MedStar Medicare Choice

RE: Revdex.com ID: [redacted] Response to Letter dated 3/28/to MedStar Medicare ChoiceDear [redacted] :Please allow us to respond to the member complaint filed with the Revdex.com regarding MedStar Medicare Choice.Problem: Member does not feel she was charged correctly for certain medical supplies.Response: The member contacted MedStar Medicare Choice on 3/2/and filed a formal grievance regarding the price of her medical suppliesMedStar Medicare Choice responded to the member in writing advising the reason for her cost shareAccording to the member's Evidence of Coverage (Chapter 4, Page 72), the member may have to pay 0% or 20% of the total cost for Medicare-covered medical suppliesCost-sharing may vary based on certain eligibility levelsWe have reviewed the member's claims and she was charged correctly for the medical supplies she purchased in The member is responsible for a 20% coinsurance as it is not covered by her secondary coverage.Problem: The member stated that a broker came to her home on 3/27/and verified that her medical supplies should be $Response: MedStar Medicare Choice outreached to the assigned broker agencyThe agency advised MedStar Medicare Choice that a MedStar Medicare Choice Broker has not been to the member’s home since Rather, on 3/27/the member was visited by a broker from another Medicare Advantage planWe are unable to comment on medical supply pricing for other health plans.Problem: The member stated no dentists are accepting new patients at the numbers she was given to callResponse - Our records indicate the member outreached MedStar Medicare Choice on 03/13/During the time of the call to Member Services on 03/13/2018, the representative offered assistance in locating dental providers for the member but the member declined assistance and advised she would call herselfThe member contacted Member Services again about dental providers on 03/28/The member was provided with a few options of participating dentistsThe dentists’ name, address, phone number was provided to the member during this callIn addition, the Member Services Representative offered to help the member secure an appointment with a dentist by calling around to the dentist officesThe member declined this assistanceThe member has since changed her health insurance carrier.If you should have any questions, please do not hesitate to contact usRegards,Lesley W [redacted] VP Government Contract Management and Oversight MedStar Medicare Choice

May 28, Re: Complaint No [redacted] Dear Ms [redacted] as the third-party administrator for MedStar Medicare Choice (“MedStar”)has received and reviewed your letter of May I • as well as the accompanying complaint submitted by a consumer of MedStar’s Medicare insurance product (the “Consumer”) at the above-captioned file number On or about April 30, 2014, Consumer filed a complaint with the Revdex.com (“EBB”) regarding a delay in receiving her premium refund in the amount of $Our records indicate that Consumer was initially enrolled in MedStar Medicare Choice Plus HMO (a plan with a premium of $per month) from November 1,through November 30, Consumer then changed plans to Med&ar Medicare Choice 1-IMO (a plan with no premium obligation) beginning December 1,2013; however, the $premium for the cancelled plan was mistakenly charged for December UPMCHP’s Premium Billing department has verified that the Consumer’s refund 01’ $was processed on May for the overpaymentAt this point, we believe that the Consumer has received her refund check, and this matter is therefore resolvedWe have also addressed the Consumer’s timeliness concerns with the appropriate departments and we apologize for any inconvenience this matter has caused; we consider the Consumer’s input a valuable source of information in helping us achieve our commitment of ensuring quality care and service Thank you for bringing this matter to our attentionIf you have any further questions or need any additional information, please do not hesitate to contact meat [redacted] Sincerely, [redacted] Associate Counsel

RE: Revdex.com ID: [redacted]Response to Letter dated 3/28/18 to MedStar Medicare ChoiceDear [redacted]:Please allow us to respond to the member complaint filed with the Revdex.com regarding MedStar Medicare Choice.Problem: Member does not feel she was charged correctly for certain...

