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T L C Marine Service Reviews (78)

This is what I received in mail from Blue Extra & a copy of my return to themTo Whom it may concern, The complaint was for both me and my wife I have the brochures and copies of enrollment forms Please contact me at [redacted] if any questions.Sincerely,

I have enclosed the requested formI am still seeking a resolution for the issue on handI have also enclosed a copy of the check that shows payment was madeI have also spoken with IBX representative that was adamant that payment was not received until I produced a checkI have yet to receive a response regarding this check

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 lawThe 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

[redacted] ***, Good morning, I am writing to acknowledge the complaint, recognized under your identification number of [redacted] , 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 his/her protected health information (PHI) for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable lawThe written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule For your covenience, I have attached a HIPAA Authorization Form for [redacted] ***'s completionYour office may returne the comleted form to my attention via fax at ###-###-#### or you may scan and e-mail it to me at [redacted] @ibx.com In the interim, we have commenced an investigation into the matter presentedUpon receipt of the completed and valid authorization form from [redacted] naming you and your office as an authorized recipient of her PHI, we will provide your office with our response [redacted] ***, should you have any questions, please contact me directly at ###-###-#### Thank you Sincerely, Rafael *D [redacted] Specialist, Executive Inquiries Department Independence Blue Cross

A HIPAA authorization form was faxed to your attention on October 13, in reference to the inquiry from [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 PHIWhile our records indicate that there is no authorization for you to receive this member’s PHI, we want you to know that we have reviewed [redacted] ’s complaint to your officeI mailed a response letter to the member on October 19, advising the issue has been resolved [redacted] ***, we appreciate your bringing [redacted] ’s concerns to our attentionIf you have any additional questions, please do not hesitate to contact me at ###-###-####Jamela W [redacted] Customer Touch Point Analyst IIExecutive InquiriesMarket St., 13th FloorPhiladelphia, PA

I am writing in response to the February 21, follow up letter to the Revdex.com regarding billing and enrollment issues with [redacted] ***’s Personal Choice Bronze H.S.AplanI have attached the response I sent to [redacted] on February 9, for your reviewAdditionally, claim [redacted] has been reprocessedBelow are the claim detailsProvider: Dr [redacted] Date of Service: January 9, 2017Provider Charge: $224.00Allowed Amount: $139.77Amount Paid: $139.77Member Responsibility: $ [redacted] ***, thank you for bringing this matter to our attention.Sincerely, Jamela W [redacted] Customer Touch Point Analyst IIExecutive InquiriesMarket 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, Feb 18:28:+0000Dear [redacted] ***, I am writing in response to the January 27, letter to the Revdex.com regarding billing and enrollment issues with your Personal Choice Bronze H.S.AplanYour complaint was received in our office on February 3, 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 consentAs 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***Please be assured that we have informed the Revdex.com that we have presented our response to youI reached out to you on February and February 8, but was unable to leave a voicemailI called to advise a payment of $was received on January 10, The payment was refunded due to the coverage being cancelled effective January 1, As a result of your inquiry to our Member Services Department on January 26, 2017, your coverage has been reinstated effective January 1, 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 youIf you have any additional questions, you may contact Member Services at ###-###-####Sincerely,Ask IBX Team Member – [redacted]

I am writing in response to the May 2, letter to Detra D [redacted] -S [redacted] on behalf of Ms [redacted] Your complaint was received in our office on May 9, and concerns a flu shot reimbursement for Ms [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 PHIWhile our records indicate that there is no authorization for you to receive this member's PHI, we want you to know that we have reviewed Ms [redacted] 's complaint to your officeIt was identified that we previously resolved this matter on March 15, 2016, and currently consider it closed.Ms***, we appreciate your bringing Ms [redacted] 's concerns to our attentionIf you have any additional questions, please contact me at ###-###-####.Sincerely,Diane H [redacted] Lead Client Services Representative Executive Inquiries Department

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 lawThe 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 attentionIf you have any additional questions, please contact me at ###-###-####.Sincerely,Diane H***, Lead Client Services RepresentativeExecutive Inquiries Department

back on 7-22-@ 2:59pm I filed a complaint against this company that I would like to re openthe case number is [redacted] unfortunately I have not been able to access my email's so I was unaware that independence had responded to the Revdex.comI do not agree with the statement that they made nor am I satisfied with the resolution of this casethey took my money and have not done anything in regards to the actual problem at handI am asking that the Revdex.com Metro Washington DC & Eastern Pennsylvania please reopen my case to attempt to resolve this problem diplomaticallyThe complaint remains the same as the case number I wrote abovetheir staff does not know what they are doing - I had had to increase the amount of funds on my FSA in order to make sure that I can account for all my medical bills all due to misrepresentation by independence blue cross their staff and their mngt staff as wellthe additional funds are funds coming out of my paychecks which exceed that of the overall family deductible and even after the family deductible has been paid in full I still owe money? I'm sorry but they are ripping me off and stealing from me.Desired Outcome: Independence blue cross owes me money more than but I am only asking for the from last yr and the from this yrUntil they provide me with the refund rightfully owed to me I will not be satisfied with anything they have to offer

