MDwise has attempted to reach out to Mr [redacted] at 11:AM, Tuesday, March 1, and left a voicemail with a direct number to a customer service manager for a return call He also left messages at 3:PM, Tuesday, March 1, and 11:AM, Wednesday, March 2, As of today, we have not heard back from Mr*** Mr [redacted] became an active member with MDwise under the HIP Basic program on January 1, MDwise is required by the State to complete a Health Needs Screening for 70% of our members within days of the date we receive notification that the member is eligible and active The day mark for Mr [redacted] is March 30, MDwise is deeply committed to meeting our Service Level Agreements with the State This is why the phone number for Mr [redacted] was placed in our automatic dialer, along with the 1,other members reported active on January 1, During that time, our records indicate that Mr [redacted] was contacted one time on February 29, He indicated to the customer service representative that he is ordering us to stop contacting him Upon this notification, the phone number for Mr [redacted] was entered into our Do Not Call list and removed from our automatic dialer systemThe personal information of our members is never sold Any information discussed during the Health Needs Screening is protected under the HIPAA and HITEC acts The first question of the of the Screening also allows members to refuse sharing of the information with MDwise care management staff and the members provider if they so desireThe gift card referenced by Mr [redacted] is accurate By completing the Health Needs Screening, a member will earn member reward points, which is enough to redeem for a $gift card However, the members can also earn additional points throughout the year by setting up an online account with MDwise, tobacco cessation, completing their annual physical, and glucose testing, which could earn them enough points to redeem for a $gift card The reward points and gift card are not a prize, but simply a way for MDwise to say thank you to our members for taking an active role in their health and well beingPlease let me know if you have any questions
On 12/5/15, Our Customer Service Department was able to reach the member and advise her that she is showing eligible back to 5/1/ She will fax or call us about the billing information so we can reach out to the provider Once that information is received, we will loop in our Claims Management team as this claim is past the timely filing deadline
9/6/at 6:PM, had a lengthy conversation with the mbrAttempted to explain to her that the state has made the ruling not to waived or credit the payment of $on her accountThe mbr insisted that this has been going on for over a year and she still wants the $be remove from her account and this is someone else mistake and she does not wish to hear anything elseI advised the mbr, I will again look into account and will call her back 9/7/at 5:PM, outreached to the member, informed her again of the denied requestAdvised for her to file an appeal with DFR to have her request be heard, the member agreed The member than again stated that her request is now over a year old and due to someone else mistake the $should be removed from her account per her requestI attempted to explain again that her request is beyond what MDwise is able to do, the member than disconnect the call
We have updated the accounts of Mrand Mrs [redacted] to reflect Dr [redacted] as their PMPWe apologize for the delay in making this changeShould the [redacted] ’s have any questions, they may contact me at mg [redacted] @mdwise.org or 317-822-
We are in receipt of your letter dated April 21, notifying us of an issue reported from Ms [redacted] In her correspondence, Ms [redacted] indicated that she continued to receive invoices from MDwise Marketplace even though she believes she did not enroll in a policy We have cancelled Ms [redacted] ’s policy, and she should no longer receive invoices Our Customer Service Team spoke with Ms [redacted] today to let her know that her issue has been resolved Please let me know if I can be of further assistance Sincerely, Elizabeth E [redacted] MDwise Marketplace Compliance Officer
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this response/resolution is satisfactory to me Regards, [redacted]
Mrs [redacted] is enrolled in a MDwise Marketplace Silver planWe have updated Mrs [redacted] ’s patient portal to reflect a paid through date of January 31, Additionally, all claims will be reprocessed to pay, as appropriateWe apologize for the inconvenienceShould Mrs [redacted] have any questions or concerns, she may contact Morgan G [redacted] at mg [redacted] @mdwise.org or 317-822-
We contacted Ms [redacted] and she informed us that she does not want MDwisse Marketplace coverage because she has coverage through another providerMs***'s MDwise coverage may be cancelled by contacting the Health Insurance Marketplace or by logging into her account on Healthcare.govShould Ms [redacted] have any questions, she may contact Morgan G [redacted] at mg [redacted] @mdwise.org or 317-822-
We researched Ms [redacted] concerns regarding the denial of her two claimsShe was, in fact, enrolled for the dates of service in questionWe are working to reprocess those claims as they were denied in errorWe have contacted Ms [redacted] to explain this processWe apologize for the inconvenience this has caused and will continue to update Ms [redacted] on the status of her claimsShould she have any further questions or concerns, she may contact Morgan [redacted] at 317-822-
I spoke with Mrs [redacted] and she informed us that she has her medication and claims are being paidI will continue to monitor Mrs***'s account to ensure that claims are processing correctlyShould Mrs [redacted] have any questions or concerns, she may contact me at mg [redacted] @mdwise.org or 317-822-
This claim is being reprocessed and paid as emergent The payment should be made on the next MDwise Connect (Marketplace) check run which is Tuesday 1/24/Member Services outreached Ms [redacted] today and advised of the result
The contact that Mr [redacted] was working with was out of the office during the week of October - Mr [redacted] was contacted on 10/31/regarding his concernsWe are still trying to address his concerns with the hospitalWe will continue to update Mr [redacted] as we attempt resolutionShould Mr [redacted] have any questions, he may contact Morgan G [redacted] at mg [redacted] @mdwise.org or 317-822-
Mdwise Marketplacet sincerely apologies for the delay in sending the [redacted] 's ID cards. Official ID cards were resent to the [redacted] s on March 15, 2017. In the meantime, MDwise mailed temporary ID cards to the [redacted] 's that should arrive in the mail on or before Monday, March 27, 2017. Should... the [redacted] 's need to access services prior to that time, they may print their ID cards from the MyMDwise portal. Again, we apologize for any inconvenience this delay has caused. Should the [redacted] 's have any questions or concerns, they may contact me at 317-822-7210 or mg [redacted] @mdwise.org.
