This letter is in response to a complaint you received from *** * ***,*** *** ***, Fort Wayne, IN Ms*** requested a refundfor certain months premiums paid during which she claims she was not insured.In the interest of maintaining protection of Ms*** health
information,great detail is not being provided in this communicationHowever, I will confirmthat Ms*** was advised she would be receiving a refundThe check wasmailed on 3/18/and she was told to allow seven to ten days for receiptWediscussed this with Ms***, and she stated that she will cash the checkand consider this matter closed.If you have additional information, please feel free to contact me at the numberbelow
Sincerely,
Scott L***Director of Compliance & Counsel
Complaint: ***
I am rejecting this response because:I received the letter and again it is them making excuses on why it is someone elses job. It is telling me to do the same thing that I have tried dozens of times to do, calling them on the phone and telling them to fix it. IF that were the solution then it would have already been fixed and I wouldn't have made this complaint in the first place.Again, the Coordinated care and all other entities invovled in this need to stop making excuses and passing it on to others. They need to get this fixed so that I can have health care. The letter refusing to do anything and just telling me to call an number accomplishes nothing. Both this Dean S*** and Terri S have done nothing and haven't even made an attempt at fixing this problem that should be a simple fix. Seriously, come on, it has been years and they do NOTHING
Sincerely,
*** ***
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have addressed the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on fileWe appreciate your patronage and thank you for bringing these issues to our attention Respectfully, Dean S*** Senior Director, Operations Broadway Suite Tacoma, WA
Dear Valued Member:
Again, I sincerely apologize for the frustration and inconvenience you have experienced during our review of this situationWe have resolved the issue and you have received your My Health Pays reward cardThe response in the mailed resolution letter you received came from myself, and I am more than happy to speak with you and explain why a refund or credit of premium will not be issuedPlease call our customer service at 1-877-687-and ask to speak with myselfIf I am unavailable please let the customer service representative know and I will return your callWe are responding in writing with resolution addressing your concerns at the address we have on file
We appreciate your patronage
Respectfully,
Dean S***
Senior Director, Operations
Broadway
Suite
Tacoma, WA
Dear Valued Member:I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on file.We appreciate your patronage and thank you for bringing these issues to our attention.Respectfully,Dean S*Director, Operations*** *** *** *** *** ** ***
Dear Valued Member:
I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issues. My team has reviewed your information and I am confident we have corrected the issues. Ambetter from Coordinated Care is dedicated to protecting your personal
health information, so I am unable to go into specifics about the resolution here. However, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on file
We appreciate your patronage and thank you for bringing these issues to our attention
Respectfully,
Dean S***
Director, Operations
*** *** *** ***
Tacoma, WA
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on fileWe appreciate your patronage and thank you for bringing these issues to our attention Respectfully, Dean S*** Senior Director, Operations Broadway Suite Tacoma, WA
Subject: Re: Revdex.com COMPLAINT #*** *** ** VS AMBETTER FROM COORDINATED CAREThe current complaint, as of about days ago, has also been resolved but took over a year and hours upon hours of my time to get taken care if I've since switched insurance companies due to their
completely inept customer service and incompetent claims processing procedures.*** **
Subject: Re: Revdex.com COMPLAINT #*** *** ** VS AMBETTER FROM COORDINATED CAREYes, those issues were resolved, eventually, after about one month and multiple calls.I've since switched insurance companies due to their completely inept customer service and incompetent claims processing
procedures.*** **
Complaint: ***I am rejecting this response because:
The complaint was not a "medical" issue so they are incorrect in saying they can't go into details because of the privacy laws
This was trying to get them to send me out my VISA health pays rewards card I have been trying for almost months to get them to send it and they keep making up excuses And I never talk to the same person so I get a different excuse each time
I find it NOT a coincidence that after I sent the Revdex.com a formal complaint my VISA card suddenly showed up yesterday
Once I put a fire under them, they figured they better not hold off any longer
I am asking that they waive one month medical premiums ($142.84) because I wasn't allowed to pay my last two months premiums from all the money I had accumulated on my VISA card
Or they can reimburse me in cash; the choice is theirs They inconvenienced me by several months delay without any reason for it Not to mention all the time and effort I spent on trying to get this resolved
I will not settle this case until they agree to compensate me one month medical premium
Thank you
*** ***
Sincerely,*** ***
Dear Valued Member,
On behalf of Ambetter from Coordinated Care, I sincerely apologize for the obvious frustration you have experienced. The erroneous invoice you received came as a result of the transition of *** *** *** *** taking over premium invoicing from the ***
*** *** *** (***). There was a long delay in the receipt of your termination record from the *** and once Ambetter from Coordinated Care began the invoicing process our billing system calculated the back dated invoice
Please discard the invoice. I have confirmed with our Enrollment Department that you enrollment record reflects the correct termination date. In regards to one of our staff members hanging up on you during an inquiry into this issue, I was unable to locate this incident in our call system. I can assure that this type of behavior is not condoned and will not be tolerated I will speak with the Customer Service agent you spoke with and ensure that he/she clearly understands our policy on providing outstanding Customer Service
I appreciate you bringing your situation to my attention
Respectfully,Dean R S*Director of OperationsAmbetter from Coordinated Care
Dear Valued Member:
I apologize for the confusion and frustration you have experiencedAn official grievance has been opened on your behalf and my team is currently reviewing your file to uncover the root causeRest assured we will continue to work diligently with you to resolve this matter
However, because Ambetter from Coordinated Care is dedicated to protecting your personal health information I am unable to go into specifics about your case hereWe will reach out to you via the contact information we have on file and provide you with an update on our investigation within a week.