August 2015Dear [redacted] :Our Manager of the Executive Inquiries DepartmentDetra D [redacted] has requested that respond to your August 3, correspondence regarding [redacted] ***The purpose of this letter is to provide you with the details of our reviews outcome.In accordance with the federal health Insurance Portability and Accountability Actknown as the HIPAA privacy ruleit 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 lawThe written approval called an authorization, must contain certain required elements for us to consider it valid under the HIPAA Privacy ruleWe appreciate your of lice submitting the authorization from [redacted] listing your office as an authorized recipient of her PHI.The matter at handIn her correspondence [redacted] shared the details of several conversations which she had with our customer service team members regarding her family deductible and how she has repeatedly received conflicting informationAdditionally [redacted] submitted her request for reimbursement of $for $for and $for in additional costs she has had to render due to her perspective that our office exceeded her deductible.Our review Upon receipt of [redacted] 's inquiryWe commenced an investigation into the concerns presented and we discovered the following:During the May 26, 2015, call our customer service can then her incorrectly advised that two individuals had to meet $towards the deductible in order for the family deductible to the netThe member has an embedded deductible which means once an individual meets their portion of the deductible: services are paid for that person without the entire family deductible being metAll other family members can contribute to the balance $to meet the family deductible

Good morning [redacted] : We want you to know that we have resolved the website access issue for [redacted] and have updated his user nameHe is now able to log on to our website Thank you for bringing [redacted] 's concerns to our attentionIf you have any questions, please feel free to contact me at ###-###-####I will be glad to assist you Sincerely, Scott Y***, Specialist Executive Inquiries

This is just an alert to inform you that I will be handling the review and response for this inquiryIn addition, your inquiry was not accompanied by a HIPAA authorization allowing us to correspond with your officeWe will allow 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***, Specialist Executive Inquiries

[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 My complaint was about my check being cashed and my insurance being cancelled w/o notifying me It took over minutes on the phone I reached out to IBC on Monday, I received conformation on 2/23/Very poorly trained customer service Thank you Revdex.com Regards, [redacted]

I am writing in response to the February 13, 2017 letter to Detra D [redacted] on behalf of [redacted] . Your complaint was received in our office on February 22, 2017, and concerns [redacted] ’s plan change request. 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. While our records indicate that there is no authorization for you to receive this member’s PHI, we want you to know that we have reviewed [redacted] ’s complaint to your office. It was identified that we previously resolved this matter on February 20, 2017 and currently consider it closed. In the event that you wish to receive details about it, we need the Authorization to Release form completed. I have attached it for your use. [redacted] ***, we appreciate your bringing [redacted] ’s concerns to our attention. If you have any additional questions, please do not hesitate to contact me at [redacted] Sincerely, Rasheeda H***Lead Client Services Rep.Executive Inquiries1901 Market Street, 13th FloorPhiladelphia, PA 19103

Good mroning [redacted] ***: I am writing inresponse to the above refereenced complaint for on behalf of [redacted] The purposoe of this letter is to inform you that we originally processed his claim for date of service June 17, 2015, and no adjustment or reprocessing of the claim is necessary [redacted] contends that his claim was not properly processed correctly as a a [redacted] employee with services rendered by [redacted] He feels he should not have been subject to the cost sharing that was assessed on his claim After further review it appears his claim processed correctly under tier2, taking a $copaymentThe services were performed at [redacted] Medical Center of the [redacted] Health system which, is not a facility within the [redacted] NetworkIf services were perfomed by a [redacted] provider, the claim would have processed under tierbenefit level Thank you for bringing [redacted] 's concerns to our attentionIf you have any questions, please feel free to contact me at ###-###-####I will be glad to assist you Sincerely, Scott Y***, Specialist Executive Inquiries

[redacted] Good evening I am writing to acknowledge our receipt of this inquiryHowever, as the email below [redacted] 's rejection is dated November 19, 2015, it is unclear what is actually being rejectedI've called your office and left you a voicemail as wellYou may call me at ###-###-#### or email me directly at [redacted] @***.com so that we can discuss Regards, Rafael *D [redacted] Lead Client Services Representative Executive Inquiries Department

I regret that [redacted] feels he is still due a reimbursement of $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/In addition, [redacted] stated in the rejection comments that he notified Independence Blue Cross twice in June of his interest in cancelling his insuranceBased on my review of [redacted] ’s call history for June 2016, our record show one call received on 6/3/During this recorded conversation, it was found that [redacted] ’s made no mention of his request to cancel coverage as of 6/27/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/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/Thanks, Chris H***Executive Inquiries AnalystMarket Street, Philadelphia, PA

I am writing in response to your recent inquiry on behalf of [redacted] for Complaint # [redacted] The purpose of this letter is to inform you that we correctly processed [redacted] ’s claim for services rendered to him on June 17, 2015, at [redacted] Medical Center of the [redacted] [redacted] contacted your office requesting assistance in getting his copayment removed for his services on June 17, He contends that according to his benefits summary booklet it states that "If you have a test," then in the subrow "Diagnostic test (x-ray, blood work)," in the column for "Your Cost If You Use" for "a [redacted] Provider" says "No Charge"However, he is being charged a copayment of $We identified that [redacted] Medical Center of the [redacted] is not a participating [redacted] provider; therefore, subjecting him to a copayment of $The following is the breakdown of his provider grid and cost sharing: In-NetworkOut-of-NetworkBenefits [redacted] NetworkPersonal Choice NetworkOut-of-Network* OUTPATIENT DIAGNOSTIC SERVICESRoutine Radiology$Copayment ( [redacted] facility), $Copayment (non- [redacted] facility)$Copayment then 70%, after deductible60%, after deductible [redacted] ***, please advise if I can be of further assistanceIf you have any questions, please contact me at ###-###-####I will be glad to assist youSincerely, Scott Y***

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf 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 $As IBX repeatedly has pointed out, [redacted] Hospital is a [redacted] providerTherefore my copay should be $once IBX understands that I have a [redacted] PPO plan and DO NOT have [redacted] as my primary insuranceIn addition, MrY [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]

[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]

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