ComplaintsforLivanta LLC

• Initial Complaint

  01/11/2024

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  LIVANTA signed off on my case without reviewing the evidence: my medical records, SNF facility records, nurses' notes, pharmacists' notes, and more. They agreed with my HMO's grievance without reviewing any factual evidence. Their employees have not been helpful in my case. I am trying to contact their director, Roger ****** Business Management; however, he won't return my calls. I want him to reopen the case with ****** because it wasn't done correctly. They are a for-profit company paid by ****** to review grievances and handle all appeals.

  Business response

  01/17/2024

  Livanta LLC is not paid by ****** to do anything. Other than that, Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements.

• Initial Complaint

  03/24/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I had filed a complaint against my family care physician, Dr.Michael ********* but recently retracted it. However, this BBB Livanta complaint that I am filing has to be escalated because they obviously filed it against the wrong provider and I don't know how this could have happened except for total incompetency and negligence. Apparently, they have the complaint being filed against MLHC Primary Care in Aston, PA. which is a blatant and unacceptable mistake and it is totally inaccurate and unacceptable . I am going to find out who oversees Livanta and register a formal complaint with that entity as well.

  Business response

  03/29/2023

  Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements.

• Initial Complaint

  03/03/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Livanta 's letter to me dated February 22, 2023 gave me an admission date of May 12, 2022 to May 16, 2022. In the body, it is stated that I told them I was admitted May 21, 2021. Later on the letter states that I was admitted from May 19, 2022 to May 24, 2022. My record indicates that I was admitted on May 19, 2021. I was not seen by a cardiologist in the hospital as stated in this letter. No one can schedule me for any procedure without my permission. I asked the physician assistant if she knew what Tachycardia was and if she knew what "as needed" meant. I did not have a Tachycardia attack--was diagnosed with it July 2019 and went to the cardiologist in October 19. I was dismissed after the second visit with a good report. The 10 milligram request was made by me--not the doctor--because the heart beat was scary. I only filled one 3-month prescription and I still have pills left. I DID NOT HAVE A TACHYCARDIA ATTACK. I called the cardiologist and she related to me that the physician assistant had told her that I had one. She would Never have told her to give me 120 milligram daily, as stated in the letter. That is preposterous. I found out after receiving my medical record that I was given 120 milligrams the night before the bathroom fall. I went into the jaws of death that night. (She said she was going to give me tramadol; my record reflects that is a no.) I have no knowledge of the renal insufficiency mentioned in the letter. No mention is made of the fact, according to my records, that I was overmedicated with anesthesia, injured my right knee with excruciating pain and found to have osteoarthritis in the left knee. I had to request the x-ray--just put me in the bed with no apology. My personal hygiene was neglected for 5 days--a long time to not even get a sponge bath. I was billed for physical and occupational therapy even though I received neither. I NO LONGER TAKE PROPANALOL. Diagnosis printout did not recommend it.

  Business response

  03/09/2023

  Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements.

• Initial Complaint

  01/06/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Livanta have been jerking me around for months now.. I've been trying to submit my horrific expin the ********************************************************** HOSPITAL EMERGENCY ROOM TO THE POINT I HAD TO RUSH MYSELF TO ANOTHER ER from midnight to 6:00am, and LIVANTA KEEPS DOING NOTHING. ON DECEMBER 8TH I CALLED in, nobody took my intake case, gives me this bogus case #NJ11198913RL, then transferred to voice-mail, nobody calls than I call back & give the bogus case number to then be told case closed? Like seriously? How can a case be closed if it was never opened or worked on. Then *************** calls me yesterday at 5pm, she was rude & when I asked "WHAT'S WITH TGE RUDNESS?" she replied "I'm sick. " Well, hello. I'm sick 2 but sweet as sugar. Livanta has lazy people ******* the phones since the pandemic. Period. Thsnks BBB.Livanta Helpline: **************** TTY: **************** Fax: **************

  Business response

  01/13/2023

  As explained in greater detail below, Livanta cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements.
  
