ComplaintsforMVP Health Care

• Initial Complaint

  05/29/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I need my ****** which is medicine for blood clots which almost killed me a couple years ago. I am allergic to ******* and ******* so I need ****** or generic insurance does not want to give that to me cause they need prior authorization which doctor gave them the authorization and they needed to also know that I am allergic to anything else and he told them just as they requested. Meanwhile this is going two weeks on phone with doctors and insurance and drug store everyday I am out of medicine now and I don’t know what I do now I want everyone to know this company is a rip off. If I don’t get my medicine I will wind up at Westchester hospital again. Please help me. Thank you

  Business response

  06/05/2024

  Good Morning Better Business Bureau, In order to review the submitted complaint, please confirm the MVP Member's Identification Number and Date of Birth.  Sincerely, Lisa M****** Associate, Senior Complaints Coordinator MVP Health Care   

• Initial Complaint

  04/17/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I am writing to file a complaint against MVP Health Care regarding their denial of coverage for my psychotherapy sessions with Headway. I have been attending these sessions for the past two months, and I recently discovered that my insurance plan with MVP Health Care does not cover services provided by Headway due to its out-of-network status. As a policyholder, I believe that MVP Health Care's denial of coverage for my psychotherapy sessions violates federal laws, including the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA). These laws require insurance plans to provide equal coverage for mental health services compared to medical and surgical services. If my plan covers out-of-network services for medical care, it must also cover out-of-network services for mental health care in a comparable manner. Furthermore, I was not adequately informed about the out-of-network status of Headway before initiating my sessions. The lack of transparency regarding network coverage has led to confusion and frustration on my part. I have attempted to resolve this matter directly with MVP Health Care, but my efforts have been unsuccessful. Therefore, I am seeking assistance from the Better Business Bureau to address this issue and ensure that I receive the coverage to which I am entitled under my insurance plan. I respectfully request that the Better Business Bureau investigate this complaint and facilitate a resolution between myself and MVP Health Care. I am committed to continuing my treatment and am hopeful that this matter can be resolved promptly and fairly. Thank you for your attention to this complaint. I look forward to your assistance in resolving this matter.

  Business response

  04/29/2024

  Dear Better Business Bureau,  MVP's Appeals Department has reviewed the member's concerns, and this issue has been resolved. Both the provider and member have been contacted directly with the resolution to the member's appeal. Sincerely, Lisa M****** MVP Health Care

  Customer response

  04/29/2024

  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.---Dear Better Business Bureau, I appreciate your assistance in addressing my concerns with MVP Healthcare. However, I must express my dismay as the statement provided by Lisa M****** is inaccurate. To my knowledge, no appeal has taken place, and the assertions made are misleading. I urge the BBB to investigate this matter further, as MVP Healthcare's actions appear to be in bad faith. Thank you for your attention to this matter. Sincerely,  ***** ***** 

  Business response

  05/06/2024

  Dear Better Business Bureau,  MVP received an appeal from the member on March 15, 2024. The Appeal Acknowledgement letter was mailed on March 29, 2024, and the Appeal Determination letter was mailed on April 19, 2024. The letters were mailed to both the member and provider. Additionally, MVP's Senior Appeals Coordinator, contacted the member on April 16, 2024 and April 17, 2024 but were unsuccessful reaching the member and voicemail messages were left.  MVP's Senior Appeals Coordinator did speak with the provider's office on April 24, 2024, and they communicated that they would speak with the member directly regarding any billing concerns.  Sincerely, Lisa M******Associate, Senior Complaints Coordinator MVP Health Plan, Inc.

  Customer response

  05/07/2024

  Dear Better Business Bureau, I am writing to express my serious concerns regarding MVP Healthcare's handling of my mental health services claim. Despite their assertion that an appeal was received and determined, I have not received any correspondence regarding such an appeal or its determination. This lack of communication raises doubts about the transparency and fairness of MVP Healthcare's processes. Furthermore, I believe MVP Healthcare's actions may constitute bad faith in accordance with insurance regulations. By denying or failing to properly investigate my claim for mental health services, they may be in violation of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA). Both of these laws mandate that insurance plans provide coverage for mental health services at parity with medical benefits. MVP Healthcare's failure to acknowledge the equal importance of mental health services compared to medical services is not only unjust but also potentially harmful to policyholders. Denying or delaying coverage for mental health services can have serious consequences for individuals in need of such care. I urge the Better Business Bureau to investigate this matter thoroughly and ensure that MVP Healthcare complies with all relevant laws and regulations. It is imperative that insurance companies uphold their obligations to act fairly and honestly towards their policyholders, especially when it comes to accessing essential health services. Thank you for your attention to this matter. Sincerely, ***** ***** 

