MedEx PSI Premier Specialties

Complaint: [redacted] I am rejecting this response because: The response from the business states that they submitted original documentation/claim to Care Improvement Plus I have not had that insurance since and the hospital and doctors office had the correct insurance information on file and all their bills were submitted to the correct insurance company I do not know where they received the CIP information but it took several months for that to be corrected which delayed the processing The company indicates in their response that the paperwork they submitted to Blue Cross included a Letter of Medical Necessity, yet they tell me they do not have this & were unable to provide it to me Therefore I called Dr [redacted] 's office and he wrote a letter weeks ago which I mailed to the appeals deptat Blue Cross weeks ago I spoke with Blue Cross today and they informed me that they have received the letter but it was not entered into their system until yesterday I spoke with a supervisor who tells me that reprocessing through the appeals process takes up to days Therefore I cannot submit any payment which I might owe them until that processing is complete They also state that they contacted TMG and received no reply I have no way to contact or speak with TMG as the company is not able to provide me with contact info for TMG, nor will Blue Cross I will pay the amount which is due following the appeal process once it is completed The company was very rude during my multiple phone conversations with them and I believe that this information needs to be reflected in the Revdex.com online account provided to the public.I am not one to ignore bills which are my responsibility But my hands are tied at this point by Blue Cross' extended need for time to resolve this issue Regards, [redacted] ***

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 The business' response regarding the Letter of Medical Necessity and my request for a copy if it does not jive with the what I was told on three occasions when I called their office It is my word against theirs at this point.I appreciate the days Hopefully I will have a response from Blue Cross by then Regards, [redacted] ***

Re: Case [redacted] Thank you for the opportunity to respondThe response from the business states that they submitted original documentation/claim to Care Improvement PlusI have not had that insurance since and the hospital and doctor's office had the correct insurance information on file and all their bills were submitted to the correct Insurance companyI do not know where they received the CIP information but it took several months for that to be corrected which delayed the processing,91L aUent and insurance Informationwas rovicI from , ***'s [redacted] when the prescription was sent to PSI, The company indicates in their response that the paperwork they submitted to Blue Cross Included a Letter of Medical Necessity, yet they tell me they do not have this & were unable to provide It to meTherefore I called Dr [redacted] 's office and he wrote a letter weeks ago which I mailed to the appeals deptat Blue Cross weeks ago_ -PSI has always had the letter ofrnedical necessityThe letter of Medical Necessity is a part of the Patient Product Agreement and prescription that Dr [redacted] signed, and thatrartha [redacted] signed as wellMs [redacted] was told on numerous gccasions that the letter of medical necessity and all required paperwork had been sent I spoke with Blue Cross today and they informed me that they have received the letter but it was not entered into their system until yesterdayI spoke with a supervisor who tells me that reprocessing through the appeals process takes up to daysTherefore I cannot submit any payment which I might owe them until that processing is complete-As a courtesy to the patient, PSI will place a hold on the account for daysif payment is not received within days, the account will be seat to cQllections They also state that they contacted TMG and received no replyI have no way to contact or speak with TMG as the company is not able to provide me with contact info for TMG, nor will Blue Cross-PSI recety~d a letter requestingthat the apQpaperwork be sent to *** [redacted] ***, SCRANTON, PA A phone number was not givenAll aop al paperworkQpli w mailedto the address as requested