ComplaintsforS C A N

• Initial Complaint

  06/26/2024

  Complaint Type:

  Product Issues

  Status:

  Unresolved

  More info

  I was vacationing in ****** and had a medical emergency. I spent a total of 12 days 8 of which were in the icu, I had double pneumonia renal failure requiring dialysis. The hospital bill total our out of pocket $100,000. We have been dealing with our insurance **** ******** and Scan (which is nearly impossible). To date we have received two checks totally approximately $16,000. Scans brochure states 100% reimbursement . We were told to read page 64 in the information. Scan sales reps are selling this as total reimbursement. We are a retired couple and we feel we were very deceived. Thank you for allowing me to hopefully warn others.

  Business response

  07/17/2024

  ********************** was contacted regarding this matter and was informed that SCAN will pay all ******** allowable charges, which may not be 100% covered. He was also advised that this is under appeal. He then informed us that no further contact is needed unless there was news in his favor regarding 100% reimbursement. 

  Customer response

  07/18/2024

   
  Complaint: 21843890
  
  I am rejecting this response because:  It is wrong to have a brochure that does not indicate your reimbursement is 100% paid with no asterisk indicating its only the ******** suggested rate. Thats a huge difference!  In my case about $80,000.  The day of my emergency my wife called and the answer was Dont worry you are 100% covered!  It wasnt we will only reimburse the given ******** rate.  That is very misleading at the least and more like false advertising , The consumer deserves full disclosure!

   

   

  T

   

   

   

   

   

  
  Sincerely,
  
  *********************************

• Initial Complaint

  03/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I still do not have a response regarding explanation of charges. These same charges from earlier visits were canceled out following my questioning in the past. The procedure dates are all past a year now and I have been trying to get an explanation since March 2023. Representatives in several calls promised to get back to me which they never did. Finally I obtained the written letter on November 2, 2023 stating I will have a response by 90 days. 90 days have more than passed. I've received nothing. I keep getting delinquent letters from Scripps since Scan advises not to pay pending investigation. I am no longer a member of Scan as of 1/1/2024. I was a member when these charges were incurred.

  Business response

  04/02/2024

  Paid encounter# ************ received 02/20/23 for $176,543.44 total charges with $300 copayment applied.  Per member benefit, member has $300 copay for outpatient surgeries.  Per notes, member paid $300 on DOS and is now receiving a bill for $80.  Contacted the provider at ************ to confirm patient account status.  It was confirmed that member did pay $300 on DOS but does has a balance for Lab work /radiology.  Per member benefit, member has $50 copay for diagnostic radiology.  Member billed correctly for $50 not $80.  Fax# ************ Attention: 736852.  Sent member copay letter.

• Initial Complaint

  02/05/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had infection on my left foot and on July 17 I had a partial foot amputation.I could not put weight on my foot for 2 1/2 months. I needed to get around the home for food and bathroom immediately. Due to advanced RA a nonelectrical mode of mobility was not adequate. On August 3 2022 we went to primary doctor and filled out the scooter required paperwork for the scooter and the doctors office called and said I was approved. August 9,2022 I purchased my scooter for $2717.66.On August 22, 2022 I submitted the paid invoice to SCAN. I followed SCANs procedures for reimbursement. SCAN called me and wanted my credit card bill. I sent this in September. In November 2022 I received a letter regarding my claims. The letter did not deny my claims but wanted further information The charges will be reconsidered upon receipt of that information. SCAN wanted my medical records and on November 10, 2022 and the medical records were eClinicalWorks emailed to SCAN. On November 22 Scan told they didnt get the medical records. I offered to send them my disk or paper copies. On December 2, 2022 still no medical records. I spoke to a SCAN supervisor ****** (sp) ******** extension 3457.On December 14, 2022 my doctor called SCAN and my doctor mailed and faxed my medical records per SCAN request. 22 December SCAN again told they havent received the records. I offered my disk and/or copies for their purposes. I made a paper copy of the records and mailed to SCAN. I left telephone messages. No responses. I filed in Riverside County Small Claims Court ******** **********. The judge in the case dismissed the case without prejudice in September 2033 there was no legsl basis for dismissal.The SCAN attorney told me snd the court he would not settle and offered no reason for reimbursement. October 2023 I contacted old age advocacy group HIPRO attorney and we sent on a letter with supporting exhibits. This was sent in-heard nothing. 2 months ago. Scan has all documents and receipts.

  Business response

  02/09/2024

  We were successful in connecting with ******************. According to ******************, he didn't understand why we were contacting him. The issue was well over a year ago and he did not have any additional comments. We offered to further assist but the offer was declined. 

