ComplaintsforThe Rawlings Group

• Initial Complaint

  02/23/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Received a phone call from my health insurance provider today, saying I needed to contact this agency and if I didn’t, I would have Medicaid sanctions. When I called, I spoke with a representative, who told me they were investigating a bill that was 2 years old. The agent said I was mailed letters and I was told to about the issue. I asked him to verify the address to where the letters were sent to, since I moved from ********** to **** and my ID was still a ********** ID. He refused. I told him, the letters were probably sent to **********, since they probably used the address on my ID. He said that that’s no way for him to know. I said he needed to do his job and figure out before threatening me with sanctions. He took a hostile tone and I reminded him of his position in customer service and it’s HIS JOB NOT MINE to verify the address of record BEFORE the company takes action against me. I even said I would send copies of my past and current ID’s to verify my addresses. I even said I would send a copy of my fiancé’s death certificate to prove when I moved to Iowa. I NEVER received a letter from this agency. I request a letter of apology and an admission of wrongdoing. Willing to speak to the media. To automatically threaten me with sanctions is irresponsible and unacceptable. They should VERIFY ANY AND ALL INFORMATION!!!

  

  Business response

  03/04/2024

  Ladies and Gentlemen:
  
              This letter is in response to the Complaint filed with your organization bearing #********. The Rawlings Company LLC (“Rawlings”) provides claim recovery services to health insurance companies and health plans throughout the country. Rawlings seeks to recover on behalf of the health plan payments made by it for medical claims which should have been paid by other parties, such as in the case of an accident caused by a third party. Once Rawlings identifies patient treatment that may be related to an accident, Rawlings mails a questionnaire to the plan member. If there is no response, a second letter is sent.

  
              On or about July 18, 2022, Rawlings mailed to the Complainant a letter with a questionnaire. Not having received a response, a second letter was sent on August  23, 2022.  These letters provided instructions on the various ways in which the requested information could be provided (including use of a toll-free number or mailing the response using a postage-paid envelope).

  
              The address used by Rawlings to mail these letters to the Complainant was provided by the health plan, and it was in Iowa. (The address Rawlings currently has on file for the Complainant matches the address we see in the Complaint.) Rawlings is required to notify the health plan when a plan member does not respond. Such was the case here. Any resulting action by the plan is not determined by Rawlings.
  
              On February 23, 2024, Rawlings received a telephone from the Complainant’s health plan with the Complainant on the line. During this call, Rawlings was able to obtain the information requested in the 2022 letters. This fact was then reported to the health plan, and Rawlings has closed its file regarding the member and the claims which caused the 2022 letters to be sent.
  
              We apologize for any inconvenience or concern that this process may have caused the Complainant.  

  
  

• Initial Complaint

  02/22/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Received a collection letter from a Rawlings Financial Services LLC in LaGrange KY. Reference number ******** saying that I owe $188.15 for a prescription drug benefit with ****** **** ****s and **** ******. I went into the portal for this insurance and there are no such charges. I have never been billed from this insurance and have no idea why I received this. I also noticed how many other people they are doing this to and that it clearly is a scam!! I want my record cleared and for this company to not contact me or send me another letter.

  

  Business response

  02/29/2024

  Ladies and Gentlemen:
  
              This letter is in response to the Complaint filed with your organization bearing #********. Rawlings Financial Services, LLC (“Rawlings”) provides data mining and claims recovery services to health insurance companies and administrators, including the Complainant’s prior health insurer. As part of its work, Rawlings seeks to recover payments which were made by its clients for prescriptions filled by a pharmacy after an individual’s coverage with that insurer or plan has ended.
  
              Information obtained by Rawlings indicates that the Complainant’s prior insurance coverage terminated on 10/1/23. His new coverage (with a different insurer) became effective 1/1/24. The services which are the subject of Rawlings’ letters were provided on 10/16/23 during which time his prior insurer had no coverage. Even so, Rawlings’ client was billed by the pharmacy and paid for those services.
  
              Rawlings agrees to have no further contact with the Complainant as requested. However, the amount stated in Rawlings’ letters remains due. Respectfully, this response is not a waiver of any right Rawlings or the prior carrier may have to pursue the outstanding amount further.        

              Please do not hesitate to let us know if additional information is needed.
  
