T L C Marine Service Inc

[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 as Answered]
 Complaint: [redacted]
I am rejecting this response because: I do not see the Revdex.com requesting access to my protected health information.  I'm more than happy to furnish my own records to the Revdex.com, upon request, which confirm payment of not only the requested monthly premium, yet also show Independence Blue Cross affording coverage for the following two separate dates of service: 9/30/15 & 10/12/15, at an in-network provider.It is important to note Independence Blue Cross is now attempting to rescind coverage, more than one year after making a business decision to afford coverage; something this one time paying policyholder finds absolutely appalling. I'm confident there are multiple media outlets which would also find Independence Blue Cross' stance to be equally disgraceful.Should the Revdex.com indicate they wish to see any records held by Independence Blue Cross, then the HiPAA authorization form is available for me to complete and submit.Otherwise, I believe Independence Blue Cross has the adequate information to take a stance and provide a final resolution regarding this complaint.  
Regards,
[redacted]

I am writing in response to the Revdex.com’s complaint id# [redacted] (see attachment). The complaint was submitted on behalf of [redacted]. I spoke to [redacted] today and advised her the primary care physician change was completed on 10/4/2016.  [redacted] confirmed that...

she has already received her new ID card and thanked me for the call.  Please let me know if you have any questions or need further assistance.  Sincerely, Chris H[redacted]Executive Inquiries Analyst1901 Market Street, Philadelphia, PA 19103

[redacted] Philadelphia, PA 19103-1480IndependenceMarch 23, 2015Mr. [redacted] The Revdex.com 1411 K. Street NW, 10th Floor Washington, DC 2005-3404Re: [redacted]File No: [redacted]I am writing in response to your March 20, 2015, email to the Manager of the Executive Inquiries Department, Detra D[redacted]. The purpose of our letter is to inform you that Mr. [redacted]'s concerns have been resolved.On March 20, 2015, we notified your office that in accordance with the federal Health Insurance Portability and Accountability Act requirement, authorization was needed from Mr. [redacted] to release his protected health information (PHI). As of today, we have not received the completed form.Because this letter provides general information, we are able to respond to you regarding the matter in question.Addressing his concerns Mr. [redacted] contacted your office about not receiving a refund for a previous account. He also advised that his current coverage is showing delinquent and in danger of cancellation. Mr. [redacted] asks that we correct his account and apply his premium payments accordingly.The concerns expressed by Mr. [redacted] have been addressed and the outcome is favorable to the member.(over)Mr. [redacted], if you have any additional questions, please feel free contact me at ###-###-####. I will be happy to assist you.Sincerely,Sylvia B[redacted], Specialist Executive Inquiries

[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:
Regards,
[redacted]
From: [redacted] <[redacted]@healthadvocate.com> To: [redacted]' <[redacted].com> Sent: Thursday, November 19, 2015 2:40 PM Subject: Health Advocate
Daniel,
 
Thank
you for contacting Health Advocate. I placed a call to 1-800-ASK-BLUE 
(###-###-####) and spoke with a supervisor, Jessica J. She advised that
there is one covered examination every benefit
period for a preventive adult visit. With that being said, she
requested a benefits booklet be sent to the physical address they have
on file for you. She advised it will take approximately 7-10 business
days to be delivered. It may be longer based on the
holiday schedule.
 
If you have any further questions or concerns, please contact ###-###-####.

 
Warm regards,
 
[redacted]
Customer Care Associate – Evening
 
Health Advocate

[redacted]
Suite [redacted]
Plymouth Meeting, PA [redacted]
Office: ###-###-####
Fax: ###-###-####
E-mail:
[redacted]@healthadvocate.com

Re:            [redacted]
File No:    [redacted]
Dear [redacted]:
I am writing to acknowledge and reply to your March 11, 2015, correspondence to [redacted], Supervisor of the Executive...

