ComplaintsforHawaii Medical Service Association

• Initial Complaint

  06/24/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  On 6/24/24 I attempted to call HMSA and was informed of a 45 min wait time. I left my name and number in the queue it is now almost 4 hours later and I have not received a call back. I called back in and currently have a 1:46 + hold/waiting time. The question I have is time sensitive and it doesn't look too promising I will get the answers I am looking for which will also cost me $1000. I am EXTREMELY disappointed in HMSA and your customer support (lack of). This is not the first time I have had ridiculously long wait times. I end up ending the call with out ever getting a call back and therefore my questions/concerns never getting answered or resolved. I will be filing a complaint with BBB in addition to this complaint.

  

  Business response

  06/25/2024

  
  Thank you for contacting the BBB with this issue. 
  
  HMSA is working hard to fill all our servicing positions with quality, local representatives.  We are committed to regain our previous servicing performance levels of an average of five minutes or less.  We are also working with our telephone systems to improve our call back feature.  We have an on-line inquiry service available on HMSA.com for you to send an e-mail to our servicing center as another option and on HMSA's My Account there is the e-mail option Ask HMSA form. 

  I will have a representative contact you and help you with your questions. 

  ************** Unger   Customer Relations Manager

  ************    **************************************  

   

• Initial Complaint

  06/04/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Unfortunately (very unfortunately, since I had ****** prior to that), my new employer only offers HMSA, and for 6 months now I have been trying to find a ******* Care Provider in my area (Kona), and even willing to drive to other cities. For 6 months, I've made some 100 calls and NO ONE in the ********** is accepting new HMSA patients. The best I got was to be added to a wait list for a PA, no doctors. The HMSA number listed on the back of the card is out of service, and the 1800 number is not reachable. I've try calling their number some 50 times. I either leave a message and never get a response, or I wait for 1 hour+ on the line, until the call is disconnected. At this time, HMSA is unable to provide any healthcare at all. No PCP, no gynecologists, not a single doctor in the island of Hawaii has accepted a new HMSA patient request. Can anyone from HMSA help me? Your website is not useful (old information, mostly drs that no longer reside in ** or do not accept new HMSA patients). I can't talk to any representative. I am out of options and DO NOT HAVE ANY HEALTH CARE AT ALL.

  

  Business response

  06/04/2024

   

  Thank you for contacting the Better Business Bureau.

  I apologize for our longer wait times when you tried to contact HMSA.  I will have a representative contact you and help find a PCP in the Kona area.

  ************************ - Customer Relations Manager   ************   

  **************************************  

  Customer response

  06/25/2024

  Unfortunately, I still have no medical care at all from HMSA. A gentleman named ***** did call me once, saying he would help me to find a primary care provider in **** area, right after the complaint was posted. I have not heard from them ever since, and I am not able to get through the phone number provided. I am back to square zero with no medical care. 
  
  Here's a screenshot with a 53:36 minutes wait time to talk to someone at HMSA and still, they did not answer. 
  

  
  

  

  Business response

  07/02/2024

   

  I apologize, this inquiry was forwarded to our Provider Operations.  I will follow up with them to make sure they contact you and help you with finding a Kona provider.

  Thank You - 

  *********************;

  Manager Customer Relations   ************   ************************************** 

   

   

   

• Initial Complaint

  06/02/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I am filing a appeal concerning a formal complaint against your employers career opportunities advertised online. For decades, your company has been known to repost deceitful postings online to obtain information of advocates in the area, practicing interviews of candidates, and curating articles to hack human identities of people in various districts in ********, Hawaii. Your organization is seen on career websites seeding information of companies legacy and various social content to manipulate the interest on various websites (such as, Adzuna, LazyApply, Linkedin, ZipRecruiter, etc).Please type on googles search engine: - careers - Job titles - Titles of Employers To help refine more information regarding my complaint You as a colleague and staff member should investigate who is curating these fraudulent interviews by utilizing branding to promote your company productivity while on the job.Your staffs MANAGEMENT are creating (seeding job postings) numerous fraudulent jobs posting (virus) of career opportunities advertised online. Various candidates detailed resumes are being extracted from websites of young advocates seeking career opportunities in ********, Hawaii. Despite the fact that your company is posting fake profiles of career opportunities. Your company is responsible for information being intercepted by con-artists manipulating data to create fake profiles for collective data used by your organization (they utilizing ideas of the dark web to demonstrate their intentions). Our community, are at risk by the actions of your organization promoting fraudulent data for untrained individuals who are unaware of the existence of fraudulent records placed into an unauthorized database. I hope your company isnt using these websites for company and commercial purposes.

  

  Business response

  06/03/2024

   

  Thank you for contacting the Better Business Bureau. 

  I received your complaint regarding - Contract Disputes, appearing to be related to employers career opportunities advertised online.   I tried calling the number you provided, ************, but the telephone number is not in service.   I will also try sending you an e-mail to the one provided - ****************************com.