  Customer response

  02/16/2024

   
  Complaint: 21142498
  
  I am rejecting this response because SCAN member services told me they had NO invoices I sent to them in their files including my small claims actions against SCAN which was dismissed without prejudice by Riverside small claims court! This is pure garbage! They received as in my BBB complaint on 3 occasions- in the fall of 2022, in small claims court in September of 2023 and as directed by old age advocacy group HIPRO whos attorney directly contacted SCAN on my behalf as well as a final demand letter sent in November 2023. NO RECORDS . Garbage! 
  The bottom line is these all mighty health care groups refuse to refund their clients for out of pocket expense! This fact is according to numerous doctors and doctors offices I have spoken to as well as HIPRO. 
  My filing of invoices do not exist- how confident! SCAN needs to be punished as the court system is also protecting them! Millions not refunded. 
  
  Sincerely,
  
  *********************

  Business response

  02/22/2024

  On February 8, 2024, we spoke with ******************, asking him to resubmit receipts associated with the cost of his equipment. ****************** refused. This would have provided the needed information to review the case. Without documentation, there isn't an avenue for resolution. 

  Customer response

  02/27/2024

   
  Complaint: 21142498
  
  I am rejecting this response because:

  I did not reject the sending of the invoices again because SCAN as I told there representative SCAN has received the invoices and accompanied paperwork on 4 different occasions.

  1- Original filing of invoices in August, September and October 2022. 
  2- Records and invoices sent in on January 2023. 
  3- Invoices given to SCAN attorney at Riverside Small Claims Court hearing September 27 2023

  4- Invoices and accompanying paperwork in November 2023

  HIPRO old age advocacy group attorney also contacted SCAN in October 2024. SCAN denies not only NOT receiving any paperwork but also has (quote) no records of the Small Claims Court hearing! (Dismissed without prejudice)

  SCAN are simply a group of liars and dont wish to pay up. They need to be held accountable. 
  If needed I can try and get the Small Claims Court documents to show they lied. 

  
  Sincerely,
  
  *********************

• Initial Complaint

  01/25/2024

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  Company is selling my personal information to 3rd parties with out my consent. I have made it clear more than 14 times. I have filed 6 complaints. They continue to not address the issuse. I want a STOP to this company violating my rights to Privacy.

  Business response

  01/25/2024

  We are bound by HIPAA (Health Insurance Portability and Accountability Act of ****) guidelines and take our obligation very seriously. The primary purpose of this piece of US legislation is to set standards to protect the privacy of an individual. Healthcare providers (SCAN), medical offices, and service providers that store or transmit health information fall within the scope of HIPAA and must therefore meet its compliance standards. SCAN does not sell member information to 3rd parties. Willful violation of this law can have severe consequences. 

• Initial Complaint

  06/23/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  On January 22, 2023 I submitted a reimbursement claim to SCAN by completed form. I mailed using the ***** I also sent receipts for the **** machine that I bought. I bought the machine from an online vendor because SCAN and Apria couldn't get their staff together to get me a machine for 3 months!!! I was slowing dying from sleep deprivation and it seemed as though no one cared.I called one more time on May 26, 2023 and spoke to *******, customer rep.When I asked about the claim, gain, no records in the database!!!!! What a bunch of bull! She was going to put in the claim again and call last week. No call. This is the worst and **OR customer service. I don't get it. I think because I filed a ******** complaint against SCAN, Apria, and the doctor about the **** machine not being shipped to me when desperately needed, they have flagged my account to make my life miserable.When I submitted the form, the SCAN website warned that the decision could take up to 90 days. I was okay with that because I had my brand new **** machine that I paid for and on my way to recovery.On May 2, 2023, I had not received a letter or email or telephone call about the deposition of my claim. I called their office at 9:59 am and spoke to ********. He told me there was NO record of my claim!!!! I was absolutely incensed!SCAN has been very pro-member in the past. This was astounding to me. I sent a letter to SCAN on May 6, ***************************************************************************************************************** 10 business days.Well we passed that deadline now!! Fortunately I had a **** trace on this letter. It was delivered to the ** Box in **********, ** on May 10, 2023 at 10:23 am. They have no excuse this time.If we can't resolve in BBB, then I will file a Small Claims action after this issue is resolved here. I'll give it another 10 business days for SCAN respond.

  Business response

  07/05/2023

  After conversations with ****************, he has been reimbursed at 100% of the cost he incurred. 

  Customer response

  07/07/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

  I would like to add that I do not have the check yet. The young lady to whom I talked about the refund said that it may take up to 10 days. I have that marked on my calendar to follow up.