  Business response

  05/09/2024

  Dear Better Business Bureau, MVP's Professional Relations Department is working with the provider directly as this issue relates to the manner in which the provider is submitting their claims. The provider is aware of the billing error has agreed to resubmit the denied claims to MVP for further review. If the member has further questions regarding this issue, please have them contact MVP's Customer Care Center at *************** Sincerely,   Lisa M******Associate, Senior Complaints Coordinator MVP Health Plan, Inc.

  Customer response

  05/10/2024

  Dear Better Business Bureau, I appreciate the response from MVP Healthcare's Professional Relations Department. However, I must emphasize that the issue at hand extends beyond billing errors. My concern revolves around MVP Healthcare's failure to recognize the importance of mental health services and their potential violation of laws such as the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA). While addressing billing errors is important, it does not address the broader issue of ensuring equal access to mental health services for policyholders. I urge MVP Healthcare to take proactive steps to rectify this situation and to prioritize compliance with all relevant laws and regulations. Sincerely, ***** *****

• Initial Complaint

  04/04/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  The issue involves how MVP of Schenectady NY is billing me for physical/occupational therapy services received at ******* ******** ******* ****** ****** during the period from 12/12/23-3/14/24. MYP is billing me for occupational therapy (applied towards deductible), as opposed to physical therapy ($40 x specialist visit), resulting in a difference of me being billed for approximately $800 more than I would have if these visits were considered "specialist" visits. I have received physical therapy on a number of different occasions at other venues, and they've always been billed through MYP (subscribing to the same policy) as specialist visits, so why is this different? I even got the billing codes from my current therapist @ **** to compare them with the codes for services I've received in the past, and they are exactly the same for the same procedures and codes!:  evaluation *****, ultrasound *****, manual therapy *****, exercises *****. The only difference is that MYP is considering the services delivered @ **** as "occupational" as opposed to "physical" therapy. I have attempted to resolve this issue with both the insurance company and the hospital, and both entities just keep insinuating that it's the problem of the other business, resulting in me getting bounced between the two. MVP says all **** needs to do is label their services as "physical" instead of "occupational" therapy, while **** insists the problem lies with MVP for creating the billing distinction between physical and occupational therapy. I have spoken with ****** financial counseling office on at least two occasions, as well with as my therapist @ ****, ***** ***** and her immediate supervisor **** *****. I have called MVP on 2/1/24, 2/7/24, 2/11/24, 3/12/24, and have received 1 ambiguously worded encrypted email from MVP representative Angel P******. I have paid $400 to **** to date, at the rate of the $40x visit I think I should be billed for the 10 therapy sessions I received.

  Business response

  04/16/2024

  MVP's Claims Department has thoroughly researched the member's concerns. MVP has contacted the member directly with the findings to this issue. Sincerely, Lisa M****** Associate, Senior Complaints Coordinator  MVP Health Plan, Inc.  

• Initial Complaint

  04/03/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unresolved

  More info

  I received an email from MVP saying that a credit card I have on file for payment is about to expire. I have used this credit card before for one time payments but this is not the credit card I use for auto pay. What’s worse is the card isin’t even on the account anywhere for me to remove so MVP is illegally storing peoples credit card information without consent. I contacted the company and spoke to a rude rep who told me she would forward to billing and someone would get back to me. No one has gotten back to me. I have since reported that card as stolen since I have absolutely no idea what they are doing with my credit card information or where it’s being stored

  Business response

  04/16/2024

  MVP's Premium Billing & Collections Department has thoroughly researched the member's concerns and will contact our member directly to provide the resolution to this issue.Sincerely,Lisa M******Associate, Senior Complaints CoordinatorMVP Health Plan, Inc.