  As you *** know, Livanta is a ******** Beneficiary and ***************************************************** ("BFCC-QIO") under contract with the Centers for ******** & Medicaid Services ("CMS"). As a BFCC-QIO, Livanta is contractually and statutorily authorized to engage in health oversight activities. Health oversight activities include overseeing the health care system - in this case, the ******** program. During the course of performing contractual and statutory duties, Livanta obtains and generates two forms of healthcare-related information: (i) QIO Information ("QIO Information" is defined as "any data or information collected, acquired or generated by a QIO in the exercise of its duties and functions under Title XI Part B or Title XVIII of the Act." 42 C.F.R. *******) and (ii) QIO Deliberations/Decisions ("QIO Deliberations" are defined as "discussions or communications within a QIO or between a QIO and a QIO subcontractor including, but not limited to, review notes, minutes of meetings and any other records of discussions and judgments involving review matters regarding QIO review responsibilities and appeals from QIO determinations, in which the opinions of, or judgment about, a particular individual or institution can be discerned." 42 C.F.R. *******.). The disclosure of QIO Information is governed by 42 C.F.R. *******, and the disclosure of QIO Deliberation/Decisions is governed by 42 C.F.R. *******. The disclosure of QIO Information and QIO Deliberations/Decisions by Livanta is highly regulated. Livanta could not identify any statutory or regulatory basis to disclose Livanta's QIO Information or QIO Deliberations/Decisions to the Better Business Bureau (BBB).
  
  In addition, Livanta's QIO Information and QIO Deliberations/Decision contain Protected Health Information ("***"). The **************** Portability and Accountability Act ("HIPAA") Privacy Rule defines a health oversight agency, like Livanta, as an entity authorized by law to oversee a program like ******** in which *** is used to determine eligibility or compliance with program standards (see 45 C.F.R. *******, definition of ************************* Under 42 C.F.R. 164.512(d), a covered entity, like CMS or a provider, *** disclose *** to a healthcare oversight agency, like Livanta, without the patient's permission if the disclosure is for healthcare oversight activities authorized by law, including oversight of compliance with program standards. Livanta, in turn, *** only use or disclose the *** it receives from CMS or a provider for healthcare oversight activities or for treatment, payment, or healthcare operations. 45 C.F.R. *******.
  
  Therefore, because the BBB does not qualify under 42 C.F.R. ******* or 42 C.F.R. *******, Livanta cannot disclose any QIO Information or QIO Deliberations/Decisions.

  Customer response

  01/17/2023

  (The consumer indicated he/she DID NOT accept the response from the business.)
  I want to personally thank BBB for always doing an excellent job getting me connected with those I struggle on my own after numerous attempts.
  
  With that said, a supervisor from Livanta named ********************* has called me dilengently & to avoid approving my medical records at this stage or on this platform being released, that's why I answered "no" of accepting the response from the business.
  
  In conclusion
  Since BBB got the ball rolling connecting me to Livanta, its best closing my case here so I can privavy while settling the matter with Livanta moving forward.
  
  Again, a million thanks to BBB for always guiding me & entrusting me & connecting me by getting hands on.

• Initial Complaint

  01/03/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Case # C-****** October 25, 2022 and November 7, 2022 I was disappointed that Livanta basically "rubberstamped" the misdiagnosis I received at **** which resulted in the removal of both of my ovaries. I believe a timely MRI, which was suggested on two separate occasions, could have prevented this unnecessary surgery which has caused major negative side effects, including hormone imbalance, loss of skin elasticity, irritability, mood swings, depression, insomnia, and substantial hair loss.01/06/2020: My gastroenterologist sent me to **** for a CT scan due to concerns about a non-cancerous submucosal mass at the appendicle o****** The appendix was not clearly identified, so a pelvic MRI was suggested to obtain a better delineation of the 2.4cm right adnexal structure, particularly if there was any suspicion for an appendiceal abnormality. No MRI was ordered.06/01/2021: A second pelvic ultrasound showed the right ovarian cyst was the same size it was 16-months prior, but a solid, liquid-filled component in the right abdomen was more prominent. Again, an MRI was suggested for further evaluation, but no MRI was ordered. An oophorectomy was performed July 9, 2021. 08/09/2021: I was told the simple ovarian cysts were NOT the problem and that the solid, liquid-filled, component that remained was likely a mucocele on my appendix.09/02/2021: An MRI was finally performed and confirmed that the structure in the right abdomen was suspicious for an appendiceal mucocele.03/31/2022: I had to undergo a right hemicolectomy because the mucocele on my appendix had spread to my ascending colon. Livanta did not evaluate what I consider to be a misdiagnosis caused by the omission of an MRI for further clarification. Instead, their independent review (11/25/2022) concluded that double ovary removal was reasonable for a 65-year old woman with a cystic mass of the right ovary. My request for reconsideration (11/07/2022) was a repeat of Livanta's initial evaluation.