  You may contact me - 

  ************************ - HMSA Customer Relations Manager - ************

  **************************************

   

   

• Initial Complaint

  04/23/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My son was seen at ***************** on Thanksgiving day 2023 he had to have emergency surgery and we have not gotten a membership report or reimbursement for this service from HMSA it affecting my credit score and continuous time wasted on the phone with ****** and HMSA to find out the status. Asking for help to clear this miserable mess that started on Thanksgiving.

  

  Business response

  04/24/2024

   

  Thank you for contacting the BBB regarding your questions on your son's November 23, 2023 claims. 

  I do show HMSA has received and paid four claims for services rendered on Thanksgiving Day, November 23, 2023,  for *****'s acute appendicitis, 

  ****** Foundation Hospital      $37,598.75   Paid $20,426.27 on 3/28/2024 to provider

  **************** Griniger     $1,678.00     Paid $884.93 on 3/1/2024

  ********************** Devisser     $834.00    Paid $180.86 on 1/26/2024

  ****************** *************;    $389.00     Paid $164.31 on 1/26/2024

  ********************** Hedemann     $1,200.00     Paid $396.76 on 2/1/2024

  I will also contact you regarding the details of the claims

  ************************ - Manager, HMSA Customer Relations 

   

   

• Initial Complaint

  04/01/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have been calling HMSA to ask a simple question about my plan. I have been trying to resolve my issue for over two weeks. the best answers I receive are, "Current hold time is 165 mins",,,," I can submit a call back request and you can receive a call back in 7 business days". Another option I have is to fill out a webform and receive a response in 10 business days. This is unacceptable and a health care provider needs to provide better customer ********************** and provide answer or assistance within a timely manner. The customer ********************** process is terrible. I don't go around and complain about businesses but this drove me to send this to you. HMSA needs to answer customers questions in a timely manner.

  

  Business response

  04/01/2024

  Thank you for contacting the BBB with this issue. 

  HMSA is working hard to fill all our servicing positions with quality, local representatives.  We are committed to regain our previous servicing performance levels of an average of five minutes or less.  We are also working with our telephone systems to improve our call back feature.  We have an on-line inquiry service available on HMSA.com for you to send an e-mail to our servicing center as another option and on HMSA's My Account there is the e-mail option Ask HMSA form. 

  We do show we received your inquiry regarding your claim dated 8/11/2022., regarding the coverage listed as secondary, and confirming if any payment is needed. 
  
   I will also have a representative contact you and help with any open questions you may have. 
  
  We apologize for the frustration and inconvenience you encountered. 
  
  ************************ - Customer Relations Manager 

• Initial Complaint

  01/29/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  They no longer answer the phone at any if their contact numbers. They also will not respond to email requests. This is in regards to a more than $400 billing error. I cannot contact them as I have spent cumulatively more than a dozen hours on hold only to be eventually hung up on.I have contacted them on their website (as per their instructions) under my account but they will not respond. The medical facility continues to send me a bill (which I have not paid yet) but HMSA has refused to respond in weeks.

  

  Business response

  01/31/2024

   

  Thank you for contacting the BBB with this issue. 
  
  HMSA is working hard to fill all our servicing positions with quality, local representatives.  We are committed to regain our previous servicing performance levels of an average of five minutes or less.  We are also working with our telephone systems to improve our call back feature. 

  I also do not show any receipt of an e-mail regarding your claims billing error of more than $400.00.

  We will contact you and help with any open questions you may have. 

  We apologize for the frustration and inconvenience you encountered. 

  ********************* - Customer Relations Manager 

  Customer response

  02/13/2024

  Apparently, this file has been closed on your end without a resolution.  Just as an update, I actually did receive a call (a message on my phone) from an HMSA customer ********************** representative. I have returned that call (twice) without any actual contact as the message tells me that the person who left me the original message will call me back and then hangs up.  As of this morning, I still have not been able to communicate in ANY manor with HMSA to ask questions as to how I might resolve this issue.

  

  Business response

  03/12/2024

   

  We have contacted the provider to refile the two claims,  10/31/23 for total charge $500.18 and 11/6/23 for total charge of $1,121.17 with the referring physician.   Then HMSA can reprocess the claim.

  ********************* - 
  Customer Relations Manager

  ************

  ************************************** 

   

  Customer response

  03/12/2024

   
  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

  01/29/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I am currently a college student attending school out of state and was involved in a car accident (pedestrian) in September 2023. Shortly thereafter, HMSA sent me paperwork regarding TPL payment information. I filled it out via their online entry. Ive repeatedly followed up (spoke to call center staff, went into the neighborhood center, sent in inquiries via Ask HMSA). I also expressed during these visits/phone calls that my hospital bill was being sent to collections due to nonpayment by insurance. Im continuing to follow up to see whats needed (giving sufficient time to settle my case prior to being sent to collections). They continue sending me paperwork that I already filled out. They also are not providing additional information as to what I need in order to settle with the hospital and doctors fees. They also continue telling me that I need to file with my no fault insurance. *** explained that I dont have a vehicle and so no fault doesnt apply. Ive also indicated on the form that workers comp doesnt apply since i was not injured during work. This case has been ongoing since October and Im unable to get resolution as to what specifically is needed. Ive also submitted the settlement letter from the ********** ********** for the vehicle that struck me). This continues to go back and forth without any resolve.