We appreciate your patronage and thank you for bringing this situation to our attention.
Respectfully,
Dean RS***
Director, Operations
*** *** *** ***
Tacoma, WA
Complaint: ***I am rejecting this response because: "I am confident the issues have been resolved." We'll that's the 14th time we've heard thatThey managed to pay out of the bills they are responsible to pay forI have emailed them copies of the billsThe medical provider still owed called them directly on July 14thThis shouldn't be difficultEVERYONE agrees they need to be paid by Ambetter and not by us, including AmbetterIf the Director of Operations (not sure of what operations) can't fix it, communication is brokenAnd what ever happened with my grievance complaints I filed with AmbetterThey call us valued customers, boy is their value system lowAll they value is that you keep sending them money.Sincerely,*** ***
Dear Valued Member,
Thank you for your patience. Again, I sincerely apologize for the confusion and frustration you have experienced during our review of this situation. I have confirmed that the claims in questions have been re-adjudicated and processed correctly per your benefit plan
We mailed you a letter dated 10/30/with additional information that further explains how we processed your claims
Thank you for bring this to my attention and if you have any questions please feel free to call our Customer Service line at *** / TDD/TTY***
Respectfully,Dean R S*Director, OperationsAmbetter from Coordinated Care
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on fileWe appreciate your patronage and thank you for bringing these issues to our attention
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereWe appreciate your patronage and thank you for bringing these issues to our attention Respectfully, Dean S*** Senior Director, Operations Broadway Suite Tacoma, WA
Complaint: ***I am rejecting this response because:until i'm sure that I won't be charged for the month of january or have this go on my credit report then and only then will I be satisfied,i'm not out to bad mouth this company if they resolve this as mentioned, my policy was canceled in december of and (again) in january of because no one canceled it when I asked them to cancel in december.Sincerely,*** ***
Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meSincerely, *** ***
This letter is in response to a complaint you received from *** * ***,*** *** ***, Fort Wayne, IN Ms*** requested a refundfor certain months premiums paid during which she claims she was not insured.In the interest of maintaining protection of Ms*** health
information,great detail is not being provided in this communicationHowever, I will confirmthat Ms*** was advised she would be receiving a refundThe check wasmailed on 3/18/and she was told to allow seven to ten days for receiptWediscussed this with Ms***, and she stated that she will cash the checkand consider this matter closed.If you have additional information, please feel free to contact me at the numberbelow
Sincerely,
Scott L***Director of Compliance & Counsel
Complaint: ***
I am rejecting this response because:I received the letter and again it is them making excuses on why it is someone elses job. It is telling me to do the same thing that I have tried dozens of times to do, calling them on the phone and telling them to fix it. IF that were the solution then it would have already been fixed and I wouldn't have made this complaint in the first place.Again, the Coordinated care and all other entities invovled in this need to stop making excuses and passing it on to others. They need to get this fixed so that I can have health care. The letter refusing to do anything and just telling me to call an number accomplishes nothing. Both this Dean S*** and Terri S have done nothing and haven't even made an attempt at fixing this problem that should be a simple fix. Seriously, come on, it has been years and they do NOTHING
Sincerely,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have addressed the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on fileWe appreciate your patronage and thank you for bringing these issues to our attention Respectfully, Dean S*** Senior Director, Operations Broadway Suite Tacoma, WA
Dear Valued Member:
Again, I sincerely apologize for the frustration and inconvenience you have experienced during our review of this situationWe have resolved the issue and you have received your My Health Pays reward cardThe response in the mailed resolution letter you received came from myself, and I am more than happy to speak with you and explain why a refund or credit of premium will not be issuedPlease call our customer service at 1-877-687-and ask to speak with myselfIf I am unavailable please let the customer service representative know and I will return your callWe are responding in writing with resolution addressing your concerns at the address we have on file
We appreciate your patronage
Respectfully,
Dean S***
Senior Director, Operations
Broadway
Suite
Tacoma, WA
Dear Valued Member:I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
*Director, Operations*** *** *** *** *** ** ***
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on file.We appreciate your patronage and thank you for bringing these issues to our attention.Respectfully,Dean S
Dear Valued Member:
I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issues. My team has reviewed your information and I am confident we have corrected the issues. Ambetter from Coordinated Care is dedicated to protecting your personal
health information, so I am unable to go into specifics about the resolution here. However, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on file
We appreciate your patronage and thank you for bringing these issues to our attention
Respectfully,
Dean S***
Director, Operations
*** *** *** ***
Tacoma, WA
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on fileWe appreciate your patronage and thank you for bringing these issues to our attention Respectfully, Dean S*** Senior Director, Operations Broadway Suite Tacoma, WA
