Complaints

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• Initial Complaint

  Date:14/11/2022

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On October 30th I purchased BD pen needles for $89.98, I submitted the claim using the application of the receipt from the pharmacy which was printed from the register and signed off by the pharmacy assistant. The claim was denied, I called greensheild on Nov 7th to confirm reason for denial. I was advised it was denied as I needed an official receipt from the pharmacy and not a register receipt. I obtain the requested receipt and resubmitted it under the same claim as I was directed to. On November 11th I got an email saying there was an update to my claim, I didn't see any so I called again. They told me to wait a few days. I then got an email stating the reason I was denied as it must be filled through the pharmacy as a prescription. I have submitted receipt for this product in the past as well as with other items with a pharmacy receipt without issue. Greensheild said that was an exception even though at the time they were processed I was never told of such a thing or I would not have done this very thing to now be refused coverage. If I had known, this could have been avoided. I'm not being dramatic when I say stress causes my blood sugar to rise and tonight it has risen over 18 because of this situation. I would like to be reimbursed for my medical equipment and also be shown where in the policy that you cannot submit on your own for later reimbursement. I would also like to know what I am able to purchase and submit on my own so that I can avoid this in the future. Thank you

  

  Business Response

  Date: 16/11/2022

  Good Morning,

  An additional exception has been granted to reimburse the October 30, 2022 claim.  We require diabetic supplies to be prescribed by a medical doctor and dispensed by the pharmacy.  We do not accept handwritten / cash register receipts.  

  We had previously allowed an exception.  The exception was granted on her January 11, 2022 statement for diabetic supplies ("One-time" exception allowed. Future diabetic supplies must be purchased on prescription. Cash
  register or hand written receipts, etc. are not eligible for reimbursement. Diabetic supplies must be filled as a prescription at the pharmacy & submitted on an official prescription receipt).

  We have left a voicemail for the plan member to contact a specific member of our Management Team to help understand the difference and ensure a smoother experience for her going forward.