  

  
  

• Initial Complaint

  02/06/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was involved in a car accident in January of 2022. I went to ****** ********** for medical help after the accident. Since it was a car accident the other parties insurance was to pay for the medical bills. Since a settlement took so long to be reached their was a lien put against my settlement, by ****** who hired the Rawlings Group to handle the situation. Eventually on January 12 of this year i received the settlement check fro $4000.00. It was made payable to me AND the Rawlings company. ********* ******* from the Rawlings Company, who was handling the case, instructed me to sign the back of the check and send it to them, they will take what they are owed $950.80 and refund the remaining $3049.20. This initial conversation, explaining to me what to do, was over the phone, and she assured me that as soon as they get their payment they'll send me the rest and it will not take more than one week, she said she would upload it into her computer same day as received and the check should be issued to me immediately after. They received their payment on Monday January 29th. I emailed today 2/6 to ask for an updated window of when my check would be sent to me and she responded with the check is still "down in finance" and that she put a "hot" request in and they are running a couple of weeks behind down there and told me to "hang in there, it's coming." This is extremely unprofessional and disrespectful handling of the situation. It is understandable to have delays, but this check I sent them was made out to me as well as them. They are a business and did not need this money urgently. I am the one who lost their car, time, and health due to the accident and this money has been on hold for years and they should have immediately refunded me the difference within the week like ********* told me they would do. It seems she wanted to make sure they got their money so was dishonest about the length of time it would take for me to be issued my money in return.

  

  Business response

  02/15/2024

  
              The Rawlings Company LLC (“Rawlings”) provides claim recovery services to health insurance companies and health plans throughout the country. Rawlings seeks to recover on behalf of health plans payments made for medical claims which should have been paid by other parties, such as in the case of an accident caused by a third party.
  
              Rawlings represents Complainant’s health plan. The health plan in this case paid medical expenses incurred by the Complainant that may have resulted, in whole or in part, from such an accident. The plan has a lien on the proceeds of the settlement which the Complainant entered into with the at-fault party or his insurance carrier. In this instance, the at-fault party’s insurance carrier issued a check made jointly payable to the Complainant and Rawlings. The Complainant endorsed the check and forwarded it to Rawlings.
  
              Per its normal process, Rawlings endorsed and negotiated the check received and also issued a check made payable to the Complainant for the previously agreed upon amount. This check was mailed to the Complainant on or about February 9, 2024.
  
              Rawlings takes seriously any issues related to its services. We certainly regret any inconvenience that this process may have caused the Complainant. Please do not hesitate to let us know if additional information is needed. Thank you. 

  Customer response

  02/16/2024

  
  Complaint: ********
  
  I am rejecting this response because: they have not sent a check on or around February 9th. This is a lie. I have not received anything. They have given me no proof of this and I have not received anything. They are operating in bad faith and purposefully trying to withhold money from people. I am not the only person they have done this to. 
  
  Sincerely,
  
  **** **********

  

  Business response

  02/23/2024

  Rawlings' records reflect that the check mailed to the Complainant on or about Feb. 9, 2024 was endorsed and negotiated on 2/20/24. We believe that this concludes the matter. 

• Initial Complaint

  01/29/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  To whom it may concern, it was brought to my attention from the law office of ******* ** ***** (who are representing me ****** *** ******* ********* that The Rawlings Company is seeking loss in the amount of $3398.45 case # ********* *in reference to their client ****** With all due respect, The Rawlings Company should be directing their subrogation claim with the ******* ********* Due to the ******* ******** negligence, they should be held liable as the responsible party. They are at fault. In addition, due to their negligence I was severely injured and suffered catastrophic physical damage to my body. Moreover, my ***** insurance is through my employer. I pay $224.00 per month for a family plan and I’m single. In addition, in my 13years with ****** this is the first time I have ever use my insurance to this extent. The Rawlings Company put a lien on my case to recover the amount mentioned above. After much research and speaking with many of my coworkers that have been injured on and off the job, I have found that this company only pursues individuals on a personal level (meaning one who hires a lawyer and sues that insurance company for negligence). Once settlement is given on behalf of the injured, Rawlings scouts out and seek reimbursement for the medical bills for ****** I’m baffled because I pay a premium as and so does ******* ***** is a billion-dollar company. It is sad when they feel that they have the right to bully and manipulate poor people. I am requesting that the lien be dropped. *** ****** who is handling the case for The Rawlings Company claims he cannot honor the request because this is a “ERISA self-funded health plan”. Per *** this information is not correct. Thank you for your time and consideration. Sincerely, **** ** ******

  

  Business response

  02/05/2024

  The Rawlings Company LLC (“Rawlings”) provides claim recovery services to health insurance companies and health plans throughout the country. Rawlings seeks to recover on behalf of the health plan payments made by it for medical claims which should have been paid by other parties, such as in the case of an accident caused by a third party. These recoveries are made based on the legal concepts of subrogation and reimbursement.
  
              Rawlings represents Complainant’s health plan. The health plan in this case paid medical expenses incurred by the Complainant that may have resulted, in whole or in part, from such an accident. The Complainant is represented by legal counsel with whom Rawlings has been working.
  
              The Complainant disputes that his health plan is an ERISA-qualified, self-funded plan. Rawlings has provided to the Complainant’s counsel information from the group attesting to the legal status of the health plan.
  