We are in receipt of your letter dated August 14, notifying us of Problem Report # [redacted] from Ms [redacted] In her correspondence, Ms [redacted] explained that several claims in May had not been paid A MDwise Marketplace Bronze Plan was issued to Ms [redacted] on 1/1/ The MDwise Marketplace Claims Team researched this issue and discovered that the Center for Medicaid and Medicare Services (CMS) erroneously sent a 4/30/term record for Ms [redacted] The next record we received was for an enrollment span of 5/1/to 5/1/15, which essentially cancelled her coverage again CMS then sent a correct enrollment record As a result of incorrect records from CMS, Ms [redacted] ’s claims initially denied Her claims have been re-processed, and the details are below [redacted] is a contracted provider and is prohibited from balance billing Ms [redacted] Claim Number Date of Service Provider Billed Amount Allowed Amount Paid Amount Check Number Date Paid Member Responsibility [redacted] [redacted] (withheld for provider incentive program) [redacted] [redacted] (withheld for provider incentive program) [redacted] [redacted] na na for deductible [redacted] [redacted] (withheld for provider incentive program) [redacted] [redacted] na na for deductible [redacted] [redacted] (withheld for provider incentive program) Our Compliance Team spoke with Ms [redacted] on 9/1/to update her on her accountThe NAIC number for MDwise Marketplace is *** Please let us know if we can be of further assistance Sincerely, Patty H [redacted] MDwise Marketplace General Counsel
Mr. [redacted] was enrolled at the date of service and his claims were denied in error. We reprocessed the two claims. The claim for date of service February 8, 2016 has not paid yet, but is currently being adjudicated. The second claim for date of service March 15, 2016 has been paid. We apologize for... the inconvenience this has caused. Should Mr. [redacted] have any further questions he may contact Morgan G [redacted] at m [redacted] @mdwise.org or 317-822-7210.
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below I was contacted by Morgan G [redacted] and she told me she was faxing a settlement offer to the hospital.After leaving many messages for Morgan over a weeks period of time and not getting any response, I decided to call the hospital.The hospital never received any communication from MDwise at all.Since then, I have left many more messages, both email and phone for Morgan...........She will not contact me.Please have someone call me and let me know whats going on...PLEASE Regards, [redacted]
We contacted Ms*** and she informed us that she does not want MDwisse Marketplace coverage because she has coverage through another providerMs***'s MDwise coverage may be cancelled by contacting the Health Insurance Marketplace or by logging into her account on Healthcare.govShould Ms
*** have any questions, she may contact Morgan G*** at mg***@mdwise.org or 317-822-
On 11/8/16, MDwise issued a refund and was mailed 11/9/11/08/@ 9:12am, a Customer Service Supervisor tried to outreach to the member, but there was no answer or voicemailWe will continue to outreach this member
We are in receipt of your letter dated April 21, notifying us of an issue reported from Ms*** ***In her correspondence, Ms*** indicated that she continued to receive invoices from MDwise Marketplace even though she believes she did not enroll in a policy We have
cancelled Ms***’s policy, and she should no longer receive invoices Our Customer Service Team spoke with Ms*** today to let her know that her issue has been resolved Please let me know if I can be of further assistance Sincerely, Elizabeth E*** MDwise Marketplace Compliance Officer
MDwise has attempted to reach out to Mr [redacted] at 11:AM, Tuesday, March 1, and left a voicemail with a direct number to a customer service manager for a return call He also left messages at 3:PM, Tuesday, March 1, and 11:AM, Wednesday, March 2, As of today, we have not heard back from Mr*** Mr [redacted] became an active member with MDwise under the HIP Basic program on January 1, MDwise is required by the State to complete a Health Needs Screening for 70% of our members within days of the date we receive notification that the member is eligible and active The day mark for Mr [redacted] is March 30, MDwise is deeply committed to meeting our Service Level Agreements with the State This is why the phone number for Mr [redacted] was placed in our automatic dialer, along with the 1,other members reported active on January 1, During that time, our records indicate that Mr [redacted] was contacted one time on February 29, He indicated to the customer service representative that he is ordering us to stop contacting him Upon this notification, the phone number for Mr [redacted] was entered into our Do Not Call list and removed from our automatic dialer systemThe personal information of our members is never sold Any information discussed during the Health Needs Screening is protected under the HIPAA and HITEC acts The first question of the of the Screening also allows members to refuse sharing of the information with MDwise care management staff and the members provider if they so desireThe gift card referenced by Mr [redacted] is accurate By completing the Health Needs Screening, a member will earn member reward points, which is enough to redeem for a $gift card However, the members can also earn additional points throughout the year by setting up an online account with MDwise, tobacco cessation, completing their annual physical, and glucose testing, which could earn them enough points to redeem for a $gift card The reward points and gift card are not a prize, but simply a way for MDwise to say thank you to our members for taking an active role in their health and well beingPlease let me know if you have any questions