  Also, I don't know what happened to this claim in January but it sure took a long time, many phone calls, several resubmissions of the form, and a complaint to BBB to get it resolved. I hope it never happens again to me or anyone else. The behavior was shameful. Overall, SCAN is outstanding in their care of its members.
  
  Sincerely,
  
  *********************

• Initial Complaint

  07/17/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Dear BBB, on Feb. 24, 2022 I went to ***************** to have my teeth cleaned; a routine deep cleaning that is listed with SCAN as zero copay with insurance card. Before the hygienist cleaned my teeth the dentist gave me a list of recommendations in addition to a cleaning and said if I didn't accept it, he couldn't help me because it's all for the good of the patient. He asked if I could pay cash/credit for office visit. I paid $300.00 on ******** credit card for a $0.00 copay cleaning. I requested a reimbursement from SCAN on Feb. 26, 2022 and have been given the runaround for a refund ever since then. First it was, ************ handles claims, then SCAN handles claims, then the grievance dept, then someone else, then it takes 30 days to investigate claim, then it takes another 30 days to re-investigate. Then once approval was granted, there was a supposed mix-up in the finance dept., then the check is in the mail; then there's no one else to talk to, etc., etc. etc. It has been five months of frustrating calls, all to no avail. I just need my $300.00 over-payment refunded to me asap. Thanks in advance for your help

  Business response

  08/12/2022

  Business Response /* (1000, 9, 2022/08/09) */ *********** has been approved for refund from ******* Quality management team in full amount of $300.00 on 07/28/2022. Member should be receiving check within 7-10 business days. An attempt to contact the member was unsuccessful, but a message was left. Continued efforts to reach the member are scheduled. Consumer Response /* (2000, 10, 2022/08/09) */ Dear BBB, a full refund was sent to me, thanks to you. Again, thanks so much for your help. I really appreciate it.

• Initial Complaint

  04/29/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Happened on 04/29/2022 (but it has happened multiple times with other patients) Scan offers transportation services for the elderly to appointments and procedures. They always say they are coming at a particular time, then reschedule or they say they are here to pick up the patient but leave within a minute not even giving us a change to bring the patient outside. This out right neglect of elderly patients is not acceptable. This keeps happening every time a patient is trying to use their transportation services. If they plan on having this service then they need to be properly trained and up hold to their end of the service. Or just not offer this service if they are non compliant with the duties they state they will uphold on their end. I will never recommend this company to any of the patients I see here in San Diego, CA and I will tell every Doctor I know to never advise on having patients use Scan.

  Business response

  06/09/2022

  Business Response /* (1000, 5, 2022/05/19) */ An attempt was made to contact the facility to gather additional information. After speaking to a representative at the facility, He could not provide specific members, names of transportation providers or information supporting the allegation. There was not anything offered to corroborate the allegations; therefore, we are unable to research the incidents referred to in the complaint.

• Initial Complaint

  12/28/2021

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  An Agent for SCAN named ****** ***** went to my elderly father's home in *******, **********. She pressured my elderly father into purchasing an insurance plan he did not fully understand, for him and my stepmother. The agent of SCAN, an unaccredited HMO provider, took advantage of my elderly father who knows little English and who has dementia. I am concerned about the actions of this agent, especially if she is selling to those in the ******************* speaking community in ******* and the ****************************. It appears she preyed on my father, and I know of one other elderly, ******* speaking couple whom she pressured into buying such insurance.

  Business response

  03/18/2022

  Business Response /* (1000, 8, 2022/02/02) */ The agent in question, has been a friend of the ******* family for over 10 years and was contacted by the member on October 14. The agent was asked to present options of coverage. After review of two options, the member and spouse collectively decided to go with SCAN based on $0 dollar plan premium, lower copays, lower maximum out of pocket, formulary savings, higher star rating and embedded dental benefit. Communication with Member's Daughter: 1/25/22 - Spoke to the member's daughter ************ who asked that we call back on Friday 1/28/22 after 2. 3/31/22 - Left a voicemail. 2/2/22 - Left voicemail. 2/2/22 - Called ************; mail box is full. - We were not able to speak to ************. The member's enrollment was successfully withdrawn. Consumer Response /* (3000, 10, 2022/02/08) */ (The consumer indicated he/she DID NOT accept the response from the business.) The company did not contact me instead the contacted my father's phone number on a day i happened to be at father's house. the rep did not reach out to me on the day/times I indicated- 1/28 -which was the day I could speak with them. This is an unsatisfactory result. I would like a follow up communication. Business Response /* (4000, 14, 2022/02/25) */ Conversation on 2/25/2022 about the enrollment process. *********** states parents did not fully understand and should not have been enrolled. Disenrollment was granted on 1/1/2022. *********** was satisfied with the outcome.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