ComplaintsforAdvanced Medical Pricing Solutions

• Initial Complaint

  11/02/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  AMPs is the third repricing company to **********************. They are supposed to resolve disputes on my behalf. They have been working on balance bills to the hospital for 2021 since February of 2023. ***** have now been turned over to collections. I have submitted all documentation and supposedly AMPs is working. They call and send emails asking for the same documentation as if they have never received anything. I do not believe the repricing is correct nor do I believe they are communicating with Solidarity or the hospital to get a resolution.

  Business response

  11/10/2023

  We apologize for any inconvenience or distress this balance billing dispute process has caused you. Although the first statement we received from you was in March 2023, we could not file a dispute at that time as the provider had not yet received the payment from your HealthShare,Solidarity. Upon receipt of the first true balance bill statement you sent in May, we immediately began disputing the excessive charges with the provider.  Thru out this process our advocacy team will continuously request from you any new statements or correspondence you may have received from the provider to ensure we have the most up to date information regarding continued billing.  We understand this can seem vexing at times, but the information is needed in order for us to stay informed with the providers intent for continued balance billing.

  With regards to the repricing, after a thorough review for clinical and correct coding, we utilize several metrics, including permitted payment levels set forth by your HealthShare and per HealthShare guidelines to determine the allowable amount on each claim. Solidarity and AMPS have partnered together to make certain you are not overpaying for your healthcare needs.  We are in constant communication with your HealthShare, so they are kept informed of the status of the account every step of the way.

  At this time, we have transitioned your accounts to our negotiations department for review and settlement.  One of our dedicated legal advocates will be reaching out to you with next steps.

  Again, we are truly sorry and are looking forward to getting this matter resolved for you. 

  Customer response

  11/14/2023

   
  Complaint: 20815748
  
  I am rejecting this response because:    It has been in dispute for for 8 months.    Getting this account settled is the only resolution.   I live in fear of my excellent credit being ruined because the accounts have been turned over for collections.

   

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

• Initial Complaint

  12/20/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  My family has had health insurance with this company for 2 years and their prescription system is completely broken. Both years we hit our family deductible and were supposed to begin receiving lower discount pricing for our families prescriptions. Due to some sort of technical glitch in their system, our family deductible continued to reset and we were overcharged for prescriptions every month. I am owed at least $2000 in refunds from the last 2 years due to this problem. I have spoken with a supervisor named *********************** on several occasions on the pharmacy benefits side of the company and she is aware and has attempted to help me get remedy to no avail. To date I have only received $262.00 in refunds. According to *****, a financial audit was to be done on our account for the last 2 years and I was due to receive refunds to make up the difference. I was told over $1000 was coming and only got $262. I would like the rest of my refunds. I can only imagine this its happening to countless other customers of this company. Please help if you can. Thank you.

  Business response

  12/22/2022

  AMPS recently acquired the previous PBM administrator and found the error in their system. We have taken steps to correct this issue and have refunded all that have been affected by this technical error. We continue to monitor the system for further inconsistencies. We are working with this specific member to ensure that he has been made whole and to provide the proper refunds due. AMPS is dedicated to improving all our newly acquired members experience and savings.

  Customer response

  12/22/2022

   
  Complaint: 18615107
  
  I am rejecting this response because:

  While ***** who I have been working with is attempting to get me the refunds I am due, To date I have only received $252.00 and am owed over $1200 for last year and even more than that this year. Once they do actually process the refunds and I receive them, i will be happy to accept this response. The other reason is the system is still not fixed. We went to fill a prescription again this week and still had to open over an hour and multiple trip to the pharmacy to get the correct price on our prescription. This has been a nightmare for my family the last 2 years and we have continued to get overcharged for our prescriptions even though we met our deductible by the middle of the year.

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

  Business response

  01/04/2023

  We have spoken with the member and there is a refund that was being sent out for the full amount from 2021 and 2021 that was over paid. 

