complaint submitted thru the Arizona Revdex.com (ID # [redacted]).

size="3"> Matrix Absence Management is a third party administrator of benefits offered by employers and/or insurance companies, and as such is bound to policy limits, documentation, and conditions dictated by our clients.  What’s more, we are unable to disclose confidential information relating to any claimant’s health condition, employment or coverage. We have completed our review of this particular case and can only offer assurances that it was thoroughly and promptly processed in compliance with the appropriate policy concerns.  Under no circumstances does Matrix deliberately delay or impede benefits, and makes every effort to expedite required documentation and available benefits. While we recognize all claimants – especially those facing severe health issues  - are anxious to have benefits approved promptly, we are equally determined to ensure such benefits are administered accurately, fully, and in accordance with the underlying policies.
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Description: Insurance - Accident & Health

Address: P.O. Box 13498, Philadelphia, Pennsylvania, United States, 19101

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