World Gym

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I have cancelled my membership. I cancelled it in March when I saw I was still getting charged past my one year membership anniversary. I called world gym to understand why I was still getting charged even though I cancelled back in December which would be the proper amount of time in the contract for a 60 days notice of cancellation. In December when I went to the gym to cancel, the woman at the desk gave me the wrong instructions for cancellation. I asked her for help. I should not be penalized for her mistakes. Now I have to pay for an additional two months past my one year membership because of this mistake. I never complained when I moved that I wouldn't be using the gym but still had to pay for my membership because I knew I had to pay until my year from the contract. However, I do not think it is ok that I have to pay for 2 more months now because of an employee's mistake on cancelling my membership. Regards, [redacted]

In review of the file for Ms. [redacted], doctor visits/claims were submitted for the period January - May 2017, with several physicians.  Medical records were requested from each physician, with not all physicians promptly providing the requested records.  The Claims Review Team pulled all the...

information together and the claims are being adjudicated in accordance with the certificate of insurance, and Explanation of Benefits should be sent within the next week.If you have any additional questions, please let me know. Yours truly,Carolyn R. O[redacted]Assistant to General CounselInternational Medical Group, 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 Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
This is not listed nor was it what was stated by Ms. J[redacted] the manager who signed our contracts. We paid for December, which we were not allowed to use, plus wrongfully charged the additional $19.50 on each account without consent for the charges. False statements were submitted to Revdex.com by this company as well as unsupported defaming information. We were charged for services that were wrongfully taken from us and treated hostile by their representatives when trying to resolve. 
Regards,
[redacted]

[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:
Mr. B[redacted] was not even professional enough to address the letter to the correct person. My name is [redacted], NOT [redacted]. As stated in the original complaint, I sent my cancellation notice well in advance of the fee in July. Had he cancelled my contract as requested, I would have paid my last monthly payment IN JUNE (the month that comes before July). Also, to date, he has STILL not cancelled my contract, today is August 21, 2014, approximately 3 months since my original request for cancellation. I want the $19.99 fee refunded for his error in not canceling my contract on time and I now want any additional fees I have been charged since July refunded as well. I am not accepting this response because it did not address the original issue. He needs better bookkeeping practices and a better understanding of how to address a complaint without responding with generic rcontract wording. I have a copy of the contract, that wasn't the issue. The issue is he should have cancelled my contract when given the cancellation notice and and only billed me for the following month (June). 
I will not accept any other resolution to this complaint other than a refund of the fees I was charged because of his error. 
Regards,
[redacted]

The person submitting the complaint does not appear to be the insured person.  An authorization has not been provided by the insured person allowing the release of PHI or PII to third parties.  That form can be accessed via http://www.imglobal.com/pdf_forms/claimform-interactive.doc...

Information regarding any amounts paid, dates of payment, and medical providers paid can be reviewed within Explanation of Benefit statements communicated to the Insured Person or accessed at https://myimg.imglobal.com If the Insured Person disagrees with any decision(s) communicated, the Insured Person may ask the Company to reconsider that decision and supply medical records and opinions to support the appeal.  The Company will then reconsider its decision based on review of any additional documentation and facts and advise the Insured Person of its decision.

Please check with member. This was resolved. member is canceled

Dear Revdex.com:I am sorry Ms. [redacted] is unsatisfied with my response.  As stated previously, the numerous providers did not promptly reply to the records requests, which delayed the claims reviews.  I just spoke with the Benefit Review team and all claims have been adjudicated. Yours truly,Carolyn R. O[redacted]Assistant to General CounselInternational Medical Group, Inc.

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. Although there is still one account still awaiting a response.  I would rather have had an apology in addition to the resolution but I am very grateful that at last the issues are being settled.  
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12302394, and find that this resolution is satisfactory to me.

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 have attached the forms related to four claims. In all of them, the response is the same, a full denial, even though the services should be covered by IMG.The response obviously uses a generic customer service language, something companies often do in order not to address what the customer is saying.Besides that, there are obviously claims, and I have also submitted an appeal to the denial of coverage on claim [redacted]. I submitted it on August 24, 2016, and I've got an automated message stating "of receipt of your e-mail by IMG and to assure you that we will handle your correspondence in a timely manner". Guess what? We are starting the month of October, and I never received a response to that. IMG never got in touch with me.This is the worst customer experience I´ve have in my 38 years of life. It´s unbelievable.
Regards,
[redacted]

Information regarding any amounts paid, dates of payment, and medical providers paid can be reviewed within Explanation of Benefit statements communicated to the Insured Person or accessed at https://myimg.imglobal.com

If a definite answer to a specific benefits or coverage question is required for any reason, the Insured Person may submit a written request to the Company, including all pertinent medical information, and a written reply will be sent to the Insured Person.  Actual eligibility determinations,...

