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Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
09/13/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Please see attachedBusiness response
09/20/2024
Dr. ****** did not want to do a complaint in regards to unapproved medication. He would like Health Nets PEER to PEER process to be revised and changed. He believes the process is too long and should be made in a shorter period of time.Customer response
09/23/2024
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.
Sincerely,
****** ****** MdInitial Complaint
09/10/2024
- Complaint Type:
- Order Issues
- Status:
- Answered
My health insurance informed me of an additional health insurance listed under my identity. It is through Ambetter/HealthNet. It is not mine. I and my insurance informed Health Net that it was not mine, is causing access of care difficulties, and requested removal many times. HealthNet has refused to remove the insurance.I am requesting that the complaint and my contact information not be posted as my identity has been stolen.Business response
09/20/2024
Health Net is still working on the members complaint. The member called back Health Net on 9/19/2024 and provided details of the complaint.
We have sent an email to privacy to research the active enrollment for this member.Initial Complaint
07/12/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have called Healthnet to see PCP. When I call every person I talk to tells me they will solve issue but they never do, they just make me wait on the phone for hours. Last week I talked to ******* who assured me she will find a PCP for me to see and will call me this week. This week she called me assigned me to a new PCP, told me that she will call me in one to schedule visit with PCP. So she told me to wait another month to schedule an appointment. She told me I will change your PCP today but you cant make an appointment with this doctor **** I have been calling Healthnet multiple times in the last couple of months I have a record of all the calls I have made and how much time I have spent with Healthnet. Yesterday, she called me from a number that in my call logs says Scam Likely. I tried calling that same number today, it says that number is not in service. Healthnet insurance is a scam, literally my phone shows me that they called me yesterday from a scam number. Today I called the office of new PCP they assigned and they told me the first available app. they have is March 2025. Now I have to call Healthnet again. So far I have been on the phone with Healthnet for hours upon hoursm each time they cannot find any doctor for me to see. All the PCPs they have assigned to me are not accepting new patients. Their website shows lots of doctors, all the doctors I have called, all the offices I have called they are not accepting new patients. I have received an email from Healthnet stating that their website is updated frequently, but in reality their website is not updated at all, they dont actually have any doctors. This is a class action lawsuit waiting to happen. I am a physical therapist myself and I provide medical care to patients everyday and I cannot get medical care. No one is actually accepting this insurance. Just now I was on the phone with Healthnet the guy told me he will help and had me on hold for 35 minutes, then hung up on me.Business response
07/23/2024
Was able to make change members PCP *************** Parnian effective 8/01/24. Member has been noifited of the outcome.Initial Complaint
06/27/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
On 11/14/23 I had a routine mammogram with Valley Radiology Imaging (P.O. **********************************) (#CADB2479221) at which time I paid the provider $225. The next day I submitted a claim to Health Net for reimbursement. Health Net claims they paid Valley Radiology Imaging and wants them to reimburse me. However, **************** claims they never received any payment from Health Net. On 2/12/24 I spoke with "****" from Health Net who said I should have been reimbursed by Health Net but an electronic check had been sent to Valley Radiology Imaging on 12/1/24. "****" was going to look into it and get back to but never did. Reference number is I-125616912. On 6/3/24, I contacted Health Net again and spoke to "******" reference number I-134954566 who said Valley Radiology was paid and they needed to route me a check. ************************ continues to state they have not been paid and to contact Health Net.Business response
09/20/2024
************************ at ********* at telephone is unable to refund member due to this being a "self-submitted claim" Provider will submit the reimbursement to HealthNet TAT ***** BD. I submitted an admin pay which was processed the member will received the check and updated EOB within 2-3 business days. I was unable to confirm if the member received the check due to no correspondence.Customer response
09/23/2024
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.
