


Based on authentic user experiences
seth schumacher
6735 reviews
N/A
6 months ago
Do not utilize this company in any way
Insurance TPA is excellent at refusing to accept claims making the claims process needlessly difficult borderline impossible and absolutely ridiculous I received care from two providers six months ago on temporary insurance through insurance TPA They have repeatedly sent me multiple thousands of dollars of bills When I call to question why they did not run anything to cover appropriate costs they claim that the providers are not sending them information I thought it was strange that both providers would not provide information One provider may have forgotten but both seems unlikely So I called both providers and gave them the address to send the claims I get another letter from insurance TPA stating that the providers have not provided information and that I will be financially responsible for all the costs if they do not So I call Insurance TPA again get on a conference call with one of the providers and facilitate them getting the information sent to the right address I find out during this call that Insurance TPA does not provide the correct mailing address for claims on the forms that they send to customers or service providers How are we supposed to send claims if we aren t provided the right address Insurance TPA also requires a year of previous services provided from any claims because it is a short term policy I have never received any letters claiming that that information was needed I called both providers and let them know that information would be required I called yesterday and neither provider has been able to update the lack of previous service with Insurance TPA I find it hard to believe that with me calling both providers and specifically stating that the year of previous services is required for the claim that neither one of them would provide such information This leaves me with no option other than believing that Insurance TPA is purposefully not updating the information to try to stick me with the bills Further calling customer service is a nightmare You have to ask the exact questions that you need information on or they won t provide it Multiple employees at the call center have been extensively rude to me I put in a request to talk to a manager that has not happened I keep having to call because they will not provide the correct mailing address to send claims to They also state that they do not place outbound calls Between refusing to place outbound calls not providing the correct address for claim submissions and making things borderline impossible for their customers by refusing to provide any information on claims or the submission process I fail to see how this insurance company is concerned with anything other than pushing the astronomical costs of medical service onto their customers Insurance TPA if you read this and care to improve at all here are some pointers Provide the correct mailing address for claims on every form that references claims or is to a customer so that the customer can at least do your jobs for you since you refuse to do your jobs properly in any capacity Provide a phone number for providers to call to clarify any confusion with required information Start an outbound call center of people that are specifically trained to request information and give providers all dates of service and any requirements for previous services rendered Train your staff to provide information without having to be specifically asked each individual question of how to submit their claims properly Stop making things so difficult for your customers You will be buried in lawsuits in a very short amount of time from people that you ve denied claims from when all information was provided properly Would it not be easier to do things the proper way than to try to screw over every customer that s ever used your service Repeat customers are how companies thrive nobody will have anything good to say about your company if you do not improve Stop being rude to your customers provide them the information they need and call providers to get claims finalized so that they aren t being resolved six years later