Business ProfileforEssence Healthcare

Sales rep ******** lies to potential customers during enrollment call.I got a post card from ******* during enrollment period in 2023.The two main things I asked about with the sales rep ******* Is my current medical PCP provider included in network.2) Is my current dentist covered in network.I spoke with "****". He initially could not find my doctor or dentist on the provider list. After a bit, he said he did find them on the "Hidden" lists.I opened a complaint with Essence Health care. Got transferred around a lot until I was able to speak to someone that appeared to be competent.I jotted down notes of my conversation on the Enrollment solicitation mailer.After I got my plan documents, I was not able to find either of my providers on it, I also looked on the website, not there either.I Spoke to a rep, and finally got in touch with a compliance officer. After several phone calls and almost 5 months later, I got the final investigation letter from ***** at *******. It states: "We reviewed your complaint. After further review, the producer your specific dental provider was not discussed in the enrollment phone call."This is an ******** lie. I remember giving **** the name and address of the providers, he looked them up on the web and found them and confirmed they were covered.The letter from Essense does not say how they determined "the producer your specific dental provider was not discussed in the enrollment phone call" Was it from talking with the Producer, or a voice recording of the call???I know the importance of having a plan with providers I have been working with for years and would NOT enroll in a plan if they were not covered.ON 4/26/2024, I was mailed a listing of providers, NONE are in the small city where I live and would require a considerable drive to and from the closest provider. You can bet I will be switching ******** Advantage plans when Open Enrollment comes around later this year.

Essence Healthcare is committed to delivering high-quality care and customer service to our members, and we take concerns from our members seriously. As such, we conduct internal investigations when we receive complaints and grievances such as this. However, to prevent the release of protected health information (PHI), the Plan is unable to disclose the details of ongoing communications with the member, but encourages the member to continue communications with the Plan if they feel that the resolution is not satisfactory.