T L C Marine Service Inc

Dear [redacted]:Our Supervisor of the Executive Inquiries Department, Detra D[redacted], has requested that I acknowledge your recent correspondence regarding [redacted]. The purpose of this letter is to provide your office with an authorization form.Compliance with the HIPAA Privacy Rule. The...

federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. PHI is individually identifiable health information transmitted or maintained in any form or medium (including written, spoken, or electronic) related to: health care, health conditions, payment for care, and identity. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule.As such, we have enclosed an authorization form so that [redacted] can complete the form naming you and your office as an authorized recipient of his PHI. Upon receipt and confirming the form’s validity, we can release our findings to you about the case.[redacted], should you have any additional questions please contact me at [redacted]. I will be glad to assist you.Sincerely,Tedra F[redacted] Lead Client Services Representative Executive Inquiries DepartmentEnclosure

January 18, 2016Dear [redacted]:Our Supervisor of the Executive Inquiries Department, Detra D[redacted], has requested that respond to your December 21, 2015, correspondence regarding [redacted]. The purpose of this letter is to inform your office that we have responded directly to [redacted].The federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information (PHI) for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. The written approval, called an "authorization", must contain certain required elements for us to consider it valid under the HIPAA Privacy rule.As we have not received a valid authorization form from your office with [redacted] naming you and your office as an authorized recipient of her PHI and to prevent any unnecessary delays, we have directed our response to [redacted].[redacted], we appreciate your office bringing [redacted]'s concerns to our attention.Sincerely,Rafael D.Specialist Executive Inquiries Department

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:The representative from Blue Cross has failed to properly investigate, or provide satisfactory answers.  My premium was raised from $484.78 to $557.02 in January 2015.  This represents a 15% rate increase as approved by the Pennsylvania Insurance Department. It was properly billed, and paid, at this rate for January and February. Suddenly in March the rate was again raised to $659.  I contacted Blue Cross and was assured it was a billing error and would be corrected. It was not.  I then contacted the Executive offices and was again assured it was a billing error.  I have been assured by 4 different people at Blue Cross that the rate is $557.02 and that my billing would be corrected. This has been an ongoing issue causing me great distress, frustration, and loss of time as I struggle to get Blue Cross to correct their fraudulent billing. Because of this we discussed a credit of $557.02 as compensation. It is insulting that the representative from Blue Cross has once again failed to conduct a proper investigation. The response they provided is unacceptable.  I want a complete explanation to why their employees have consistently confirmed the rate is $557.02 and the extra rate increase in March was in error and would be corrected. The Pennsylvania Dept of Insurance approved a 15% increase, yet Blue Cross is charging me a 36% increase. I request written evidence to show that the Insurance Dept approved them to pass on a 36% rate increase.The level of incompetence of Blue Cross employees is astounding.
Regards,
[redacted]

I am writing to acknowledge receipt of the November 28, 2016 correspondence you addressed to Detra D[redacted], Supervisor of the Executive Inquiries Department. This complaint was received in our office on December 5, 2016. The concerns presented by Ms. [redacted] are being reviewed,...

and will be addressed upon finalization of our review. As you know, the Federal Health Insurance Portability and Accountability Act, known as HIPAA, requires that we obtain an individual’s written approval before disclosing his/her protected health information (PHI). In order for us to provide your office with a resolution, Ms. [redacted] may complete the attached HIPAA Authorization Form. I have also faxed the HIPAA form to your attention at ###-###-####. Ms. Ortiz, thank you for bringing this matter to our attention. Sincerely, Kathleen L[redacted]Lead Client Services RepresentativeExecutive Inquiries[redacted], 13th floorPhiladelphia, PA 19103

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
Again, I do not have [redacted] insurance (I am not sure why this error has been so persistent). My claim was submitted under the [redacted] PPO (ID [redacted]), for which the copy for a [redacted] provider should be $0. As IBX repeatedly has pointed out, [redacted] Hospital is a [redacted] provider. Therefore my copay should be $0 once IBX understands that I have a [redacted] PPO plan and DO NOT have [redacted] as my primary insurance. In addition, Mr. Y[redacted] continues to fail to return any of my calls regarding this issue to try to resolve the matter outside of the Revdex.com, which I find to be disappointing and unprofessional behavior. 
Regards,
[redacted]

To:  [redacted]The Revdex.comMy complaint has been resolved.  We received the refund owed to us.  I wish the company would see my complaint and perhaps realize that returning customers call would allay frustrations.  Thank you for your help.[redacted]Sent...

from [redacted] Mobile App

I am writing in response to the May 2, 2016, letter to Detra D[redacted]-S[redacted] on behalf of Ms. [redacted]. Your complaint was received in our office on May 9, 2016 and concerns Ms. [redacted]'s billing account activity.We have received the valid HIPAA authorization from Ms. [redacted], which lists your...

