Signs of Success

Revdex.com of CENTRAL INDIANA NDelaware Street, #Indianapolis, IN 46204- RE: Revdex.com Complaint ID Number [redacted] FAX 317-488- We received your letters regarding the above-referenced complaintsMHS has also received notice of this issue through a number of avenues, including the Indiana Family and Social Services Administration (FSSA)We are happy to take this opportunity to let you know that we have contacted our member about her issuesWe made attempts to talk to her on the phone, and a letter was sent on November 10, and informed FSSA of our findingsBecause the issue is already addressed, and because of our concern not to disclose an individual member's protected health and demographic information, we are declining to publish here the details of this particular situationWe thank you for your assistance to our plan member and for your dedication to businessaccountabilitySincerely, Scott L [redacted] Director, Compliance

We received your letter regarding the above-referenced complaint on November 20, Thank you for the opportunity to address the concerns of our Ambetter from MHS memberThe member in this case expressed concern that his premiums were different amounts, he was not enrolled in the rewards program for receiving preventative services and he has unpaid claims.After conducting a thorough investigation we found this member's premium has remained the same since his enrollmentAfter reviewing claims for this member we found some that denied claims because the provider is not in network with Ambetter from MHS and authorization was not obtained prior to the service the provider the provider billed with incorrect informationIn his complaint this member stated he was not enrolled in the rewards program for receiving preventative servicesAmbetter from MHS found this member has received rewards however the rewards card has not been activatedAmbetter from MHS has attempted to reach our member to address his concernsWe thank you for your assistance to our plan member and for your dedication to business accountabilityBest Regards, Scott L [redacted] Director Compliance (317) 684-

January 6, Revdex.com of CENTRAL INDIANA NDelaware Street, #Indianapolis, IN 46204- RE: Revdex.com Complaint ID Number [redacted] Dear Ms***: We received your letter regarding the above-referenced complaint on December 21, Once your complaint was received we conducted a thorough investigation of this issue We have corrected the issueAmbetter from MHS has contacted our member to inform her we have corrected the issue Because the issue is already addressed, and because of our concern not to disclose an individual member’s protected health and demographic information, we are declining to publish here the details of this particular situation We thank you for your assistance to our plan member and for your dedication to business accountability Best Regards, Rebecca S [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.Brittany has indeed contacted me regarding my complaints but they have not been resolvedFor instance - the echo web coordinator had sent me an e-mail stating that two types of crowns maybe coveredBrittany said only type of crown would be covered, the stainless steelHer objection to the statement made be the echo coordinator does not hold water because Brittany stated that the echo coordsaid the word 'maybe' was used and so the other crown is not part of my benefits, but the word 'maybe' applies to both types of crown not just the one that Brittany is objecting toBrittany also stated that it is hard to determine the coverage without an actual code to go with itMy objection, if I don't know what type of crown is covered I could potentially go to every dentist in the network and they could all use a code for a crown that is not covered and I will be wasting my time, money, and other resources and would no longer have a job since I would have to keep calling off to visit every dentist in the network until they 'hit upon the right code' to perform the workBrittany also stated that I could go to an out - of -network dentist but that would most likely not be coveredI have already tried two in-network dentist and one said the procedure is not covered, the other dentist I contacted said they didn't think it was covered but if it was it would be a stainless steel and they don't perform the workWhat good is dental coverage if the dentist in the network won't perform the work? MHS is also refusing to provide me with a summary of benefits that tells me what is covered and to what percentSeveral months ago I went to get my eyes checkedThe information provided on the MHS network stated they cover pair of glassesI did not look into it further, it didn't say there were any restrictions, etcBut MHS did not cover the full expense of the glassesWhen I complained to the Revdex.com I received a statement saying the case was dismissed because I failed to fully investigate my coverageNow I am trying and MHS is refusing to give me the informationTo Resolve just the dental issue this is what needs to happen. The right to see my out of network dentistTo have that dentist compensated up to the amount an in-network dentist would have been compensatedThe right to choose the more expensive crown WITH NO ADDITIONAL COST TO THE INSURANCE CARRIER THAN WHAT THEY WOULD NORMALLY PAY FOR WHATEVER TYPE OF CROWN THEY DO COVERI believe this request to be fair to both parties involvedI am not expecting them to pay more than what they would normally pay, just pay that same amount to an out-of-network provider and I will pay the additional expense to have the work performed correctlyFINALLY, MY INSURANCE IS RUNNING OUT WITH THIS PROVIDER (AT THE END OF THE MONTH IS MY UNDERSTAIDING) SO IF I AM UNABLE TO GET TO A DENTIST BECAUSE OF MHS INABILITY TO FOLLOW THROUGH, THE WORK SHOULD BE PAID FOR AT THE EARLIEST OPPORTUNITY WHETHER OR NOT I AM STILL COVERED BY MHS
Regards,
*** ***