  Business response

  01/06/2023

  Livanta LLC ("Livanta") cannot respond to the complaint without potentially disclosing protected health information ("***"). As described below, Livanta must obtain direction from the Centers for ******************* Services ("***") to release *** - the signed Authorization to Release Health Info you sent to Livanta is insufficient.
  
  As a ******** Beneficiary and ***************************************************** ("*****QIO"), Livanta LLC ("Livanta") is statutorily authorized to engage in health oversight activities. Health oversight activities include overseeing the health care system - in this case, the ******** program. The ***** Privacy Rule defines a health oversight agency, like Livanta, as an entity authorized by law to oversee a program like ******** in which *** is used to determine eligibility or compliance with program standards (See 45 CFR *******, definition of ************************* Under 42 CFR 164.512(d), a covered entity, like the Centers for ******************* Services ("***") or a provider, *** disclose *** to a healthcare oversight agency, like Livanta, without the patient's permission if the disclosure is for healthcare oversight activities authorized by law, including oversight of compliance with program standards. Livanta, in turn, *** only use or disclose the *** it receives from *** or a provider for healthcare oversight activities or for treatment, payment, or healthcare operations.
  
  A disclosure of *** to the Better Business Bureau ("BBB") is not part of a *****QIO's health oversight activities under the ******** program. Moreover, a disclosure to BBB of a ******** beneficiary's *** is not part of treatment, payment, or healthcare operations (45 CFR 164.512(a), uses and disclosures for which an authorization or opportunity to agree or object is not required). This can be confirmed by checking ***' privacy notice contained in the ******** & You handbook, which is provided to all ******** beneficiaries. ***' privacy notice limits disclosures to health oversight activities and treatment, payment, or healthcare operations. Therefore, any disclosure of a ******** beneficiary's *** must first be authorized by the ******** beneficiary. Such an authorization must be submitted to the covered entity, ***, not the *****QIO or Livanta. Once a formal authorization is submitted to and approved by ***, *** will make such a disclosure or the *** project officer will direct Livanta to make such a disclosure. However, Livanta cannot disclose *** to the BBB before authorization is submitted to *** by the ******** beneficiary and approved by ***.
  
  *** has outlined the process to allow a ******** beneficiary to authorize the disclosure of *** to a third party like the BBB. A ******** beneficiary *** submit a form to *** that authorizes disclosure of ***. That form can be found at *******************************************************************************.
  
  Therefore, Livanta cannot disclose any *** to the BBB about a ******** beneficiary unless directed by ***. And such direction will need to be based upon a formal authorization submitted by the ******** beneficiary to ***. I hope this adequately explains the restrictions placed upon Livanta and the steps a ******** beneficiary can take to authorize a third party like the BBB to obtain ***.

  Customer response

  01/12/2023

  (The consumer indicated he/she DID NOT accept the response from the business.)
  My complaint against Livanta has not been resolved.
  
  Livanta is contracted to provide an independent review of complaints filed against ******** providers to help improve healthcare outcomes and reduce hospital readmissions.
  
  In my case, Livanta's review of my medical records reads more like a justification for a medical misdiagnosis which led to the unnecessary removal of both of my ovaries, causing a permanent, and extremely negative, impact on my health and lifestyle.
  
  I had to be readmitted for a second surgery to remove the actual medical concern, a mucocele on my appendix, which could have been detected if an MRI had been performed as suggested on two separate occasions.
  
  The suspicion of the mucocele occurred during a routine colonoscopy when my gastroenterologist discovered colonic mucosa at the opening of the appendix. The sample tested negative for cancer, but she was concerned about what was growing there so she sent me to the ****************************** for a CT scan.
  
  The radiologist noted that the appendix wasn't visible during the initial scan and suggested that an MRI be performed if there were any clinical concerns about a mucocele of the appendix. An MRI was not ordered.
  
  The attending physician ultimately concluded that a cystic right ovary was the culprit.
  
  A year later, a second MRI was suggested for further clarification of the right adnexal lesion, but again this diagnostic test was not ordered and surgery for double ovary removal was scheduled.
  
  Post-surgery, a solid mass remained, so an MRI was finally performed and it showed I had a mucocele on my appendix. By this time, the lesion had spread, so I had to undergo a right hemicolectomy to remove my appendix and large section of my ascending colon.
  