On 12/5/15, Our Customer Service Department was able to reach the member and advise her that she is showing eligible back to 5/1/ She will fax or call us about the billing information so we can reach out to the provider Once that information is received, we will loop in our Claims Management team as this claim is past the timely filing deadline
9/6/at 6:PM, had a lengthy conversation with the mbrAttempted to explain to her that the state has made the ruling not to waived or credit the payment of $on her accountThe mbr insisted that this has been going on for over a year and she still wants the $be remove from her account and this is someone else mistake and she does not wish to hear anything elseI advised the mbr, I will again look into account and will call her back 9/7/at 5:PM, outreached to the member, informed her again of the denied requestAdvised for her to file an appeal with DFR to have her request be heard, the member agreed The member than again stated that her request is now over a year old and due to someone else mistake the $should be removed from her account per her requestI attempted to explain again that her request is beyond what MDwise is able to do, the member than disconnect the call
We have updated the accounts of Mrand Mrs [redacted] to reflect Dr [redacted] as their PMPWe apologize for the delay in making this changeShould the [redacted] ’s have any questions, they may contact me at mg [redacted] @mdwise.org or 317-822-
We are in receipt of your letter dated April 21, notifying us of an issue reported from Ms [redacted] In her correspondence, Ms [redacted] indicated that she continued to receive invoices from MDwise Marketplace even though she believes she did not enroll in a policy We have cancelled Ms [redacted] ’s policy, and she should no longer receive invoices Our Customer Service Team spoke with Ms [redacted] today to let her know that her issue has been resolved Please let me know if I can be of further assistance Sincerely, Elizabeth E [redacted] MDwise Marketplace Compliance Officer
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this response/resolution is satisfactory to me Regards, [redacted]
Mrs [redacted] is enrolled in a MDwise Marketplace Silver planWe have updated Mrs [redacted] ’s patient portal to reflect a paid through date of January 31, Additionally, all claims will be reprocessed to pay, as appropriateWe apologize for the inconvenienceShould Mrs [redacted] have any questions or concerns, she may contact Morgan G [redacted] at mg [redacted] @mdwise.org or 317-822-
We contacted Ms [redacted] and she informed us that she does not want MDwisse Marketplace coverage because she has coverage through another providerMs***'s MDwise coverage may be cancelled by contacting the Health Insurance Marketplace or by logging into her account on Healthcare.govShould Ms [redacted] have any questions, she may contact Morgan G [redacted] at mg [redacted] @mdwise.org or 317-822-
We researched Ms [redacted] concerns regarding the denial of her two claimsShe was, in fact, enrolled for the dates of service in questionWe are working to reprocess those claims as they were denied in errorWe have contacted Ms [redacted] to explain this processWe apologize for the inconvenience this has caused and will continue to update Ms [redacted] on the status of her claimsShould she have any further questions or concerns, she may contact Morgan [redacted] at 317-822-
I spoke with Mrs [redacted] and she informed us that she has her medication and claims are being paidI will continue to monitor Mrs***'s account to ensure that claims are processing correctlyShould Mrs [redacted] have any questions or concerns, she may contact me at mg [redacted] @mdwise.org or 317-822-
This claim is being reprocessed and paid as emergent The payment should be made on the next MDwise Connect (Marketplace) check run which is Tuesday 1/24/Member Services outreached Ms [redacted] today and advised of the result
The contact that Mr [redacted] was working with was out of the office during the week of October - Mr [redacted] was contacted on 10/31/regarding his concernsWe are still trying to address his concerns with the hospitalWe will continue to update Mr [redacted] as we attempt resolutionShould Mr [redacted] have any questions, he may contact Morgan G [redacted] at mg [redacted] @mdwise.org or 317-822-
Mdwise Marketplacet sincerely apologies for the delay in sending the [redacted] 's ID cards. Official ID cards were resent to the [redacted] s on March 15, 2017. In the meantime, MDwise mailed temporary ID cards to the [redacted] 's that should arrive in the mail on or before Monday, March 27, 2017. Should... the [redacted] 's need to access services prior to that time, they may print their ID cards from the MyMDwise portal. Again, we apologize for any inconvenience this delay has caused. Should the [redacted] 's have any questions or concerns, they may contact me at 317-822-7210 or mg [redacted] @mdwise.org.
