ComplaintsforAmbetter from Silver Summit Healthplan, Inc.
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Complaint Details
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Initial Complaint
05/20/2024
- Complaint Type:
- Billing Issues
- Status:
- Resolved
Surgery Date: March 19, 2024 Ins. Premium: $929.47 per month ; $2800.00 to *************************** ************ (Prostatectomy)Complaint: Sound medical practices. Denial of hospital stay 2 months after procedure. It is under appeal.Business response
08/20/2024
Please acknowledgement letter.Business response
08/21/2024
BusinessMost Recent MessageDate Sent: 8/20/2024 5:12:29 PM
Please acknowledgement letter.Customer response
08/22/2024
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
01/22/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
Subject: Urgent Medication Coverage Appeal Dear Ambetter,I am writing to express my deep concern and frustration regarding the denial of coverage for a crucial medication that is essential to my health and well-being. I have been using this life-saving medication for almost a year, and my doctor had submitted a prior authorization last year in March, outlining the critical reasons for its necessity.Starting the year with Ambetter again, I am alarmed to learn that coverage for my medication has been refused, putting my life at significant risk. I kindly request that Ambetter reconsider and provide coverage for at least the injection I urgently need for this month. My doctor is prepared to initiate the prior authorization process for the upcoming months.Your prompt attention to this matter is crucial in ensuring my continued access to vital medical treatment. I appreciate your understanding and cooperation in resolving this urgent situation.Sincerely,*******************************Business response
02/21/2024
***See attached document***
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Customer Complaints Summary
2 total complaints in the last 3 years.
2 complaints closed in the last 12 months.