ComplaintsforFidelis Care

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Complaint Details

Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.

Initial Complaint
05/24/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I underpaid Fidelis for my coverage on February 28 therefore my Plan was terminated. I have been requesting to be refunded since March. I have yet to be refunded $500. I have made multiple requests.
Business response
06/05/2024
**** ** **** ****** ******** ****** ****************************** ******************
Review ID: ********
To Whom It May Concern:
Fidelis is in receipt of your letter dated May 24, 2024 regarding a complaint filed by consumer ***************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan has addressed the concerns directly with the complainant.
Initial Complaint
03/18/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Invoice is overcharging me. Please fix the invoice to reflect the $1,274.48 that I should be charged. ** State of Health backdate canceled my wifes plan effective 12/1/23 since I never recieved an invoice or health care for my wife in December and she couldn't see a Doctor. I recieved an email if this extra ammount wasn't paid we would loose health coverage. That is not operating in good faith. Please work it out with ** State of Health since I have already been on a 3 way call with Fidelis Care and ** State of Health and ** State of Health said everything is done on their end and Fidelis Care needs to update the invoice now.
Business response
04/01/2024
***** ** **** ****** ******** ****** ******************************************************************************
Review ID: ********
To Whom It May Concern:
Fidelis is in receipt of your letter dated March 18, 2024 regarding a complaint filed by consumer *******************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Initial Complaint
03/05/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
My fiance enrolled her twin 8 year old daughters in Fidelis. Due to a change her in tax credit status, their coverage was canceled. Although the agreement stated that this could occur (in very fine print), no one from Fidelis notified her about the termination in coverage. She must now pay out of pocket for their annual physicals and has no coverage for her daughters for the month of March. She paid two months in advance and Fidelis kept the money without any warning of termination of coverage.
Business response
03/18/2024
To Whom It May Concern:
Fidelis is in receipt of your letter dated March 5, 2024 regarding a complaint filed by consumer *****************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Customer response
03/19/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

We were contacted by a representative from Fidelis. She stated that they need to do a thorough investigation but that she could not even promise we would get a call back regarding their decision. Fidelis has already begun deducting money that my fiance already paid toward future premiums without any acknowledgement of their actions.

Sincerely,

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

Business response
04/01/2024
Fidelis is in receipt of your letter dated March 20, 2024 regarding a complaint filed by consumer *****************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Customer response
04/01/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

I understand that Fidelis cannot release protected health information and must conduct communication directly with me. However, the issue of the complaint has not been resolved to my satisfaction. Until there is a resolution, I will not remove the complaint.

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

*****************
Initial Complaint
02/12/2024
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I asked to have Wife added to my health care plan in December. Fidelis care never provided an invoice for my Wifes plan and never provided a card in the Month of December. Now I received an invoice for March for $2,402.26. My invoice should only be $1274.48 They are trying to charge me for December in March meanwhile my wife could never see a doctor in December since they refused to send me an invoice for her in December and never sent a Health Care Card even after I called 6 times requesting these things. I paid my individual plan in December and they are even trying to double bill me for that as well in this new invoice as if I didn't pay for my individual plan. Please have them update the invoice to $1274.48 for the Month of March. Thank you
Business response
02/26/2024
Fidelis is in receipt of your letter dated January 25, 2024 regarding a complaint filed by consumer *******************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Initial Complaint
01/25/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
It's impossible to speak with a human being from this company excluding their call center in *****. Called over five times, hung up on every time they tried to transfer to the retention department. I was already having a bad time for years with this outfit. At this point, I will most likely be ending business with Fidelis after many years given this latest encounter, but I would still appreciate it if I could provide feedback about my experience here to a representative.
Business response
02/08/2024
Fidelis is in receipt of your letter dated January 25, **** regarding a complaint filed by consumer ***********************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Customer response
02/23/2024
Better Business Bureau:

Just going to switch insurance companies at this point, nothing seems to be working out here. You can close this complaint.

