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Molina Healthcare Rating
Address: 5605 N,MacArthur Blvd Suite 400, Irving, Texas, United States, 75038
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Molina Health Care refuses to pay for emergency services which were outlined as covered in my summary of coverage. Will not give an answer or inquiry.
I was seen in 2017 at an emergency room that was declared as a "non-participating provider". Molina Healt Care has refused to pay for the emergency services, even though it is outlined as covered in the contract that I signed and in in the summary of coverage for that year. Under my summary of coverage, it states that I would pay a $150 copay for the emergency services.
I have been trying to contact Molina for two years now to resolve this issue. They have somehow managed to "lose track" of recorded phone calls where they admitted that they were the ones responsible for paying the hospital. I have tried to open and inquiry with them multiple times, and was told I would receive a letter in the mail to answer the inquiry. I have never received a letter. The customer service representative I spoke to once "forgot" to submit the inquiry.
They are claiming they don't have access to my summary of benefits for that year. I have a pdf copy saved to my computer. I have offered to email it them, and they refuse to even look at it.
I am hoping to resolve this issue so that the the hospital, *** Health Care, gets paid the amount that Molina Health Care outlined they would pay in my summary of coverage for 2017. I will gladly pay the $150 copay to the hospital. I want this removed from my credit report, as this was a mistake on Molina Health Care's part, and they are not actively trying to help me resolve this issue.
I signed up for Molina on 12/13/2018. I decided I couldn't afford it. I cancelled everything on 12/28/2018. They told me I'd be refunded in 7-10 days.
as of 1/30/2019 I haven't received a refund
I just want the $93.96 refunded to me.
I have been credited back the $93.96 from Molina Healthcare. It took 7 weeks to get the money back. Thank you so much for your concern.
MOLINA MARKET PLACE THE ENT THAT ARE LISTED DO NOT TAKE THIS INSURANCE AND THEN WHEN YOU CALL THEY TELL YOU THEY WILL SEND IT TO A CASE WORK AND YOU NEVER HEAR ANYTHING BACK. SO THEN YOU TRY AGAIN AND YOUR TOLD TO DO A PRIOR AUTHORIZATION THROUGH YOUR DOCTOR BUT NO ENT IN TEXAS (WE HAVE TRIED ALL OVER TEXAS) WILL DO IT BECAUSE MOLINA WILL NOT PAY THEM. SO MY SON WHO IS 4 HAS HAD SWOLLEN TONSILS AND LYMPH NODES NOW FOR ALMOST 5 MONTHS NOW AND I AM GOING TO JUST HAVE TO FIGURE OUT HOW TO PAY CASH FOR HIS TO SEE A DOCTOR TO FIGURE OUT WHAT IS WRONG WITH HIM BECAUSE THE INSURANCE I PAY FOR EVERY MONTH DOESN'T HELP US.
A bill that is covered they have not paid c claiming I had other insurance which was then proved to them I didn't is now on my credit report. Not paid
April XX XXXX ambulance ride
They rejected bill
Talked to several employees
They wont let me or provider speak to billing
I cant get housing with this on my credit
They are giving the run around
They need to pay this and contact all credit bureos including bay are credit where my private medical information was sold to get it removed
Molina& health insurance market place processed my insurance application that I cancelled immediately because I could not afford the premiums.
I received a call from the Insurance Marketplace and when I was quoted a price of $264.00i immediately revoked and rejected the insurance because I could not afford it. I was unemployed ofr 1year and 6months, ran out of unemployment pay checks, was loosing my home, car etc. I advise the rep that I cannot give any payment because of my financial hardship and that I am she should cancel the application.
Later I kept getting letter asking for more document from me so that they could verify my income. I did not submit any additional information they were asking of me. March XX XXXX I was employed and still was received letters from them asking me to submit more documents because I did not complete the application and they needed more information from me. I refused and did provide any additional information because I had insurance on my job.