Thank you for the opportunity to address the concerns of our Healthy Indiana Plan (HIP) memberThe member in this case expressed concern that a claim from March of had not been processedThis claim was
for a visit to a waclinic at a drugstoreWe checked our system and found this person was in the Healthy Indiana Plan, assigned to Managed Health Services (MHS) from 03-01-through 09-30-During that span, this person was assigned to a Muncie Primary Care Physician in the network and was provided with lots of information about the plan, how to obtain care and how to ask questionsThe Healthy Indiana Plan has benefits designed by the State of Indiana, Family and Social Services AdministrationPrimary care doctor visits in-network are covered, but out-of-network care requires prior authorization except in an emergencyOn March 24, 2014, the member sought care at a "Take-Care Clinic," inside a Walgreens storeMHS received the claim and it rejected because this provider is not set up in our systemWe contacted the provider and learned they are in the Anthem network for HIP, but are not interested in joining MHS' networkFurther, their records show they told our member at the time of the visit that he or she would have to be a self-pay since they were not in the MHS network and MHS had not authorized out-of-network primary careWe are unsure why the member might have thought that this visit would be covered by MHSWe do show that we received a complaint from this member by way of the MHS Facebook page on March 18, In response, we researched her situation, called her and shared the findings above on or about March MHS strives to provide reliable coverage and reliable customer supportWe regret that this member has been inconveniencedThank you for bringing this matter to our attention
Best Regards,
Margaret L*** (Meg)
MHS and Ambetter from MHS, Compliance Manager

Complaint: ***
I am rejecting this response because:
We never rejected to make payments when the truck broke down we put all the money in to repairs in February when it broke down we made the payments until we contacted the bank in March asking to trade the truck in we didn't reject payment we asked to trade for a different truckThe bank came back stating to offer to expand our company to buy a second truck this reply was to the dealer *** ***When *** rejected the offer of expanding the compa y because the first truck needed repairs the bank offered for us to fill out a form sent to our email to delay payment by a month or two and to and them for an extended loan to fix the truckThat was by email from MichaelWe stayed to him that if we can't get the loan we would default on payment of truck and would offer than to turn the truck in for voluntary reposesion as we couldn't work on it if we couldn't get the loan amount to fix itWe filled out forms, emailed themCalled the bank daily for updates to which they stopped answering callsMichael stated that the CEO was trying to make a decision but at the same time they emailed *** *** verifying the truck was in their posesion that they will be reposesing it their name to fix the truck and than re sell it once it is fixed to *** in order to take Alexs name out*** *** gave us a heads up but we said that it's fine as long as we can get the truck back by April to continue payment on truckShe I Called in April Michael still had no answers from CEO and eventually stopped taking calls from my numberWe had to use a different pho e to call the bank to request status of the expansion of loan or reposesion or of their decisionMichael than told us to NOT call them and that he can't rush the ceoThat if he was us he would advise us in to finding a new job and that most likely the truck would be repossed by the bank and soldThat we won't know for how much until they sell itSo it's not that we refused, we attempted many times and have emails to prove we attempted to contact the bank we have call logs as well from our cell phone provider showing we called dailyWe attempted to resolve this issue but the bank purposely withheld or didn't communicate of their decisionThey stretched their sweet time out to where we had no choice But to close the company because we coudlnt continue to pay insurance and truck payments and repairs when the truck was at the shop since early March*** *** than took the repairs up with the bank where we sent them the quote of repairs and they approved them with the mechanic at *** *** the repairs ended up being 15,000, we got the copy of the emails from *** *** stating that the bank stopped communicating with them and have not yet paid the bill and asked us to contact the bank to see if we can get an updateWhen no phone calls emails and no letters were received from bank I contacted them again by email as well as left a boicr mail, neither one was replied toIn October I sent another emajm and all they said was pay the past due amount since April to be in good standingWhen I replied to them I again was ignoredMy complaint here is that the bank has ignored us!!!!!! They can't communicate timelySo to accuse us of breaking a contract was fine we stopped paying because we didn't have the truck because the bank stopped communicating with us and agreed to pay the repairs and didn't do so timelyThey didn't communicate their decision of reposesing it or removing one of the names from loanThey didn't return callsThey didn't email backThey were negligent and as guilty of not communicating with their clients to try and resolve the issue of non paymentWorst bank to try and communicate with.
Sincerely,
*** ***