Sincerely,

***********************
Initial Complaint
01/24/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have been trying since late December to get my online Health Portal and my dependent children linked to my account to pay the premium and see records of charges and coverage. I had a case # ******** opened to fix but after over 7 calls to have rectified they have removed it and now left me with NO access at all to SHUT OFF AUTO PAY to my bank and can't register again since it says "my old account names exist". I see another person has complained about this issue recently. I called again **** and waited over 25 mins for a supervisor and then was put to voicemail with no call backs. Every answer is "wait a day and it will all clear up" Each day more access is damaged and removed. My # with them is *********, I am a retired *** data specialist and I believe they have a data breach and are covering up locked access to records. I need a call from a supervisor to fix it, say it can't be fixed, to offer compensation since I can't change plans now under the *** of Health election windows. Next step is NYS AG Office for a fraud complaint. Thank you!
Business response
02/07/2024
Fidelis is in receipt of your letter dated January 24, **** regarding a complaint filed by consumer ****************************** Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Initial Complaint
01/19/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
My account is currently in a grace ****** because the payments that I made over the year were not correctly applied to my account. The ********************** online transaction history which I am attaching shows that I am paid through Feb ****. Since Jan 10, **** I have been unsuccessful in getting this resolved and therefore my prescriptions are being charged at full price.Payments not correctly applied:Date transaction ID Amount ----------------------------------------------------------Jan 4, 2023 ******** $688.82 Jan 9, 2023 ******** $688.82 Jan 18, 2023 ******** $570.69 Jun 7, 2023 ******** $570.69 Jun 7, 2023 ******** $570.69
Business response
02/05/2024
Fidelis is in receipt of your letter dated January 19, **** regarding a complaint filed by consumer ******************** Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Customer response
02/14/2024
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 and the matter has been resolved.

Sincerely,

*******************
Initial Complaint
01/08/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Hello, I'm writing about a predatory policy of entrapment I've experienced with Fidelis Care. From 2023 to ****, My Fidelis Care insurance went up from $148/mth to $221. This nearly 50% increase happened without my foreknowledge and no word from Fidelis Care. I believe this to be a predatory instance of entrapment given the amount of the increase as well as the timing of the increase. Given that enrollment for insurance happens in Oct/Nov, by January a customer (myself) is finally visiting doctors and settled into the plan. It's a lot of work to find doctors that will take the insurance and shopping around for plans is made even more challenging for anyone on a budge (me, and hundreds of thousands of others). If this is due to the merger with ambetter, a merger that likely took over 2 years to happen as these are two large companies, they could have given us a heads up in September so that we could consider other options. Rather than let us know ahead of time, they let us know overnight, and just 2 months after new members have enrolled. This is unethical and I'm writing because I believe I should not have to pay more until the end of this years contract -- the normal time that people re-enroll in healthcare. Thank you for considering, *****************************
Business response
01/22/2024
To Whom It May Concern:
Fidelis is in receipt of your letter dated January 8, **** regarding a complaint filed by consumer *****************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Initial Complaint
12/27/2023
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Hi,For whatever reason, I can no longer make online payments on my account. I've been in contact with IT for weeks now (8 weeks to be exact)...The latest case number is *********. The error message is attached here and says "Member Account ID is mapped to a different user". IT deleted the profile so many times but is saying that the problem is on the processing provider side and there will never be a fix. How is that a solution? I just want to make online payments, but this won't work for me. I spent hours on the phone with them, and none of their fixes worked. Please advise.
Business response
01/08/2024
Fidelis is in receipt of your letter dated December 27, 2023 regarding a complaint filed by consumer ************************** Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
Customer response
01/11/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

Can I request more time?

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

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

Customer response
01/19/2024
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 and the matter has been resolved.

Sincerely,

*************************
Initial Complaint
12/27/2023
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I would like to file a complaint against Fidelis Care. I received an invoice from ************************** in ************* for the services of ******** 2022 and I contacted ***** from **************************, and she informed me that Fidelis Care and Denta Quest never notified the group that I had an annual dental cap and therefore they billed me $770.00. Every time I call Denta Quest a customer service a Denta Quest worker checked all the claims they said it shows every claim shows Patient Responsibility is $0 and they tell me to reach out to ************************** and They will not return my phone calls. When I file a complaint with Fidelis Care Grievance and Denta Quest Grievance they will me I do owe money to ************* Dental. I went to another ************ last year as well they also were told by Fidelis Care and Denta Quest that I had unlimited Annual Cap. If two ************ offices in town being told that I have no annual dental cap and then I get a bill in the mail Fidelis Care and Denta Quest should be under Investigation. I am not paying $770.00 and Fidelis Care and Denta Quest should pay for it not me. I want Fidelis Care to contact **************************. I had to include this bill in ********************. Please contact ************* Dental **** State ******************************************* *************
Business response
01/09/2024
January 9, 2024
Better Business Bureau
******************************************************************************
Review ID: ********
To Whom It May Concern:
Fidelis is in receipt of your letter dated December 27, 2023 regarding a complaint filed by consumer ***************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.

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