office as an authorized recipient of her PHI and are able to share the details about our review.The matter at hand In her inquiry to your office, Ms, [redacted] expressed concerns about her billing account activity and the denial of services, as a result.Our review Our records indicate that Ms. [redacted]'s monthly premium payments of $1,106.10 were applied to her account each month. However, it was identified that an enrollment file was received from the Federally Facilitated Marketplace (FFM), which resulted in the creation of two billing accounts. As a result, Ms. [redacted]'s payments were being applied to the wrong billing account.Independence Blue Cross offers products directly, through its subsidiaries [redacted] Health Plan East and [redacted] Insurance Company, and with [redacted] Blue Shield. Independent Licensees of the Blue Cross and Blue Shield Association.It was identified that we previously resolved this matter on April 18, 2016, and currently consider it closed. Ms. [redacted]'s billing account was corrected and her impacted claims were reprocessed.Ms. [redacted], we appreciate your bringing Ms. [redacted]'s concerns to our attention. If you have any additional questions specific to this matter, please contact me at ###-###-####. I will be pleased to assist you.Sincerely,Diane H[redacted] Lead Client Services RepresentativeExecutive Inquiries Department

Re:         [redacted]                                                      Dear Ms. [redacted]:        I am...

writing to acknowledge our receipt of the May 2, 2016, correspondence you addressed to Detra D[redacted]-S[redacted], Supervisor of the Executive Inquiries Department. As you are aware, the federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule. Our records indicate that there is no authorization for you to receive this member’s protected health information or PHI. As a result, we cannot disclose any information regarding our member. Please have Mr. [redacted] complete the attached Authorization to Release Information form. Once the document has been completed please forward it to my attention. Ms. [redacted], thank you for your patience while we resolve this matter. Should we finalize our review before the completed authorization form is received, we will respond directly to Mr. [redacted]. Sincerely,          Yvonne M. P[redacted], Lead Client Services Representative Executive Inquiries

RE: Member:  [redacted]       Revdex.com ID #: [redacted] Dear [redacted], Our records indicate that there is no authorization for The Revdex.com to receive this member’s protected health information or PHI. As a result, we cannot disclose any information...

regarding our member. Please complete the Authorization form I faxed to your attention at ###-###-####. Once this information is received and processed, we will be able to release the PHI to you as a designated recipient. Jamela W[redacted]Customer Touch Point Analyst IIExecutive Inquiries[redacted]Philadelphia, PA [redacted]

I am writing to acknowledge our receipt of the March 4, 2016, email you addressed to Detra D[redacted],Supervisor of the Executive Inquiries Department. In...

order to fully address the concerns you have presented, additional research is necessary.  I have forwarded your correspondence to the appropriate liaison(s) for further review.              I have reviewed  the Authorization to Release Information form that accompanied your inquiry.Unfortunately, the document cannot be considered valid for two reasons: 1) the Health Plan,  and 2)Member Signature sections of the form are not completed correctly. The Health field should list thecoverage plan in question and the member written signature is required. Please have Ms. [redacted] complete another authorization form. Once the document has been completedplease forward it to my attention. Should we finalize our review before the completed form is received,we will respond directly to Ms. [redacted]. Ms. [redacted], thank you for your patience while we resolve this matter.You may expect our response shortly. Sincerely,          Yvonne M. P[redacted], Specialist Executive Inquiries

Good Afternoon [redacted],
Check number [redacted] has been issued to [redacted] in the amount of $346.03 to the member's correct mailing address:
[redacted]
Bristol, PA [redacted].
[redacted] should receive the check shortly.
If you have any additional questions regarding this matter, please feel free to contact me at ###-###-####. I will be happy to assist you.
Sincerely,
Sylvia B[redacted], Specialist
Executive Inquiries

From: [redacted] <[redacted].com>Date: Thu, Sep 24, 2015 at 7:09 PMSubject: Complaint ID [redacted]To: [email protected] Whom It May Concern:The business I filed a complaint with took care of the problem and I received the refund check in the mail yesterday for the proper amount....