  Livanta is supposed to be the advocate for ******** patients. Instead, my medical dispute with **** was rejected and the apparent misdiagnosis was defended because Livanta's medical reviewer concluded that the removal of both ovaries is an acceptable procedure for a woman of 65 when there is a concern about cancer.
  
  I would counter that removing both ovaries is not an acceptable procedure if the surgery is not necessary, which was the physician's initial conclusion when he noted my ovaries were cystic, but small, and likely non-cancerous.
  
  I contend that an MRI should have been ordered after the initial CT scan to obtain a correct diagnosis. At the very least, an MRI should have been ordered prior to any surgical procedures were performed.
  
  See Attachment/File: Colonoscopy Biopsy Report

  Business response

  01/17/2023

  As explained in greater detail below, Livanta cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements.
  
  As you *** know, Livanta is a ******** Beneficiary and ***************************************************** ("BFCC-QIO") under contract with the Centers for ******** & Medicaid Services ("CMS"). As a BFCC-QIO, Livanta is contractually and statutorily authorized to engage in health oversight activities. Health oversight activities include overseeing the health care system - in this case, the ******** program. During the course of performing contractual and statutory duties, Livanta obtains and generates two forms of healthcare-related information: (i) QIO Information ("QIO Information" is defined as "any data or information collected, acquired or generated by a QIO in the exercise of its duties and functions under Title XI Part B or Title XVIII of the Act." 42 C.F.R. *******) and (ii) QIO Deliberations/Decisions ("QIO Deliberations" are defined as "discussions or communications within a QIO or between a QIO and a QIO subcontractor including, but not limited to, review notes, minutes of meetings and any other records of discussions and judgments involving review matters regarding QIO review responsibilities and appeals from QIO determinations, in which the opinions of, or judgment about, a particular individual or institution can be discerned." 42 C.F.R. *******.). The disclosure of QIO Information is governed by 42 C.F.R. *******, and the disclosure of QIO Deliberation/Decisions is governed by 42 C.F.R. *******. The disclosure of QIO Information and QIO Deliberations/Decisions by Livanta is highly regulated. Livanta could not identify any statutory or regulatory basis to disclose Livanta's QIO Information or QIO Deliberations/Decisions to the Better Business Bureau (BBB).
  
  In addition, Livanta's QIO Information and QIO Deliberations/Decision contain Protected Health Information ("***"). The **************** Portability and Accountability Act ("HIPAA") Privacy Rule defines a health oversight agency, like Livanta, as an entity authorized by law to oversee a program like ******** in which *** is used to determine eligibility or compliance with program standards (see 45 C.F.R. *******, definition of ************************* Under 42 C.F.R. 164.512(d), a covered entity, like CMS or a provider, *** disclose *** to a healthcare oversight agency, like Livanta, without the patient's permission if the disclosure is for healthcare oversight activities authorized by law, including oversight of compliance with program standards. Livanta, in turn, *** only use or disclose the *** it receives from CMS or a provider for healthcare oversight activities or for treatment, payment, or healthcare operations. 45 C.F.R. *******.
  
  Therefore, because the BBB does not qualify under 42 C.F.R. ******* or 42 C.F.R. *******, Livanta cannot disclose any QIO Information or QIO Deliberations/Decisions.

• Initial Complaint

  11/13/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Please read my attached document where all will be explained.

  Business response

  12/05/2022

  Business Response /* (1000, 5, 2022/11/16) */ Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements. Consumer Response /* (3000, 7, 2022/11/17) */ (The consumer indicated he/she DID NOT accept the response from the business.) No, I do not accept Livanta's response because it's a cop out, but it's precisely what I expected. Mine was a long surgery, but I've had long surgeries before, and this was the first time I was ever injured, an injury with which I'm still contending, with no end in sight. When I read Livanta's decision letter, it appeared to me they were implying: it was a long surgery--stuff happens! (No, stuff happens when someone in charge doesn't pay attention or is careless!) I'm hoping my complaint will prod Livanta to recalibrate how they treat Medicare patients in the future, and strive to consider and review all reports with which they are presented before rushing through a "review" and sending out what resembles a form letter. It seemed to me they were simply going through the motions. If they are willing to make positive changes, then all this will not be for naught and future Medicare patients who reach out to them for help will benefit.