Sincerely,
***** *****Initial Complaint
03/18/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
On 3/14/2024 I contacted Health Net about my ***************** Premiums, for I did not quite understand the way they were charging me for my insurance. The representative explained the process and said I had to make my premium payments, which on my bill stated I owed $48.36 (mailed 03/01/2024) the rep. ****** I owed $72.54 by end of March (03/31/2024). I explained that I would make a payment for $24.18 (03/14/2024) and would pay remaining balance of $48.26 on 03/22/2024, which would be my my next pay period from my job. She stated that would be fine and to be sure premiums were paid before 03/31/2024.On 03/15/2024 I have a pending charge of $48.36 on my debit account which I did not authorize and with this unauthorized charge , I now do not have enough funds in my debit account to get to and from work the next few days until I get my pay check on Friday 03/22/2024. I cannot afford to loose my job. I explained to the rep. **** I would pay on Friday 3/22/2024 due to my budget.This charge of $48.36 is one I did not authorize and I consider this to be a fraudulent charge and I need my monies released immediately..Business response
09/20/2024
Health Nets ******************* has responded to you inquiry, and we have been advised that the call you made on March 14, 2024 has been reviewed and it was confirmed that the *** representative you spoke with did not review payment history and coverage enrollment spans to identify the reason as to why your payment went up to $48.36 and you were informed that paying $24.18 during that time the suspension will be removed. Please be advised that the *** representative you spoke to has been coached on the importance of setting proper expectations and identifying the need to minimize customer effort through providing accurate information. Additionally, to avoid similar incidents in the future, the *** representative has been coached on the importance of Health Nets promise and commitment in providing compassionate and trusted assistance to our enrollees.We strive to ensure the best possible service and regret if you felt the service, you received was anything less than optimal. Furthermore, Health Nets Membership Accounting and ********************** has responded to our inquiry,and we have been advised that there is no refund due at this time and it was confirmed that you are enrolled with a premium amount of $587.17 and an APTC amount of $561.99 leaving you responsible for an amount of $24.18. You currently have no balance due having been paid through April 30, 2024. In addition, it was confirmed that you are enrolled in automatic payments (autopay). Please accept our apologies for any difficulties you may have encountered. Your feedback is important to us, and we appreciate the time you have taken to share your experiences. This information will help us to improve service to our members.Initial Complaint
02/06/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
We chose health net PPO for our insurance for 2024. We have used the same health care broker for years and she made sure our medical network (****** ************* / ****** Health) was covered and contracted with this insurance. I also called ****** health network to confirm they were contracted. It also lists this network on their website and covered CA. After taking my son to his 1 year well visit and vaccinations, i find out that his doctor is not covered and the reason being (although this verbiage is listed NOWHERE to delineate between the two when advertising or speaking to customer service) is on vs off exchange. I now have a $1600 bill for a routine well visit for my child. It was false advertising and they made me believe that my sonss doctor was covered. I have since gone to your website to read the reviews on health net and ive actually never seen so many 1 star reviews. They are fraudulent and need to be looked into. Ive file an appeal to have my bill paid through healthnet to no avail. I will file a complaint with CDI as well. Its unacceptable what they are doing tk their customers. They should be stopped.Business response
03/12/2024
The claim for the well visit that the member son received on 1/16/2023 was reprocessed and pd by Health Net on 2/28/2024 to the provider of service. The provider has been notified of the payment and the member should not receive any further bills.Initial Complaint
12/19/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
I am on a health plan with my mother. I turned 26 this year and immediately received a letter that said I had to leave the insurance with my mom because of my age. I was sent the letter in August 2023 and was told that by October 2023 I had to call Health Net and remove myself from this health plan. Health Net is now charging my mom a single payment of $600 because I am no longer in the insurance. How are you going to charge this when the insurance themselves said I could no longer be in this plan ? Please be careful with this insurance they will bill you for no reason!!Business response
01/02/2024
We have made multiple attempts on 12/20/2023, 12/26/2023, and 12/28/2023 to reach the member by email and phone to obtain information regarding this complaint. We have received no response from the member at this time. Please have the member reach out to us for further assistance.Initial Complaint
11/21/2023
- Complaint Type:
- Product Issues
- Status:
- Resolved
This is about a Pending approval on crowns/ ID # ************ :My general dentist submitted it first on 11/08/2023, and supposedly it was never received, which I do not believe, and submitted it again on 11/15/2023, and now your department is telling my dentist it will take 7 to 10 days to get an answer from you.It is an emergency, why would you even consider ask me to wait that long, when I am in pain, I just had three root canals and have wholes in my teeth & am at risk of infection ???? I also have a lot of decay under other teeth with existing crowns, it cannot wait !Are you joking ?This should have been approved on the same day it was requested !Your lack of professionalism is endangering my health !!!!Unacceptable !I am filing a complaint today with the Better Business Bureau and contacting the medical board of dentistry in CA with another complaint as well.Additionally, I am contacting Medical with a third complaint, and also recommend they no longer do business with your company.This is absolutely outrageous !Contact my through the BBB website with an answer/resolution, do not contact me privately.***************************Business response
12/01/2023
The Members complaint was file through the appeals process and a decision by the Appeals team with Healthnet was made to uphold the denial for the Dental Authorization as the Member did not meet the Medi-Cal Dental Manual of Criteria for the crown which explains that a crown cannot be placed on a tooth that still has half of the tooth structure remaining that is not damaged from decay or trauma.Customer response
12/01/2023
Complaint: 20893341
I am rejecting this response because:Clearly, whoever handled the claim does not know how to read !
