1
out of 5
POSTED: | BY: Bri
Systemic Administrative Failures and Lack of Transparency
Where to begin. The record keeping is horrendous making it nearly impossible to audit the accuracy of payments. I have 3 dogs and the EOB line items do not list which pet it is associated with despite me asking multiple times for this addition.
Claims processing is slapdash with very little attention to detail. I’ve had significant diagnostic inaccuracies made in my claims, line items missed, denials due to unmet deductibles despite being well past the deductible. I’ve spent 10+ hours auditing EOBs and have appealed twice (which required time and documentation from my veterinarian). At least one of my appeals was approved. I think I’m still waiting on the outcome of the other but I’m unclear because I receive no communication other than a new EOB, which I’ve established are nearly impossible to decipher.
I’ve made phone calls requesting additional info and received promised call backs that never happened. I’ve sent emails that went unanswered.
When I call, I am always met with delightful customer service reps who are not enabled to really help in anyway. I’ve been blocked from speaking with or receiving any communication from the claims department who i assume would be better able to answer any of my questions.
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