  

  Business response

  02/22/2024

   

  Thank you for bringing this to my attention.  

  We have been able to update the Third Party Liability information that No Fault was not applicable, and we have reprocessed the claims.  
  
  Payments were paid to the participating, mainland providers, as noted on the attached. 

  If you have any questions, please give me a call. 

  ************** Unger  - Customer Relations Manager

  ************ or ************************************** 

  Customer response

  02/26/2024

   
  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

  01/23/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have PPO health insurance through HMSA. I had an emergency room visit while I had HMSA insurance. The date of service was 2/09/2023. My claim # is 23277E0029544. I am receiving a bill from ******** *** for $2,408.00. I called HMSA back in October 2023, and they said that they would apply the insurance to the *** bill, and then ******** *** would send me a new bill with the insurance applied. ******** *** originally sent me the $2,408.00 bill with no insurance applied, so I just need my insurance to be applied to the bill and to receive a revised bill with the insurance applied. I called ******** ***, and they said that I need to call HMSA. I have been on hold for 3 hours with HMSA and I cannot get though to anyone. I just need this to be resolved so that I can pay my ******** *** bill, and HMSA needs to apply the insurance that I paid a monthly premium for. I have spoken with HMSA several times about this, but they will not apply the insurance, so I need help from the Better Business Bureau. I am receiving late notices from ******** ***, and I just want my insurance to be applied so that I can pay my bill. Thank you.

  

  Business response

  02/02/2024

   

  Thank you for bringing this issue to our attention. 

  Looking at the claim 23277E0029544 for service date 2/9/2023, I do show that HMSA did make payment to you on 10/11/2023, check number M702932 for $1,926.40.  This left you with a co-share or member liability of $481.60.   We will contact you to make sure you received the check. 

  Also, we do apologize for the long hold times.  

  HMSA is working hard to fill all our servicing positions with quality, local representatives.  We are committed to regain our previous servicing performance levels of an average of five minutes or less.  We are also working with our telephone systems to improve our call back feature.  We have an on-line inquiry service available on HMSA.com for you to send an e-mail to our servicing center as another option and on HMSA's My Account there is the e-mail option Ask HMSA form. 

  Thank you - 

  ************************,  Customer Relations Manager 

   

• Initial Complaint

  01/05/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I have called HMSA four times with no proper result (Dec 8, 18, 29) being on hold for an extended period of time, each call. Today, Jan 5, I have been on hold now for over 1 1/2 hours and soon need to hang up. Also, emailed HMSA today, on Jan 5. I repeatedly requested a **** GUIDE TO BENEFITS for RETIRED **** members with ******** to be mailed to me. I have received two 2023 editions. I have many doctor visits coming up & surgery and need this guide. I need your help to get me the proper guide.

  Customer response

  01/13/2024

  After a few more calls, I have finally received the booklet that I requested. This complaint has been resolved to my satisfaction. I would like to close this complaint. Thank you.

• Initial Complaint

  01/05/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have been on hold for over 2 hours to ask a basic question about my medical benefits that I cant find an answer to online. This is unacceptable for a for-profit company making $735/mo on my premium. Where is all that money going? Not toward hiring phone staff, apparently. It would seem to be lining the executives pockets. I demand either better service or a reduced price that better reflects the poor quality of service.

  

  Business response

  01/19/2024

   

  Thank you for contacting the BBB with this issue. 
  
  HMSA is working hard to fill all our servicing positions with quality, local representatives.  We are committed to regain our previous servicing performance levels of an average of five minutes or less.  We are also working with our telephone systems to improve our call back feature.  We have an on-line inquiry service available on HMSA.com for you to send an e-mail to our servicing center as another option and on HMSA's My Account there is the e-mail option Ask HMSA form. 

  
   I will also have a representative contact you and help with any open questions you may have. 

  
  We apologize for the frustration and inconvenience you encountered. 

  
  ************************ - Customer Relations Manager 

  Customer response

  01/19/2024

   
  Complaint: 21104634
  
  I am rejecting this response because:

  This is the stock response that HMSA has been giving to complaints on this issue for months now. Instead of getting shorter, the hold times continue to get longer.
  

  The fact that it was a stock response and not an individual response does not give me faith that the business is actually working to address this issue.

  
  Sincerely,
  
  Naga Nataka

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