However, even though the issue was solved; I feel like it should never have gone as far as a it did to get resolved! I should have never needed to go as far as filing a complaint with the Revdex.com nor with the NAIC. The customer call center at IBX has always been a source of extreme frustration, deep lack of information and full of confusion on the parts of all people involved. Any time I ever called their customer care line to deal with any type of issue, I was always put on hold, sent from one person to another. More often than not I would have to ask to speak to a supervisor because the person I was dealing with at the time did not have the information I needed, or was ill-equipped to deal with what I needed help with. In my experience as a customer with this company, the whole call center needs a complete overhaul. From the bottom on up! Scratch that, the whole company needs to be re-evaluated, and overhauled. I am so thankful and grateful that I am no longer a customer of theirs to be quite frank. Sincerely,[redacted]

November 20, 2015Dear [redacted]:I am writing to acknowledge and respond to your November 11, 2015, correspondence to Detra D[redacted], Supervisor of the Executive Inquiries Department. Your inquiry was written on behalf of [redacted], who contacted your office regarding her efforts to have an...

outstanding claim issue resolved.Our review As you are aware, the federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law, The written approval, called an "authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule.Your inquiry did not include our Authorization to Release Information form, and our records indicate that there is no authorization on file from [redacted] for you to receive this member’s protected health information or PHI. Having completed our review, rather than delay our response, please be advised that we have corresponded our findings directly to [redacted].[redacted], thank you for bringing [redacted]'s concerns to our attention, and for allowing us the opportunity to be of assistance.Sincerely,Yvonne P.Executive Inquiries

July 31, 2015
Revdex.com Metro Washington, DC and Eastern Pennsylvania
1441 K St. NW, 10th Floor
Washington, DC  20005-3404
 
Re:      [redacted]      Complaint...

ID#:           [redacted]
 
Dear [redacted]:
 
Our Supervisor of the Executive Inquiries Department, Detra D[redacted], has requested that I respond to your July 22, 2015, correspondence regarding [redacted]. 
 
The federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing her protected health information (PHI) for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule.
 
As we have not received an authorization form from your office with [redacted] [redacted] naming you and your office as an authorized recipient of her PHI and to prevent any unnecessary delays, we have directed a general response.
 
We have located a policy for [redacted]; however, with an address adifferent than presented in the complaint. Additionally, our records indicated that we received a call  on July 21, 2015 and transferred a call from [redacted] to [redacted] at ###-###-#### to update her Primary Dental Office.
We trust that this information will be helpful to you. Please contact me at ###-###-#### with any additional questions specific to this matter and I will be pleased to assist you.
Regards,
Rafael *. D[redacted]
Specialist, Executive Inquiries Department
Independence Blue Cross

I am writing to acknowledge receipt of the October 7, 2016, correspondence you addressed to Detra D[redacted], Supervisor of the Executive Inquiries Department. This complaint was received in our office on October 21, 2016.The concerns presented by [redacted] are being reviewed, and will be...

addressed upon finalization of our review. As you know, the Federal Health Insurance Portability and Accountability Act, known as HIPAA, requires that we obtain an individual’s written approval before disclosing his/her protected health information (PHI). In order for us to provide your office with a resolution, [redacted] may complete the attached HIPAA Authorization Form.[redacted], thank you for bringing this matter to our attention. Sincerely, Diane H[redacted], Lead Client Services RepresentativeExecutive Inquiries Department 1901 Market Street, 13th FloorPhiladelphia, PA 19103

I am emailing you in response to the letter dated December 28, 2017, addressed to Detra D[redacted] on behalf of [redacted] under complaint ID [redacted].As you know, the federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule, requires that we obtain an individual’s written approval before using or disclosing his/her protected health information (PHI) for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule.As we have not received a valid authorization form from your office with [redacted] naming you and your office as an authorized recipient of his PHI, and to prevent any unnecessary delays, we have directed our response to [redacted] directly.[redacted], we appreciate your office bringing his concerns to our attention. If you have any additional questions, please contact me at ###-###-####.Sincerely,Diane H[redacted], Lead Client Services RepresentativeExecutive Inquiries Department

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and has been resolved.I do not consent to the HIPAA form
Regards,
[redacted]

This is just an alert to inform you that I will be handling the review and response for this inquiry. In addition, your inquiry was not accompanied by a HIPAA authorization allowing us to correspond with your office. We will allow 10 days to receive the HIPAA authorization form, after...

that  we will respond directly to our member.
For your convenience, I have attached a blank HIPAA form that you can have our member complete and sign.
if you have any questions, please feel free to contact me at ###-###-####. I will be glad to assist you.
Thank you,
Scott Y[redacted], Specialist
Executive Inquiries

Good afternoon [redacted]:
I am writing in response to your recent inquiry on behalf of [redacted]. I forwarded her grievance request to our Medicare Member Appeals to department for review and response. Her case is pending the review and a determination is forthcoming. once the...

determination is made available, [redacted] will be contacted by our Medicare Member Appeals Department.
Thank you,
Scott Y[redacted], Specialist
Executive Inquiries

Dear [redacted]:
I am writing to acknowledge our receipt of [redacted]'s complaint to your office. I will be in touch with your office shortly with a resolution. In the interim, if you have any questions, please feel free to contact me at ###-###-####. I will be happy to assist you....


Sincerely,
Sylvia B[redacted], Specialist
Executive Inquiries