Healthcare Gov - We enrolled with the Marketplace; paid premium and still don't have coverage. What a tragedy?
We enrolled with Marketplace, selecting Scott & White Health Plan; our coverage was effective for March 1, 2016. I forward a payment to Scott & White Insurance Comp on February 23, 2016. I've spoken to numerous of representatives from Scott & White and all said they haven't received a payment from me, so therefore, I'm labeled as not having coverage until they receive a payment. I forward a letter by fax on March 10, 2016 attaching proof of payment with back and front of cleared check from my bank. I've explained to both Scott & White, the Market-Place and Dept. of Insurance the urgency of this matter, that I was running out of insulin, so I must see a doctor for prescription. Scott & White representative Ms. Chelsea K. says to fax the proof to billing because there were no number to contact them; and there were no supervisor I could speak to above her.
I set-up a doctor appointment for March 17, 2016 with one of their providers, assuming the matter would be resolved by then. I contacted a representative on 3/14/16 he said he would send billing an email; stating the payment went to an incorrect contract number and someone will contact me with the resolution. Before attending our scheduled doctor appointments on 3/17/16; I contacted Ms. Lindsey approximately 2:15 pm; she said it was okay for me to keep my schedule appointment today; because the payment was being processed. We arrived at the doctor's office at 4:00pm to discover the receptionist could not verify coverage with Scott & White, as she and myself spoke to Ms. Victoria (Ms.Vickie) from S&W's call center. After speaking to Ms. Vickie I asked her to review all documentation and conversations leading up to the most recent with Ms. Lindsey; regarding my case. She attempted to contact billing (who wasn't suppose to have a listed number according to Ms. Chelsea), but no one answered. I told Ms. Vickie how embarrassed and humiliating this experience was for me as I was standing in the middle of other patients discussing this matter. She than said we would have a supervisor to look into the matter as I continue to hold. Ms. Vickie couldn't contact a supervisor, so she requested the doctor's phone number from the receptionist, stating she will call her right back with the information. At 5:45pm while setting in the doctors office, the receptionist said the representative from Scott & White hasn't called back, so we would have to rescheduled our appointments until they can confirm coverage. I told the receptionist I need to see a physician as soon as possible because I was running out of insulin. She contacted her Manager and he stood by their policy. So, after spending two hours at the Kelson Clinic my husband and I was turned away because the provider (Scott & White) would not verify coverage. In one or two days I will be completely out of insulin. I need to be connect with an higher authority to solve this matter asap. I have never experience a situation like this one in my entire life as pertaining to insurance coverage verification. This sums it all up!!!
This person wrote the review because of "problems with payment and poor customer services" at Healthcare Gov. Reviewer claimed that he or she lost $556 and wants Healthcare Gov to "since we were turned away from our scheduled doctor's appointments; that scott & white health plan be repsonsible for paying for the next visit and pay for the insulin needed".
The author asks this business to immediately contact him/ her to briefly discuss his/ her negative experience with the company.