• Initial Complaint

  11/02/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I cannot share enough how bad the customer service is at Livanta. Over several days, I tried to create a complaint. It seems the agents spend more time trying to keep from actually doing any work and today, I had 3 employees that were sarcastic and rude. The very first agent never gave me a claim number. Each time I have called in, I'm asked for the claim number, and I explain that I was not given one. They then ask for the Medicare number, phone number and name and then say none was ever created in the system. So, I ask what I am supposed to do, since this has gone on for several days, and they say I needed to wait for a response from (XXX) XXX-XXXX ****** Today someone told me the extension was incorrect and it should have been 2452. I asked for a supervisor when an agent was extremely sarcastic, and she transferred me back into the system for another agent. You explain everything to them, and then they ask questions, demonstrating they never listened to anything you said. One agent could not capture a simple phone number without asking for it several times. When I asked for her name, she said it was Azieta. When I repeated it back as it was an unusual name and I wanted to ensure I captured it correctly, she said "that's what I said" as sarcastically as she could. If this was an isolated case, that the competence level was not every call that had issues, I would not be writing to you. But I have spent several hours over days getting nowhere but extremely frustrated. I have written to Mr. ****** and have forwarded the email to you below. How could this be the company the federal government contracted the work for seniors? It is difficult enough as a senior to get help and having a company that seems to ensure every call is so difficult that you give up. Is that the intention of Livanta, to ensure they make it so difficult that you just give up? Is Mr. ****** being held responsible for the lack of staffing and the lack of training?

  Business response

  11/09/2022

  Business Response /* (1000, 5, 2022/11/04) */ Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements. Consumer Response /* (3000, 7, 2022/11/04) */ (The consumer indicated he/she DID NOT accept the response from the business.) Medicare said they are investigating Livanta about this issue, so why cannot Livanta?

• Initial Complaint

  01/08/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Case# INXXXXXXAP ******** J ******* DOB ******** My MIL was supposedly approved for a 20day rehab facility stay (Rosewalk **** N ****** *** ****** IN XXXXX) after a knee replacement surgery done 12/9/2021. On 12/23/2021 Livanta denied her PRIOR to completing her 20 days. At this point my MIL still could not stand on her own, they denied coverage beyond 12/25/2021. Since 12/23/2021 she has received no PT due to denial and prior to was only receiving 15min per Kate the social worker @ Rosewalk this was due to insurance not covering more than 15min. I filed appeal on 1st denial and was not allowed any info/reason for the original denial because Livanta stated they dont provide any information, I was told the only information they could provide was that her vitals were normal. My MIL was not there for unstable vitals or any underlying condition she was there to recover from knee replacement surgery and be able to walk. I did 1st appeal stating both myself and Rosewalk confirm she is not able to ambulate herself. She lives alone. We were denied a second time, again no reason provided other than vitals are normal and pt is able to care for self. Where did this information come from? Dr. D. head over Rosewalk wont release her because she is high risk and unable to ambulate so how did Livantas Dr Steven H. S. determine she was capable to do things on her own if she can't even ambulate on her own? She has been in bed for almost 30 days wearing a diaper 24/7 because she can't get up! Now not even 15min of PT per day because of the Livanta denial. And how can Livanta expect people to appeal when we are given zero information? What was the denial based on? She can not walk or ambulate herself so what false documentation was this denial based on? I have spoke with social worker, Kate, several times and she doesn't know either. My MIL is sitting in a bed 24/7 at Rosewalk, with no PT to help because of this.

  Business response

  01/21/2022

  Business Response /* (1000, 5, 2022/01/12) */ Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements.

• Initial Complaint

  12/20/2021

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  On 12.2.21, I mailed a quality complaint for dates of 10.1.20-10.5.20 to Livanta via federal express. There is an outstanding payment of $1,405 from myself. On 12.16.21, I mailed a second quality complaint to Livanta via federal express for dates of 10.6.21-10.29.21. After several voices messages, I have not been able to receive status of my quality complaints, acknowledgement of receipt of complaints or case numbers for complaints. I would appreciate your assistance to get a response from Lavinta.

  Business response

  02/03/2022

  Business Response /* (1000, 5, 2021/12/21) */ Livanta LLC cannot affirm or deny any matter related to this complaint without potentially violating federal and state law or requirements. Consumer Response /* (2000, 7, 2021/12/26) */ (The consumer indicated he/she ACCEPTED the response from the business.) On 12.24.21, I received an email and I spoke with Mrs. Lamerial D. She explained that they attempted to contact me at a former phone number in Missouri. My current phone number is ************. You may close this complaint.

*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. ↩