benefit verifications, final coverage decisions and claim adjudications, and final payments and/or reimbursements of benefits or claims can be determined and adjudicated only after or at the time a proper and complete Proof of Claim is submitted, an opportunity for reasonable investigation and/or review is provided, cooperation is received, and all facts and supporting information, including relevant data, information and medical records when deemed necessary or appropriate by the Company, are presented in writing.  The following items must be submitted by or on behalf of the Insured Person to be considered a complete Proof of Claim eligible for consideration of coverage (“Proof of Claim”): (a) a duly completed, timely submitted, signed Claim Form and authorization for release of information; (b) all original itemized bills and statements of services rendered from all medical providers involved with respect to the claim; and (c) all original receipts for any costs, fees or expenses that have been incurred or paid by or on behalf of the Insured Person with respect to the claim, including without limitation all original receipts for any cash and/or credit card payments. The Insured Person has 90 days from the date a claim is incurred to submit a complete Proof of Claim, and the Company at its option may pend resolution and adjudication of submitted claims and/or may deny coverage: for Proofs of Claim submitted thereafter; for incomplete Proofs of Claim; and/or for failure to submit a Proof of Claim.

Mr. [redacted] cancelled his gym membership on Sept 9, 2017 and paid his cancellation fee of 2 months dues.  It was an error on our part that he was billed on October 1, 2017.  I am a little astounded that he filed this so quickly before even giving us a chance to correct the mistake. ...

  He could have spoke to anyone at the front desk and left a message with them and our manager would have called him back.  He did call on October 4 and spoke to our front desk manager who credited his credit card back for the dues that we mistakenly took on October 1.  He is cancelled out and will not be charged again.

Actual eligibility determinations, benefit verifications, final coverage decisions and claim adjudications, and final payments and/or reimbursements of benefits or claims are determined and adjudicated only after or at the time a proper and complete Proof of Claim is submitted, an opportunity for reasonable investigation and/or review is provided, cooperation is received, and all facts and supporting information, including relevant data, information and medical records when deemed necessary or appropriate by the Company, are presented in writing.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted].   The reply is general and does not address the specifics of my claim. However, I will wait  for the business to perform this action and, if it does address my claims, will consider this complaint resolved.
Regards,
[redacted]

I am rejecting this response because:First, I should be able to continue the same terms that I had, which was 20 dollars a month and able to use both gyms.  why isnit that all of a sudden they didnt let me use both?....they said that since 2008 everything change and thats a lie becuase a month ago I was able to use both....Plus Glen was very rude and unprofessional with me on the phone.  When I told him I was to contact Revdex.com he said with a very sarcastic voice "oh have fun with that, do what ever you want, " and hung up on me....I need to be able to attend both gyms like iwas before with just 20 dollars a month!  ive been a member since 2006!!...and ice brought many members to the gym with me!

August 16, 2014
Dear [redacted],Thank you for Speaking to me about a week ago. As I explained all our members who are not paid in full and therefore pay monthly sign the agreement that I am presenting. Paid in full members sign the same agreement the only difference is that a monthly paying member agrees and signs to make 12 monthly payments and then go on a month to month agreement thereafter where they can cancel with 30 days written notice. The rate guarantee fee which the customer signed and all monthly customers must sign states that every January and July, they understand that they will pay a $19.99 rate guarantee fee. So the fee is charged to all active members on those two months. Our membership completely complies with the Pennsylvania State requirements for health clubs and fitness centers.If you have any questions please do not hesitate to contact us.Kind Regards,Bob BOwner

Actual eligibility determinations, benefit verifications, final coverage decisions and claim adjudications, and final payments and/or reimbursements of benefits or claims are determined and adjudicated only after or at the time a proper and complete Proof of Claim is submitted, an opportunity for...

reasonable investigation and/or review is provided, cooperation is received, and all facts and supporting information, including relevant data, information and medical records when deemed necessary or appropriate by the Company, are presented in writing. If a definite answer to a specific benefits or coverage question is required for any reason, the Insured Person may submit a written request directly to the Company, including all pertinent medical information, and a written reply will be sent. In the event the Company denies all or part of a claim, the Insured Person has a reasonable opportunity to appeal the denial under which there will be a review of the claim and the determination. Insured Persons shall have 60 days from the date that the notice of denial was mailed within which to appeal the determination, and have the opportunity to submit written comments, documents, records, and other information relating to the claim. The Company’s review will take into account all comments, documents, records, and other information submitted by the Insured Person relating to the claim, without regard to whether such information was submitted or considered in the initial claim determination.

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 already sent written email few months back on the concern with claims rejected stating pre-existing condition even though it is not. But no action from insurance company. I was told to contact doctor office to discuss further & not with insurance company. I am getting bill dues from Doctor office as claims were rejected]
Regards,
[redacted]

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.   This does not address the issue I raised initially on the phone.  I want to pay the remaining months in full right now, because I do not wish to expose my new address to the gym. The gym would receive all of the money they are owed over the remainder of the contract and the relationship would be severed immediately. This is a very reasonable request and the representative on the phone was not able to explain or provide reason why this was not possible. Again it is more than fair and equitable to all, as the gym gets the full dues they are owed, and I get peace of mind that they will not automatically continue to charge my account after the year is over    Regards,   [redacted]