We are in receipt of your letter dated August 14, notifying us of Problem Report # [redacted] from Ms [redacted] In her correspondence, Ms [redacted] explained that several claims in May had not been paid A MDwise Marketplace Bronze Plan was issued to Ms [redacted] on 1/1/ The MDwise Marketplace Claims Team researched this issue and discovered that the Center for Medicaid and Medicare Services (CMS) erroneously sent a 4/30/term record for Ms [redacted] The next record we received was for an enrollment span of 5/1/to 5/1/15, which essentially cancelled her coverage again CMS then sent a correct enrollment record As a result of incorrect records from CMS, Ms [redacted] ’s claims initially denied Her claims have been re-processed, and the details are below [redacted] is a contracted provider and is prohibited from balance billing Ms [redacted] Claim Number Date of Service Provider Billed Amount Allowed Amount Paid Amount Check Number Date Paid Member Responsibility [redacted] [redacted] (withheld for provider incentive program) [redacted] [redacted] (withheld for provider incentive program) [redacted] [redacted] na na for deductible [redacted] [redacted] (withheld for provider incentive program) [redacted] [redacted] na na for deductible [redacted] [redacted] (withheld for provider incentive program) Our Compliance Team spoke with Ms [redacted] on 9/1/to update her on her accountThe NAIC number for MDwise Marketplace is *** Please let us know if we can be of further assistance Sincerely, Patty H [redacted] MDwise Marketplace General Counsel
Mr. [redacted] was enrolled at the date of service and his claims were denied in error. We reprocessed the two claims. The claim for date of service February 8, 2016 has not paid yet, but is currently being adjudicated. The second claim for date of service March 15, 2016 has been paid. We apologize for... the inconvenience this has caused. Should Mr. [redacted] have any further questions he may contact Morgan G [redacted] at m [redacted] @mdwise.org or 317-822-7210.
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below I was contacted by Morgan G [redacted] and she told me she was faxing a settlement offer to the hospital.After leaving many messages for Morgan over a weeks period of time and not getting any response, I decided to call the hospital.The hospital never received any communication from MDwise at all.Since then, I have left many more messages, both email and phone for Morgan...........She will not contact me.Please have someone call me and let me know whats going on...PLEASE Regards, [redacted]
We are sorry for the inconvenience. A refund in the amount of $has been requested and will be mailed to the member next week. Thank you
We contacted Ms*** and she informed us that she does not want MDwisse Marketplace coverage because she has coverage through another providerMs***'s MDwise coverage may be cancelled by contacting the Health Insurance Marketplace or by logging into her account on Healthcare.govShould Ms
*** have any questions, she may contact Morgan G*** at mg***@mdwise.org or 317-822-
On 11/8/16, MDwise issued a refund and was mailed 11/9/11/08/@ 9:12am, a Customer Service Supervisor tried to outreach to the member, but there was no answer or voicemailWe will continue to outreach this member
We are in receipt of your letter dated April 21, notifying us of an issue reported from Ms*** ***In her correspondence, Ms*** indicated that she continued to receive invoices from MDwise Marketplace even though she believes she did not enroll in a policy We have
cancelled Ms***’s policy, and she should no longer receive invoices Our Customer Service Team spoke with Ms*** today to let her know that her issue has been resolved Please let me know if I can be of further assistance Sincerely, Elizabeth E*** MDwise Marketplace Compliance Officer