I disagree with the statement they have have all emails to back up my account as their receptionist was not communicating the decisions supposedly made by the owner of bank on or loanMichael kept saying “our ceo has not made a decision yet, we will call or email you as soon as we have decided “ that went on for over a monthWe asked them in loan modification to approve a repair or trade in our truck to which they replied with “we will expand the loan for a second truck to expand business but won’t let you trade this one in” the tech equipment guy Bryan who was communicating with bank told us that the bank now wanted to take the truck away from us in to their own name for the repairs and re sell the truck to *** once repairs are complete to remove Alex’s name from loanI kept calling the bank and Michael kept saying that there was no word from ceo and this is all available in email formatThan when making a call in April Michael said “we have not herd from the ceo and most likely at this point ceo will decide to repo your truck to do the repairs and I’m not you but if I was I would look for a different job, stop calling us we will call you when our ceo makes a decision but seeing as he is our ceo I can’t rush him on his decision” this phone call was made in presence of two witnesses on speaker phone as the bank stopped answering calls from my number and would only answer from a phone o previously didn’t call fromI’m sure they have caller Id as when I called on daily basis for updates Michael would greet me with “hello Natalia, no I have no answers yet” I will have to consult with an attorney as to what to do next because the bank is just rediclilous we have an email from Michael stating that we need to fill out forms and provide estimates of tech equipment repair charges for the bank to pay the repair costs

Thank you for allowing us this opportunity to address the concerns of our insured, Mr*** ** ***
"letter-spacing: -0.45pt">Our records confirm that Mr, *** has paid three months' premium to Ambetter from MHS, so that his premiums are paid through May 31, Our system shows that his coverage is effective March 1, with no designated end dateThe system shows two claims have been received and processedOf course, for coverage to continue after May 31, premium payments need to continueOur system shows no lapse in coverageIf Mr*** has claims incurred on or after March 1, that have not yet been processed, we request he please send those for processingWe are enclosing a stamped, addressed envelope in the copy of this letter sent to his attention, for this purposeAmbetter from MHS strives to provide reliable coverage and reliable customer serviceWe regret that Mr*** was frustrated, but, are pleased we could provide this information to you and our memberWe thank you for your assistance to our plan member and for your dedication to business accountabilityBest regards, Margaret ** *** Compliance Manager, MHS & Ambetter from MHS (317) 684-Cc: Mr*** *** *** * *** *** *** ** ***

“The facts are simpleIn June of 2016, the complainants borrowed money and promised to pay it backWe would not have loaned them any money if they had not promised to pay it backThey signed a contract promising they would pay it backThey broke their promiseThey stopped making payments to pay back their loanDespite signing on a page of their contract promising that “The due dates for payments and the performance of the other obligations under this contract are among its most crucial provisions” and that they would be in default if “Borrower fails to pay on or before the due date the full amount of any scheduled payment” they broke their promise and did not make payments on their due dates They broke the promise on the page they signed saying they would be in default if “any check, note or other instrument given for a payment is dishonored when presented for payment” because they bounced payments for having insufficient fundsThe borrowers broke important promises in the contract Sadly, despite not making payments the Borrowers were asking us to loan them even more moneyWe try to do everything we can to help our borrowers, but when our borrowers don’t make payments our hands are tied

'Times New Roman'">We received your letter regarding the above-referenced complaint on May 27, MHS had already received notice of this issue through a number of avenues, including the Indiana Department of Insurance and the Indiana Family and Social Services Administration
We are happy to take this opportunity to let you know that the issue has already been addressed and this member has received detailed written notice, as have the named State regulatory agencies
Because the issue is already addressed, and because of our concern not to disclose an individual member's protected health and demographic information, we are declining to publish here the details of this particular situation
We thank you for your assistance to our plan member and for your dedication to business accountability
Best Regards,
John B***
Vice President of Compliance and Regulatory Affairs

On May 17th, 2016 [redacted] and [redacted]) applied for a semi-truck loan through Green Truck Financial. On that same day, they were pre-approved for their loan. On May 31st, 2016 [redacted] decided to pursue a different semi-truck for financing through [redacted]...