My general dentist has shown proof by providing x-rays to Health Net that there is "severe decay", I repeat, "severe decay" under the crown, it is already causing me to be in pain, as it has been there for a long time.
Since Health Net is refusing to provide me with the dental care I desperately need, I will follow by filing another complaint with the CDI which regulates dental insurances in California, I will also file a complaint with the attorney general of California, and will go all the way up to the ***************** with a complaint if necessary, I will also consult the services of an attorney, and since I have this insurance through Medical, I will contact Medical with another complaint and recommend that they no longer do business with Health Net, not to mention all the online negative reviews I will leave about Health Net, to expose the appalling way they treat patients, people will know about it, which could very likely affect this company's bottom line.
This is an outrage & I will not stand for it !
Business response
04/02/2024
An appeal for the Members complaint completed by both Liberty Dental and Healthnet and both appeals were upheld stating the Member did not meet the Medi-Cal Dental Manual of Criteria for the crown which explains that a crown cannot be placed on a tooth that still has half of the tooth structure remaining that is not damaged from decay or trauma. What this means is that approximately half of the tooth structure must be missing from trauma or disease. The **ray(s) do not show that this tooth has had that much damage.Customer response
04/03/2024
Complaint: 20893341
I am rejecting this response because:Actually, this decision was overturned weeks ago and treatment was received, so the person who wrote this reply is obviously clueless & misinformed, which is really unprofessional and laughable.
Sincerely,
***************************Business response
04/05/2024
We have reached out to Liberty Dental and confirmed that they did overturn the member's appeal on 2/5/2024. We apologize for the inconvenience.Customer response
04/09/2024
Better Business Bureau:I am not impressed by the lack of communication and professionalism.
***************************Initial Complaint
11/01/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
This has been going on for many years now, I used to have Health *** services and I've moved on to a different service. The problem is, they would issue a refund for psychotherapy sessions which they assured would be refunded, I've called throughout the years getting different answers and different coordinators that would resolve the issue, the last coordinator that attended me was ******************** The the Appeals and Grievances Case Coordinator in which was following my case, she knew the amount I'd be refunded also which I have on file, I've tried calling back but her number reports as not available anymore, her number was ************ which I've tried contacting many times with no luck. I have the receipts, their 2 letters and all the required information that *** be necessary. I've also sent them emails, contacted customer service and such and there has been no resolution. **** receipts are from 2014 and 2015 respectfully and the letter they issued was from April of the present year of 2023.Business response
11/10/2023
We have been working with the Member to get the reimbursement checks for his services re-issued. The original checks were mailed to the Members' old address that we had on file. Check#******** $98.85 and CK#******** $1459.88 have been voided and reissued to the Member. These checks were sent via ***** (************), the Member emailed that he received the checks. We are still in the process of getting the final check $5641.27 voided and reissued. We will continue to be in contact with the Member until the final check is received.Customer response
11/14/2023
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.
Sincerely,
***********************Initial Complaint
10/10/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
i am a member of healthnet. member ************. i purchased at home covid test, back in feburary 2022. i called in healthnet prior to purchasing the test to see if the test are covered, i was told the tests are covered, and will be reimbursed. Healthnet representative helped me file an appeal with my state for hearing the state denied the reimbursement. i want healthnet to reimburse my purchase, since their agent was the one who told me to purchase the testBusiness response
10/20/2023
Health Net has processed the members Covid test reimbursement request and will be issuing a check to the member. Our team will continue to update the member .
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Customer Complaints Summary
47 total complaints in the last 3 years.
10 complaints closed in the last 12 months.