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My father had a stroke and we are supposed to have 100 days of coverage in a skilled nursing facility. They stopped payment on both the skilled nursing facility AND his physical therapy after only 20 some days. Heartless.
We have a recurring policy with them and my wife had two hand surgeries. One in Oct 2018 which was mostly covered. In November I removed one dependent from the policy and it send them into a tailspin. They charged $200 more than the monthly premium and the after numerous calls reduced the premium to 4 times the original premium. Before I made the change I called and asked if her upcoming second hand surgery would be covered. They said yes, however every time you call this place you get a new rep and have start all over again. Well the Dec 2018 was not covered and applied to a new deductible and not out pocket similar to the surgery in October.
Seven calls were made when it was finally escalated to an investigative unit who finally told me they would not cover it and I am responsible for the entire bill. They will not connect me to this department as they claim they do not have extensions. Stay away from these people if you possibly can as they don't give a damn about their policyholders and can't explain reasoning as to why the second surgery was not covered.
My husband is required to get insurance for his job, and my job mandates Highmark. Since we have to have two insurances, we just buy the catastrophic plan for my husband's which is the cheapest. They rarely cover anything, but since his birthday is earlier in the year, they are supposed to be primary and Highmark is secondary. Long story short, I have spent countless hours trying to get Highmark to provide maintenance of benefits. Many, many phone calls. Eventually, I learned that the most effective way is to go through their message center and send the EOB from the other company. This is ridiculous because the other insurance is also affiliated with Blue Cross. Even when I do this, sometimes it takes several attempts to get the maintenance of benefits to be provided.
My husband and I have excellent credit, and I am terrified that our credit rating will be harmed because we are not paying bills that we should not have to pay for. I don't understand why they will not just put a note on our account to provide the maintenance of benefits. There are also services which are surprisingly not covered, such as newborn care when my son was born in the hospital -- ordinary birth expenses. If I could go with another company, I would.
I have been suffering from pain and numbness since Feb 3. I have had an X-ray and nerve tests, still no diagnosis. My Dr wrote a referral for an MRI. They denied it stating I needed proof of pt or chiropractor for last 6 weeks. Highmark has been paying for both since February so why do they need to prolong my pain and suffering while I get a letter from my chiro that what they have been getting paid for since February really happened. What a bunch of jerks! Wish I had UPMC!
I sprained my ankle almost 3 months ago. Had several x-ray which came back normal. I have been in extreme pain with my foot. Tried several different braces with no relief. With severe swelling and ankle and foot pain how can an insurance company do this for insurance that I pay for? I have exhausted all avenue on my own. My attorney with be contacting you regarding this matter. This is going to turn into much more than a rejection of a MRI. Because you have a bunch of idiots working in your authorization department. I do authorizations at my job. I work with NaviNet. I know.
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Having had shingles already at 53 I spoke with my doctor and he wants me to have the vaccine as once you have shingles you are at higher risk to get again. I had no idea you could get again and that is not something I ever want again. My immunity was for a few years so now I need to get the vaccine. I cannot get it covered since I am not 60. Even with my doctor's orders, NO... Our contract says 60 and we make the rules. No way to argue the point, ask for a variance, nothing... So where do you complain? I asked what options I had to try and get this covered. The options given by Susan at the Highmark - supervisor - was have the vaccine and pay for it. That is an option that you have. When you are denied coverage you can appeal, however the contract says 60 so it will not be covered. No way to formally request any variances in insurance. Does not seem like the way it has always been.
They randomly select medications to not cover anymore. Some patients NEED them but just continually get denied life altering medications. Never spoke with anyone that was rude or mean. They are just relaying information. It's to their fault. They offer help as much as they can but their own options are limited. Generally speaking, the coverage is good. Their internal policies are what I believe to be the problem. Plus, they could add a much easier and faster process for people needing exemptions. I was able to see a reputable doctor that fixed up all the issues I had going on. He helped me maintain the battle of getting healthy both mentally and physically.
I never really had any issues with the claims processing. It usually went through and I never had to file any claims. Of course if I had it probably would have been OK. Never had any issues with customer service because I never had to talk to them unlike many insurance companies I have had in the past. Still can't believe I'm no longer with Highmark. I had to change primary care doctors because they were not covered under my insurance plan, doctors I had been going to for years. I had to pack up shop and leave the ones who knew me. Overall value was decent because I got it through my union, however 2200 a quarter still seems pretty expensive to me considering the company also matched the payment.
My major use of claims processing use was for my daughter and the hospital or doctor's office usually handled that as soon as I gave them my card so there was little effort on my part. During the five years that I used this provider, I never once had to contact customer service regarding any issue. The coverage options are extensive and include single and family plans with usually three different tiers to choose from to meet every customer's needs. Through my employer I only paid $50 per paycheck for a family plan which included my wife and daughter with dental and vision also included so I don't think that can be beat.