[redacted] and on that same day Green Truck Financial provided a good-faith estimate (GFE) to [redacted] for the financing of the semi-truck. On June 3rd, 2016 Green Truck Financial sent loan documents to [redacted] and on June 16th, 2016 [redacted] signed their loan documents for the purchase of 2011 Volvo VNL670 VIN [redacted] at the price of $50,251.00. This purchase price includes a 3-year/500k mile warranty from AGWS under the agreement number [redacted] also placed an $11,000 down payment on the above described collateral and their first payment of $827.27 was scheduled for July 3rd, 2017.              On June 28th, 2016 the borrower signs a loan modification agreement to defer their first payment, as they are unable to successfully make it on time. This moves their first payment out to August 3rd, 2016. On August 8th, 2016 Green Truck Financial received notice through our bank that [redacted]’ first payment was returned as insufficient funds. On October 8th, 2016 Green Truck Financial was notified that [redacted]’ 3rd payment was returned as insufficient funds.              On February 28th, 2017 [redacted] sent an email to Green Truck Financial requesting that [redacted] be removed from their loan entirely as a co-borrower, then followed that up on March 10th, 2017 by requesting their second payment deferment, this time for both March and April 2017. On March 20th, 2017 [redacted] applies through www.greentruck.us to be the sole borrower on the collateral in question. 10 days later, on March 20th, 2017 [redacted] have decided to remove [redacted] from the business and the loan, however, the President and CEO of Green Truck financial, David Andersson, denied their request on this same day. The following day, on March 31st, 2017 Green Truck Financial was presented with a bill from [redacted] in the amount of $14,743.76 for [redacted]’ semi-truck.              On April 3rd, 2017 Green Truck Financial receives an email from [redacted] notifying us that they are unable to make their April 2017 payment, have placed a stop payment on their bank account and are unable to pay the repair bill from [redacted]. They are advised on April 4th, 2017 that Green Truck Financial will not be removing [redacted] from the loan. On April 21st, 2017 someone named [redacted] emails Green Truck Financial with a request as to the status of their loan modification request, as this was the second such request on this loan, Green Truck Financial declined the request at this time.              On May 17th, 2017 Green Truck Financial receives a follow-up on the bill from [redacted] was reminded via phone call of this invoice, and that it was their responsibility. During this phone conversation, [redacted] indicates that they are walking away from the truck and abandoning their loan. On this same day, Green Truck Financial receives a request from [redacted] on behalf of [redacted] to cancel the warranty on their vehicle. This request was denied.              On October 9th, 2017 [redacted] reached out to Green Truck Financial to ask what decision had been made on their truck. At this time they were reminded of the conversation from five months prior where they had notified Green Truck Financial that they were abandoning their semi-truck and loan.              [redacted] & [redacted] have not made a payment on their contract with Green Truck Financial since March of 2017.

Revdex.com of CENTRAL INDIANA 151...

N. Delaware Street, #2020 Indianapolis, IN 46204-2599   RE: Revdex.com Complaint ID Number [redacted] FAX 317-488-2224
We received your letters regarding the above-referenced complaints. MHS has also received notice of this issue through a number of avenues, including the Indiana Family and Social Services Administration (FSSA). We are happy to take this opportunity to let you know that we have contacted our member about her issues. We made attempts to talk to her on the phone, and a letter was sent on November 10, 2016 and informed FSSA of our findings. Because the issue is already addressed, and because of our concern not to disclose an individual member's protected health and demographic information, we are declining to publish here the details of this particular situation. We thank you for your assistance to our plan member and for your dedication to businessaccountability.
Sincerely,
Scott L[redacted]
Director, Compliance

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.This business did not resolve this problem until January 14,2017. It is resolved now. Thank you for all your help. 
Regards,
[redacted]

January 6, 2017   Revdex.com of CENTRAL INDIANA 151 N. Delaware Street,...

#2020 Indianapolis, IN 46204-2599   RE: Revdex.com Complaint ID Number [redacted]   Dear Ms. [redacted]:   We received your letter regarding the above-referenced complaint on December 21, 2016. Once your complaint was received we conducted a thorough investigation of this issue.   We have corrected the issue. Ambetter from MHS has contacted our member to inform her we have corrected the issue.   Because the issue is already addressed, and because of our concern not to disclose an individual member’s protected health and demographic information, we are declining to publish here the details of this particular situation.    We thank you for your assistance to our plan member and for your dedication to business accountability.      Best Regards,     Rebecca S[redacted]

We received your letter regarding the above-referenced complaint on November 20, 2015. Thank you for the opportunity to address the concerns of our Ambetter from MHS member. The member in this case expressed concern that his premiums were different amounts, he was not enrolled in the rewards...

program for receiving preventative services and he has unpaid claims.After conducting a thorough investigation we found this member's premium has remained the same since his enrollment. After reviewing claims for this member we found some that denied claims because the provider is not in network with Ambetter from MHS and authorization was not obtained prior to the service the provider the provider billed with incorrect information. In his complaint this member stated he was not enrolled in the rewards program for receiving preventative services. Ambetter from MHS found this member has received rewards however the rewards card has not been activated.
Ambetter from MHS has attempted to reach our member to address his concerns.
We thank you for your assistance to our plan member and for your dedication to business accountability.
Best Regards,
 
Scott L[redacted]
Director Compliance
(317) 684-1482