Inquiries Department. Your inquiry is written on behalf of [redacted], who contacted your office regarding his efforts to obtain precertification approval of the device used in conjunction with a Bronchial Thermoplasty procedure.
[redacted] is an associate of the Independence Blue Cross Family of Companies. As such, I have forwarded your inquiry to our Human Resources Division for review and response.
We welcome the opportunity to be of assistance and thank you for bringing this matter to our attention [redacted].
Sincerely,
Yvonne P[redacted], Specialist
Executive Inquiries

I am writing to acknowledge receipt of the October 11, 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 in complaint ID number [redacted] are...

being reviewed, and we will be in direct contact with the member based on the status of the account. [redacted], thank you for bringing this matter to our attention.Sincerely, Rasheeda H[redacted]Lead Client Services Rep.Executive Inquiries[redacted]Philadelphia, PA 19103

I am writing in response to the February 21, 2017 follow up letter to the Revdex.com regarding billing and enrollment issues with [redacted]’s Personal Choice Bronze H.S.A. plan. I have attached the response I sent to [redacted] on February 9, 2017 for your review. Additionally, claim [redacted] has been reprocessed. Below are the claim details. Provider:                       Dr. [redacted]Date of Service:             January 9, 2017Provider Charge:           $224.00Allowed Amount:         $139.77Amount Paid:               $139.77Member Responsibility: $0 [redacted], thank you for bringing this matter to our attention.Sincerely, Jamela W[redacted]Customer Touch Point Analyst IIExecutive Inquiries1901 Market St., 13th FloorPhiladelphia, PA 19103This message has been content scanned by [redacted]. [redacted] uses policy enforcement to scan for known viruses, spam, undesirable content and malicious code.From: [redacted].comTo: [redacted].comSubject: Billing and Enrollment InquiryDate: Thu, 9 Feb 2017 18:28:15 +0000Dear [redacted], I am writing in response to the January 27, 2017 letter to the Revdex.com regarding billing and enrollment issues with your Personal Choice Bronze H.S.A. plan. Your complaint was received in our office on February 3, 2017. In accordance with the federal regulation, the Health Insurance Portability and Accountability Act (HIPAA), we are unable to discuss any of your protected health information (PHI) to any persons or entities without your written consent. As we have not received an authorization form the Revdex.com and Staff as an authorized recipient of your PHI, we could not direct our response to Rep. [redacted]. Please be assured that we have informed the Revdex.com that we have presented our response to you. I reached out to you on February 7 and February 8, but was unable to leave a voicemail. I called to advise a payment of $73.13 was received on January 10, 2017. The payment was refunded due to the coverage being cancelled effective January 1, 2017. As a result of your inquiry to our Member Services Department on January 26, 2017, your coverage has been reinstated effective January 1, 2017. Additionally claim # [redacted] will be reprocessed to pay per your preventive benefits at 100% of the allowed amount. [redacted], we appreciate your allowing us the opportunity to assist you. If you have any additional questions, you may contact Member Services at ###-###-####. Sincerely,Ask IBX Team Member – [redacted]

[redacted]
I am writing to acknowledge the inquiry regaridng [redacted].
We are currently investigating [redacted]'s concerns and will provide our response to as expeditiously as possible. This is not our final response.
We appreciate your providing the HIPAA authorization for [redacted]....


Thank you,
Rafael ** D[redacted]
Specialist, Executive Inquiries Department

I am writing to acknowledge receipt of the September 8, 2017, correspondence to Detra D[redacted], Supervisor of Executive Inquiries Department. This complaint was received on September 18, 2017. The concerns presented by [redacted] are being reviewed as an appeal and will be addressed...

directly with her once the investigation is completed. 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, it would be necessary for [redacted] to complete the attached HIPAA Authorization Form. [redacted], that you for bringing this matter to our attention. Sincerely, Chris H[redacted]Executive Inquiries Analyst 1901 Market Street, 13th FloorPhiladelphia, PA 19103P  ###-###-####

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
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. 
Regards,
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
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. 
Regards,
[redacted]

After relentless run arounds, I did speak with someone who gave me some reason why they wouldn’t pay. I offered him to talk with HR (Jerry) and my workplace and sort it out. He said that he knew Jerry and would call. I spoke with Jerry a couple weeks later, and no one had contacted him about my claim. I work with someone who went through the exact same process, only hers was resolved. In addition, while going through all of my invoices I found 4 claims that I had paid for and was not supposed to. I submitted them and got a letter that they were reviewing these. This was at least 2 months ago. I got 1 response to 1 of the claims and it said that the service needed to be performed at a [redacted] facility -- it WAS, and that is what is on my letterhead (it’s the hospital that I work for.) I am so frustrated. My credit score has suffered (it was not a bad score at all). Please advise of any legal action I can take. I want/need to have this resolved. Again, thank you for contacting me. I do have specific names, invoices, etc if needed. Respectfully,[redacted]