  Customer response

  01/04/2023

   
  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

  09/16/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  AMPs is the third party to my healthshare, Solidarity. They are supposed to resolve disputes on my behalf. They have done nothing to resolve my son's ****. His name is *************************, date of service 6-18-21. Total bill is $864. I paid $94.97. The provider, ********************************* is billing me the remainder, $769.03. I am being sent to collections tomorrow, 9/17/22. I have called AMPS EVERY SINGLE DAY this past week and they have promised to call the provider immediately and then call me right back. They did not. Yesterday, they waited until 5PM to try and call the provider and OBVIOUSLY, the doctor's ****** was closed. Again, the promised to call the provider first thing this morning, and still they have not. Also, I asked them for an email copy of the dispute letter to the provider and they have failed to send one to me, It looks like a dispute has not been filed and they are fine sending my bill and my credit to collections. Finally, they are saying that $94.97 is the fair amount to pay the anesthesiologist for emergency surgery in the hospital. That is not a fair amount to the doctor for his anesthesia work in the hospital. I am convinced their numbers are wrong.

  Business response

  09/23/2022

  We sincerely apologize for the negative experience you've had in not getting the call back that you were promised and rightfully deserved. We realize that receiving a balance bill is distressing and understand the time constraint presented after providers threat to send account to collections. This bill was priced per the fair and reasonable guidelines set forth by your plan and we can assure that the dispute was resent to the provider on 9-16-22.  A call was conducted the same day to confirm dispute was received.  Since, we have escalated your bill and our negotiations team has been in contact with the provider to resolve the remaining balance on the account. You will receive an email from the member experience manager, who will be monitoring the bill until resolution; email will contain direct contact information should you have any additional questions.

• Initial Complaint

  02/08/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I had employer health insurance thru a separate company that was fine for the first year but terrible when they began using AMPS. Little if any of the bills would be paid and the provider would then seek the balance of the **** from me.Attempting to get it resolved, the insurance told me to contact AMPS who continued to drag it out saying it was part of the process. The bills are from July-Sept 2021, it took until Feb 7, 2022 for AMPS to tell me they dont actually have contact with the provider and that I should contact the insurance as to why the bills are STILL not resolved.The attached is an example of how they led me to believe otherwise and that I did everything I was responsible for.The bills are not going away and the provider is only becoming more aggressive. It has affected my ability to seek care and it should not continue to be my problem.I seek ALL bills to be resolved FULLY without any further need for me to be contacted by AMPS or for me to need to contact them, and all negative credit for me to be cleared.

  Business response

  02/14/2022

  Good Afternoon,

  AMPS is the claim repricing vendor for this member's health plan. We do not administer or pay benefits. We recommend you contact the health plan's third-party administrator, Maestro Health, for further information. A point of contact at Maestro would be *****************************, who manages this member's health plan. Her email address is ************************** At this point, AMPS considers this matter closed, however feel free to contact me directly should you have any questions. Thanks!
  

  Customer response

  02/14/2022

   
  Complaint: 16742082
  
  I am rejecting this response because:
  AMPS spent months yanking me around about what was being done to resolve the balance bulling. 
  Sincerely,
  
  *********************

  Business response

  02/21/2022

  Per our call with ************ on 2/15/2022, we informed her that disputes for each of her claims were filed with the provider on 11/05/2021 and 1/17/2022. As part of the dispute process, we must allow the provider a total of ninety (90) days to acknowledge, research and respond to said disputes in accordance with the Fair Credit Billing Act (FCBA) guidelines. We have since been in touch with ************** health plan who has given the Third Party Administrator approval to reprocess the claims for additional payment to the provider. Our Member Experience Manager has been in touch with ************ and has verified that no credit reporting has taken place. We will maintain contact with her until complete resolution.

  Customer response

  02/21/2022

   
  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,
  
  *********************

*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. ↩