medical supplies.Response: The member contacted MedStar Medicare Choice on 3/2/18 and filed a formal grievance regarding the price of her medical supplies. MedStar Medicare Choice responded to the member in writing advising the reason for her cost share. According to the member's Evidence of Coverage (Chapter 4, Page 72), the member may have to pay 0% or 20% of the total cost for Medicare-covered medical supplies. Cost-sharing may vary based on certain eligibility levels. We have reviewed the member's claims and she was charged correctly for the medical supplies she purchased in 2018. The member is responsible for a 20% coinsurance as it is not covered by her secondary coverage.Problem: The member stated that a broker came to her home on 3/27/18 and verified that her medical supplies should be $0. Response: MedStar Medicare Choice outreached to the assigned broker agency. The agency advised MedStar Medicare Choice that a MedStar Medicare Choice Broker has not been to the member’s home since 2016. Rather, on 3/27/18 the member was visited by a broker from another Medicare Advantage plan. We are unable to comment on medical supply pricing for other health plans.Problem: The member stated no dentists are accepting new patients at the numbers she was given to call. Response - Our records indicate the member outreached MedStar Medicare Choice on 03/13/2018. During the time of the call to Member Services on 03/13/2018, the representative offered assistance in locating dental providers for the member but the member declined assistance and advised she would call herself. The member contacted Member Services again about dental providers on 03/28/2018. The member was provided with a few options of participating dentists. The dentists’ name, address, phone number was provided to the member during this call. In addition, the Member Services Representative offered to help the member secure an appointment with a dentist by calling around to the dentist offices. The member declined this assistance. The member has since changed her health insurance carrier.If you should have any questions, please do not hesitate to contact us. Regards,Lesley W[redacted] VP Government Contract Management and Oversight MedStar Medicare Choice

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
 
[redacted]

May 28, 2014
Re: Complaint No. [redacted]
Dear Ms. [redacted]
[redacted] as the third-party administrator for MedStar Medicare
Choice (“MedStar”). has received and reviewed your...

letter of May I • 2014. as well as the accompanying
complaint submitted by a consumer of MedStar’s Medicare insurance product (the “Consumer”) at the
above-captioned file number.
On or about April 30, 2014, Consumer filed a complaint with the Revdex.com
(“EBB”) regarding a delay in receiving her premium refund in the amount of $60.00. Our records
indicate that Consumer was initially enrolled in MedStar Medicare Choice Plus HMO (a plan with a
premium of $60 per month) from November 1,2013 through November 30, 2013. Consumer then
changed plans to Med&ar Medicare Choice 1-IMO (a plan with no premium obligation) beginning
December 1,2013; however, the $60 premium for the cancelled plan was mistakenly charged for
December 2013.
UPMCHP’s Premium Billing department has verified that the Consumer’s refund 01’ $60 was
processed on May 5. 2014 for the overpayment. At this point, we believe that the Consumer has received
her refund check, and this matter is therefore resolved. We have also addressed the Consumer’s
timeliness concerns with the appropriate departments and we apologize for any inconvenience this matter
has caused; we consider the Consumer’s input a valuable source of information in helping us achieve our
commitment of ensuring quality care and service.
Thank you for bringing this matter to our attention. If you have any further questions or need any
additional information, please do not hesitate to contact meat [redacted]
Sincerely,
[redacted]
Associate Counsel

Review: On November 2013 I requested a change to my enrollment. I was paying $60 per month. The amount is automatically taken from my bank account each month on the 1st. On December 1, 2013 it was too late for me to cancel. On December 18, 2013 at 9:10 am EST I called requesting a refund of my $60, I was told it would be mailed within 4-6 weeks. I called again on February 10, 2014 at 9:30 am as a follow up to my previous call and spoke to Amelia, I was told the refund would be processed in the next few days. On March 24,2014 I wrote a letter and mailed thru USPS paying for signature confirmation #[redacted] and still have not heard back. In the letter I wrote (copy in my file) I asked to process my refund and left my phone number to contact me if there were any further concerns. I have heard nothing.Desired Settlement: Please mail my refund to [redacted]

Business

Response:

Review: can't get in touch with them even would like to be able to talk to someone to resolve the problemDesired Settlement: need prescription for epilepsy med if I don't get it I may have a seizure tried calling then but no satisfaction been on same med for since 15 yrs old now 68 yrs old sorry I got into medstar what a joke

Review: My father [redacted] is receiving bills for oxygen that he has never received. In fact on the day of my my bother [redacted]'s funeral ([redacted]'s son) I requested oxygen be delivered to the funeral hone June 9th, 2014 jeopardizing my fathers life. Since then despite what I say Medstar continues to bill my father for portable oxygen he doesn't receive from them.Desired Settlement: Please have them stop billing my father[redacted] account # 134284 for oxygen he never receives from them