I regret that [redacted] feels he is still due a reimbursement of $282.00. However, the attached billing history and letter previously issued to him explains why [redacted] is not due a refund of $282.00, as his policy was cancelled for non-payment of premiums on 8/1/16. In addition, [redacted] stated in the rejection comments that he notified Independence Blue Cross twice in June 2016 of his interest in cancelling his insurance. Based on my review of [redacted]’s call history for June 2016, our record show one call received on 6/3/16. During this recorded conversation, it was found that [redacted]’s made no mention of his request to cancel coverage as of 6/27/16. Since [redacted] enrolled in an on-exchange plan through the Federally Facilitated Marketplace (FFM), it would have been necessary for him to contact them directly at ###-###-#### to cancel his coverage as of 6/27/16. Please note, I reviewed [redacted]’s enrollment profile, and there is currently no record of a transaction being received from the FFM approving his policy cancellation effective 6/27/16. Thanks, Chris H[redacted]Executive Inquiries Analyst1901 Market Street, Philadelphia, PA 19103

Dear [redacted]:
 
I am writing to acknowledge our receipt of your September 18, 2015, correspondence to Detra D[redacted], Supervisor of the Executive Inquiries Department. We appreciate your writing to alert us to your concern(s).
 
As you may be aware, under the...

federal government’s Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule we are required to 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.
 
Our records indicate that there is no authorization on file for us to disclose information to you concerning this member. In order to provide you with the requested information, please have [redacted] complete the attached Authorization to Release Information form. To be considered valid, all areas of the document must be completed. Instructions are listed on the back of the form should assistance be required. Once you have received the completed docment, please return it to us for processing. 
 
Should we finalize our review before the completed form is received, we will be required to correspond our findings directly to [redacted]. In the interim, please be advised that I have forwarded your inquiry to the appropriate liaison(s) for further review.
 
Sincerely,
 
 
 
Yvonne *. P[redacted], Specialist
Executive Inquiries
 
Attachment

Member: [redacted]Revdex.com Complaint ID [redacted]Dear [redacted]:                   I am writing to acknowledge receipt of the January 9, 2017, correspondence you addressed to Detra D[redacted], Supervisor of the Executive Inquiries Department. This...

complaint was received in our office on January 17, 2017.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. Ms. Ortiz, thank you for bringing this matter to our attention.Sincerely,Diane H[redacted], Lead Client Services RepresentativeExecutive Inquiries Department

April 7, 2015
[redacted]
Revdex.com/Metropolitan Washington D.C. and Eastern Pennsylvania
[redacted]                   [redacted]...

[redacted]           [redacted]
I am writing to respond to your recent letter to the Supervisor of the Executive Inquiries Department, Detra D[redacted].
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.
While our records indicate that there is no authorization for you to receive [redacted] PHI, because the nature of [redacted] complaint is general in nature we are able to respond to your office.
We received an email confirmation from our Web Support Unit advising that [redacted] account is operable and she should be able to obtain his account online.
[redacted], thank you for writing. If you have any additional questions, please contact me at [redacted]. I will be happy to assist you.
Sincerely,
Sylvia B[redacted], Specialist
Executive Inquiries

[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 as Answered]
 Complaint: [redacted]
I accept the resolution except for one item:I am rejecting this response because: I spoke with the FFM bout the 1095--A-form.  They have stated that it is up to Independence to contact them and verify that I did not have coverage for January 2016.  The 1095 I received clearly states on it that was sent by Independence.  Independence needs to contact FFM and get this tax form resolved.  It was Independences mistake, not mine.
Regards,
[redacted]

I am writing to acknowledge receipt of the below email addressed to Detra D[redacted], Supervisor of the Executive Inquiries Department. This complaint was received in our office today, December 14, 2017.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.Sincerely,Diane H[redacted], Lead Client Services Representative

November 9, 2015Dear [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.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 such, We have enclosed an authorization form so that [redacted] could complete the form naming you and your office as an authorized recipient of his PHI so that we can provide your office with our response upon the conclusion of our investigation.[redacted], should you have any additional questions, regarding this matter, please contact me at ###-###-#### and I will be glad to assist you.SincerelyRafael D., SpecialistExecutive 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:After contacting, the business, this issue is still not resolved.  Collection notices are continuing to recur and now a hospital procedure that had been scheduled must be canceled because of this ongoing error and the incompetency of the business to appropriately handle and resolve this request.Does the Revdex.com offer any insights into legal action?
Regards,
[redacted]