I have now filed my tax 2017 and I received a letter from the IRS that says that MOLINA-HEALTHCARE MARKETPLACE has paid for insurance for me $1322.05 I did not complete the application, neither did I submit all the documents, I did not choose any insurance plan or make no insurance payments. so why did they still processed my incompleted application and is now claiming that they paid insurance for me which I declined from the very beginning. I called
I called MOLINA and they said that the MARKETPLACE Submitted the form to them (MOLINA). I called the market place April X-XXXX and I told them that I had immediately cancel the application so why did they still go ahead and processed it without my consent. I spoke with GORDON WILSON AT THE MARKETPLACE and he said that they did not received any payments from me in the first place so the application should not have gone thru or even sent out to MOLINA.
I did not approve this insurance policy premium payments, I did not accept the insurance plan, I did not choose any insurance plan, nor make any payments.....Why are they claiming that they made insurance premium payments on my behalf that I did not consent to??
this is affecting my tax return refund. my taxes are held back because they claim to make insurance payments for me which I did not approved. They need to reversed and discontinue their false claim of making payments on my behalf. get this off my record so that the IRS can continue with my refund.
Molina has researched this case and found that on April 06, 2017, Molina's Call Center received a telephonic call from subscriber/complainant, ***, indicating she received a Health Insurance Marketplace Statement (form 1095-A) reflecting her with 2017 Molina Healthcare coverage; however, Ms. indicated she did not complete her application with the Federally Facilitated Marketplace (FFM). Molina reviewed Ms. case and determined that on January 19, 2017, Molina received an eligibility file from the FFM reflecting Ms. eligible under Molina Marketplace Consumer Choice Bronze Plan, effective March 01, 2017 with a termination date of July 31, 2017. Additionally, the aforementioned FFM eligibility file reflected Ms. approved monthly Advance Premium Tax Credit (APTC) in the amount of $264.41 for a total of $1322.05 and a subscriber monthly premium responsibility of $0.00.
On April 16, 2018, a Molina representative spoke with Ms. via telephonic call and apprised her of the aforementioned information. Ms. was advised to contact the FFM at (XXX) XXX-XXXX and file a Health Insurance Marketplace Casework System (HICS) case of which Ms. verbalized her understanding.
(The consumer indicated he/she DID NOT accept the response from the business.)
An application which I denied to be opened and asked the agent to immediately cancel the application was not done. The agent submitted and incomplete application so why was the application not denied in the first place. Why did Molina and the Marketplace Insurance continue to process an application that was incomplete and missing proper documentation from me. That application should not have been accepted in the first place, secondly it should not have been processed, and MOLINA AND THE HEALTHCARE MARKET PLACE INSURACE Should not have force medically coverage on me. by that time I was already employed and receiving coverage from my job.
I call the Health CARE MARKET PLACE and the both parties keep giving me a round about. Healthcare market place rep MAYALA told me to call MOLINA AND then MOLINA told me to call back the HEALTHCARE MARKET PLACE and this cycle has been going round and round.
The matter is simple, I should not have been given medical coverage by MOLINA due to incompleted application.
Lists of psychiatrists and psychologists are outdated and useless.
I have been looking for a psychiatrists and psychologists for the past four months. I'm tired of calling the names on the lists given to me by Molina only to have the Dr s. Say they only treat nursing home patients or are in west Texas instead of Richardson. I need Molina to contact someone in my area who will see me. On an outpatient basis. Otherwise I'll seek treAtment at an emergency facility and Molina will pay all charges. Can't wait to get some adequate health care next year. Do I have to wait?
Want Molina to find me a shrink and a psychologist.
Dear Dispute Resolution Department:
On April 17, 2018, a Molina representative reached out to subscriber/complainant, ***, via telephonic call to advise him that the Revdex.com complaint filed was being addressed. The representative provided Mr. with three (3) confirmed in-network providers.
Molina is presently working with additional providers to expand its network to continue to improve access to care. Molina's online provider directory is updated weekly to ensure all contracted providers are included. Updating of the provider directory is a collaborative effort as contracted providers also have the responsibility to update Molina of closed panels or requesting to exit Molina's network. As part of Molina's commitment to its members, Molina's member services team is available to assist members with PCP and/or Specialist selection and help arrange appointments.
If you have any questions, please feel free to contact me at (XXX) XXX-XXXX extension XXXXXX or email me at ***@molinahealthcare.com
Sincerely,
Eugenio *** IV
Appeals and Grievances Specialist