              The language of the health plan document specifically states that rights of subrogation and reimbursement exist in favor of the health plan. Additionally, the health plan language specifically provides that the plan automatically has a lien to the extent of benefits paid on any settlement or judgment the Complainant may obtain.
  
              As the Complainant is represented by legal counsel, Rawlings will continue to work with his attorney to reach resolution of the health plan’s claims.
  
  Rawlings takes seriously any issues related to its services. We certainly regret any inconvenience that this process may have caused the Complainant. Please do not hesitate to let us know if additional information is needed. Thank you. 

• Initial Complaint

  01/25/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I received a letter from Rawlings Financial Services claiming that I owe over $9,500 to ********* for prescription drug benefits. There was no member number, group number or anything else associated. I spent 3 hours on the phone with ********* and they have no record or my owing any money for services i recieved while being covered under their plan. This is ridicoulous and this needs to stop. I am currently serving overseas and wasted a bunch of time. Clearly this is a scam and shouldn't be allowed to happen.

  

  Business response

  02/02/2024

  Please see attached letter.

  Customer response

  02/04/2024

  
  Complaint: ********
  
  I am rejecting this response because I had received any other letter from Rawlings or *********, more over, ********* ***** does not have any record of my owing any money for any prescriptions at all.  I spent over 3 hours on the phone with the final resolution that I owe nothing, therefor there is no need for Rawlings to contact me for anything regarding past prescription or medical claims
  Sincerely,
  
  *********** *******

• Initial Complaint

  01/02/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This scammy company is trying to collect a "debt" of $1,792.20 that does not exist. They are claiming ***** paid for prescription drug benefits during March 2023 and they are claiming I was "not covered" during that time, therefore I must pay that money back. I was in fact covered, and my monthly premium was paid in full - I called ***** ******* from Rawlings Financial Services LLC on November 19th and explained to her that they had erroneous information because I was covered during that month and in fact all claims appears to be approved and processed on my ***** Portal. A little more than a month later after our conversation, on December 29th, I received another letter from them continuing to attempt to collect the "debt", I gave ***** a call back and she did not answer the phone. My reference number is #********* Please stop collecting "debt" that does not exist and verify information before you buy any "debt" that you want to collect on behalf of a health insurance company.

  

  Business response

  01/08/2024

  Please see the attached letter in response to this Complaint, and let us know if you should need any additional information. 

  Customer response

  01/08/2024

  
  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,
  
  ***** ********

  ***If you are interested in supporting the BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent via Venmo to @bbbcefky or mail your donation to BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

• Initial Complaint

  11/06/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Received a collection letter from Rawlings financial services saying they are collecting for prescription I owe to blue cross blue shield of Georgia. I checked with the pharmacy and they don’t show any of these prescriptions. I haven’t had this insurance for 2 years and now they are saying I owe for prescriptions. Reference number is ********

  

  Business response

  11/09/2023

  Attached is the response of Rawlings Financial Services to Complaint # ********. Please let us know if you should need any additional information. 

• Initial Complaint

  10/23/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I received a letter (reference number ******** stating that in owe $389.71 to Anthem Blue Cross Blue Shield, my old insurance through my employer for prescription benefits. I signed into my old insurance portal, checked my records and I do not have any outstanding debt or any record of any money owed. All prescriptions were approved and covered at time of service by the insurance company. This seems to be a scam, as it lists no group or member number, or specifics about any prescription I’ve had. I never received any letter, Explanation of Benefits follow-up or bill from Anthem BCBS in regards to this matter, just this threatening letter from Rawlings. I would like a confirmation that I do not, in fact, owe any money.

  

  Business response

  11/01/2023

  Attached please find the response of The Rawlings Group to Complaint #********. Please let us know if you should need any additional information.

• Initial Complaint

  10/09/2023

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  ******** financial services is a scam trying to collect money on prescriptions that I never filed. I have never used BCBS & do not carry any outstanding debts for medical bills or prescriptions. I want this company to cease & desist all letters to me. This is a fraudulent scam that needs to be addressed!

  

  Business response

  10/19/2023

  Attached you will find ********' response to Complaint #********. Please let us know if you are in need of any additional information. Thank you.

• Initial Complaint

  08/28/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Rawlings financial services is a scam trying to collect money on prescriptions that I never filled. I went on to BCBS website & do not see any outstanding debts for medical bills or prescriptions. I want this company to cease & desist all letters to me. This is a fraudulent scam that needs to be addressed!

  

  Business response

  09/07/2023

  Attached please find the Response of The Rawlings Group  to Complaint No. ********. Thank you. 

   

  ******** ** ***** 

  *****************************   

  Customer response

  09/07/2023

  
  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.
  
  Sincerely,
  
  ***** ******

  
  

  ***If you are happy with BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other free services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent to: BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

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