Subject: Re: Revdex.com COMPLAINT #*** *** ** VS AMBETTER FROM COORDINATED CAREThe current complaint, as of about days ago, has also been resolved but took over a year and hours upon hours of my time to get taken care if I've since switched insurance companies due to their
completely inept customer service and incompetent claims processing procedures.*** **
Subject: Re: Revdex.com COMPLAINT #*** *** ** VS AMBETTER FROM COORDINATED CAREYes, those issues were resolved, eventually, after about one month and multiple calls.I've since switched insurance companies due to their completely inept customer service and incompetent claims processing
procedures.*** **
Complaint: ***I am rejecting this response because:
The complaint was not a "medical" issue so they are incorrect in saying they can't go into details because of the privacy laws
This was trying to get them to send me out my VISA health pays rewards card I have been trying for almost months to get them to send it and they keep making up excuses And I never talk to the same person so I get a different excuse each time
I find it NOT a coincidence that after I sent the Revdex.com a formal complaint my VISA card suddenly showed up yesterday
Once I put a fire under them, they figured they better not hold off any longer
I am asking that they waive one month medical premiums ($142.84) because I wasn't allowed to pay my last two months premiums from all the money I had accumulated on my VISA card
Or they can reimburse me in cash; the choice is theirs They inconvenienced me by several months delay without any reason for it Not to mention all the time and effort I spent on trying to get this resolved
I will not settle this case until they agree to compensate me one month medical premium
Thank you
*** ***
Sincerely,*** ***
Dear Valued Member,
*Director of OperationsAmbetter from Coordinated Care
On behalf of Ambetter from Coordinated Care, I sincerely apologize for the obvious frustration you have experienced. The erroneous invoice you received came as a result of the transition of *** *** *** *** taking over premium invoicing from the ***
*** *** *** (***). There was a long delay in the receipt of your termination record from the *** and once Ambetter from Coordinated Care began the invoicing process our billing system calculated the back dated invoice
Please discard the invoice. I have confirmed with our Enrollment Department that you enrollment record reflects the correct termination date. In regards to one of our staff members hanging up on you during an inquiry into this issue, I was unable to locate this incident in our call system. I can assure that this type of behavior is not condoned and will not be tolerated I will speak with the Customer Service agent you spoke with and ensure that he/she clearly understands our policy on providing outstanding Customer Service
I appreciate you bringing your situation to my attention
Respectfully,Dean R S
Dear Valued Member:
I apologize for the confusion and frustration you have experiencedAn official grievance has been opened on your behalf and my team is currently reviewing your file to uncover the root causeRest assured we will continue to work diligently with you to resolve this matter
However, because Ambetter from Coordinated Care is dedicated to protecting your personal health information I am unable to go into specifics about your case hereWe will reach out to you via the contact information we have on file and provide you with an update on our investigation within a week.
We appreciate your patronage and thank you for bringing this situation to our attention.
Respectfully,
Dean RS***
Director, Operations
*** *** *** ***
Tacoma, WA
Complaint: ***I am rejecting this response because: "I am confident the issues have been resolved." We'll that's the 14th time we've heard thatThey managed to pay out of the bills they are responsible to pay forI have emailed them copies of the billsThe medical provider still owed called them directly on July 14thThis shouldn't be difficultEVERYONE agrees they need to be paid by Ambetter and not by us, including AmbetterIf the Director of Operations (not sure of what operations) can't fix it, communication is brokenAnd what ever happened with my grievance complaints I filed with AmbetterThey call us valued customers, boy is their value system lowAll they value is that you keep sending them money.Sincerely,*** ***
Dear Valued Member,
*Director, OperationsAmbetter from Coordinated Care
Thank you for your patience. Again, I sincerely apologize for the confusion and frustration you have experienced during our review of this situation. I have confirmed that the claims in questions have been re-adjudicated and processed correctly per your benefit plan
We mailed you a letter dated 10/30/with additional information that further explains how we processed your claims
Thank you for bring this to my attention and if you have any questions please feel free to call our Customer Service line at *** / TDD/TTY***
Respectfully,Dean R S
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereHowever, a comprehensive reply regarding the issues you reported was sent directly to you at the address we have on fileWe appreciate your patronage and thank you for bringing these issues to our attention
Dear Valued Member: I apologize for the frustration and inconvenience you have experienced in attempt to resolve these issuesMy team has reviewed your information and I am confident we have corrected the issuesAmbetter from Coordinated Care is dedicated to protecting your personal health
information, so I am unable to go into specifics about the resolution hereWe appreciate your patronage and thank you for bringing these issues to our attention Respectfully, Dean S*** Senior Director, Operations Broadway Suite Tacoma, WA
Complaint: ***I am rejecting this response because:until i'm sure that I won't be charged for the month of january or have this go on my credit report then and only then will I be satisfied,i'm not out to bad mouth this company if they resolve this as mentioned, my policy was canceled in december of and (again) in january of because no one canceled it when I asked them to cancel in december.Sincerely,*** ***
Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meSincerely, *** ***