Very hard to send claims through. My son broke his arm and needed surgery last year. They sent me the bill once and I called to ask if it's covered and they said "sure, not a problem, just pretend you didn't get the bill". I did as they said and the hospital sent another bill, then another, and another. It took almost six months for my claim to go through and for me to stop receiving bills. They try very hard to make you satisfied and to ensure that you are completely taken care of all your needs. Never leave you until all of your questions have been answered. Everything is always covered. Whenever I put a claim through it's covered. Also, I barely have any co-pays and they are always ten dollars or less. Great value! I get it through work so I don't pay anything but co-pays and that's a great value to me. I strongly recommend it because most companies use this insurance.
I've lost my card and had to submit a claim. And they handled it very well. Payment was made promptly. And all future payments were submitted on time. And never affected my credit. I never had to deal with customer service. The people I talk to when applying for the insurance were very helpful and very polite. They covered all my medical needs. Very low deductibles. Also had coverage on wife and kids. And they provided very good coverage. I would highly recommend Highmark. The value for medical insurance is very reasonable and affordable. For all of my medical needs. With very low deductibles. Highly recommend this insurance company.
I was happy with the process, got the doctors I wanted, and I didn't have to wait for months to be accepted which usually I have issues with this. Everyone was friendly and understanding. They knew and understood their job which was great when they could explain my options. They knew what they was talking about when helping me understand. The coverage is amazing, got the doctors I wanted and more. Also they are simple about special doctors and other services too. Wasn't difficult and that makes me happy. I couldn't be more happier, not only just for me, but my family as well. Good doctors, good service, good choices, I feel comfortable with this service.
Well what can I say that everyone else hasn't? It's slow. I have to call back many times to take care of a problem. Accounts always slow when you need them and screwing up my accounts. To get to the point, you're customer service is **. I didn't know where you hired the people you have but they're stupid. I can't say anything bad 'cause they got the job done. It took a long long long long long time but they got it done. The price was ok but it looks great. I can afford it most of the time. I can't cancel my plan the next day. Pretty ** thing to do.
I've lost my card and had to submit a claim. And they handled it very well. Payment was made promptly. And all future payments were submitted on time. And never affected my credit. I never had to deal with customer service but the people I talk to when applying for the insurance were very helpful and very polite. They covered all my medical needs. Very low deductibles. Also had coverage on wife and kids. And they provided very good coverage. I would highly recommend Highmark. The value for medical insurance is very reasonable and affordable. For all of my medical needs. With very low deductibles.
Customer service is top notch. They make you feel like a person and not a number. I even signed my mom and dad up for this insurance. Filing a claim is very easy!!! Customer service is great! The wait time is not long when you call. They are able to answer all of your questions and if they don't know the answer they will find someone to help you. The cost of the insurance is comparable with other insurance companies. The deductibles are very reasonable. I only pay 20 dollars for an office visit. You always get what you pay for. The value is comparable to other insurance companies. Actually, the value is better. Our school district uses Highmark as well.
Claims process was easy and not stressful. They made everything easy to understand whenever we had questions regarding any bills we received. Customer service was great and everything was pretty much available online on their site. The wait time to speak to a customer service rep was not always quick but that was expected. They also called often to follow up on certain phone calls. Coverage was good. I am sure it could have been better but the employer we had coverage through was responsible for the choices we had. I would recommend Highmark. We paid a high premium through my husbands employer. When I had it with my employer prices were great. Plus I had better coverage especially while I was pregnant.
I've never had any issues with the claims processing with my coverage from Highmark. Highmark was very convenient and easy to understand. I only contacted customer service one time about a claim that wasn't covered. They were very kind, helpful and patient, and took care of the claim for me. They walked me through everything that could have gone wrong so I could understand where the miscommunication was. The coverage was great! I was hardly left with anything to pay after Highmark made their payment to my providers. I kept all of the same doctors, specialists, and stayed with the same hospitals and outpatient clinics. For the amount that I paid for Highmark, it was definitely worth the price. It was the best insurance coverage I have ever had. Low copays, small out of pocket fees, nothing costs too much with Highmark.
Quality customer representative who make it Very easy to file a claim and getting reimburse for out of pocket funds. The usual claim and reimbursement process was resolved in under a month! The staff was very knowledgeable and extremely helpful. They made it very easy to sort out hospital Bills and turned an unpleasant experience into something that could have been a lot more tolling. All in hospital stays are covered. Prescription copays are not that high and routine visits were great. Had a wide range of Drs that accepted. I got a great bang for my buck. It was required by my employer and it was definitely worth paying for. Would see not recommend opting out.
My health care worker usually took care of my claim forms because I don't see too good. They usually took care of all my paperwork for me. It covered all my doctor's appointments for me and it also covered my eye doctor and specialist doctors that I needed to see. It also covered all my prescription. It was an excellent value because my husband work paid for the policy. We only had to pay a small deductible. His employer paid for everything else. So it was an excellent value.
They never paid for my husband's back surgery. It was very expensive and we had to take our savings out to pay for it. The doctors were kind enough to lower the price for us. No one would help us. When we called they didn't know what was going on. They didn't care about my husband or any of us. They treated us like a piece of **. They never paid for surgery. EVER. It was like why bother having healthcare insurance?! I want to switch but, I live in WV and that's the only available choice. Terrible! Everything is terrible about this healthcare. They just treat you like a number no matter what. Don't even care about you at all.
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