  Customer response

  04/19/2024

  Better Business Bureau: I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below. No one from company has reached out to me . I still have no answers as to why my credit card info was being stored Regards, ****** ************

• Initial Complaint

  12/18/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I am trying to get a medication I have not tried called ******** for severe clinical depression. I have tried the others MVP has suggested and none of them help. I and my doctor have been trying to get this authorized since September, 2022. We have done everything asked of us to no avail. MVP refused to let me speak to the person/department that makes the decision. I am in desperate need of this medication.

  Business response

  12/28/2022

  Ms. *******'s request for a formulary exception for ******** was denied. All documentation submitted has been reviewed by an MVP Medical Director. The request does not meet regulations for a Formulary Exception under section 40.5 of the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance. 

  Thank you,

  Lisa M******

  Associate, Senior Complaints Coordinator

  MVP Health Plan, Inc.
  

• Initial Complaint

  02/20/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I signed up for the dental rider coverage for 2021. I did not want to carry it for 2022. I called them to cancel it for 2022 in December of 2021 when I got a bill for the new year. They told me I needed to cancel it in writing because they needed my signature. I could e-mail my statement or mail it. The most simple way for me to do that was to write it on the invoice to be sure it was cancel for the right person and mail it. I wrote that I did not want to renew the coverage and signed it. I got a letter from them dated Feb. 7 stating that if I didn't pay the current amount owed by April 30 they would be covered by Original Medicare instead of the ********** that I was getting. I called them, not understanding the letter and they told me that I owed for the dental coverage which I cancelled. They insisted that I need to cancel it on a plain sheet of paper, not the bill. They said I still owed them for the months of Jan. & Feb. and they would not cancel those charges even though I did not use the policy. I just received another bill. MVP also charged me for two $100.00 deductable charges on the dental cover for that year.. I had called about it and they so caringly said they would take care of it and send me a confirmation. Instead they sent me a letter saying they would not cover a $100. charge for a comprehensive exam totally disregarding their charging me double for the deductable of $100.00. I am still trying to resolve that issue here in mid February of 2022.

  Business response

  03/12/2022

  Good Morning,

  MVP has researched the member's concerns. The member contacted MVP on December 28, 2021 and was advised to e-mail the request to the MVP representative directly. It was explained that the request must be dated and signed, and once received the representative would forward to Medicare Enrollment. MVP does not have a record of receiving the e-mail. The member contacted MVP on February 18, 2022 and it was determined that she had submitted the disenrollment request on her December 2021 premium invoice, which is mailed to a lock box. The member was explained the correct disenrollment process, and that a written request must be sent to MVP Health Care Medicare Enrollment at 220 Alexander St. in Rochester, NY 14607. 

  If the member has further questions regarding this issue, please have her contact MVP's Medicare Customer Care Center at ###-###-####.

  Sincerely,

  Lisa M******

  Associate, Senior Complaints & Fair Hearing Coordinator

  MVP Health Care 

  
  

• Initial Complaint

  01/14/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I was a MVP Advantage Plan customer since I turned 65 and became eligible for Medicare, but switched on October 31, 21 to a Medicare Plan F and a Drug Prescription Plan with *****, as the open enrollment period was in place. The new plans started on Nov 1, 2021. I called MVP to cancel the plan. They would not want to hear it and told me that I have to pay until Dec 2021. I send in a letter of cancellation. As the requests came for more payments even as I already used the services of ****** **********, MVP still wanted to collect the Dec payments. The automatic Nov payment had already been collected. I told them that instead of owing them, they should be refunding my Nov payment. I send in several more letters of cancellation. Now, I am threatened by MVP with a collection agency. This is outrageous. Are they defrauding more older customers that want to get out of the Advantage Plans into a more substantial Medicare Plan? I need your help to stop them. What they are doing is not correct. Another thing was they "re-enrolled" me against my will with them and sent more invoices. I called Medicare and UHC, and they assured me that MVP has no right to re-enroll people. thank you so much, ***** *****

  Business response

  03/12/2022

  Good Morning,MVP has thoroughly researched the member's concerns. MVP's records do not indicate that the member had a Special Election Period that would have allowed her to be disenrolled from her MVP plan as of November 1, 2021.If the member has any questions regarding this issue, please have her contact MVP's Medicare Customer Care Center at ###-###-####.Sincerely,Lisa M****** Associate, Senior Complaints & Fair Hearing Coordinator MVP Health Care   

  Customer response

  03/14/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that I cannot fight this company. They always win no matter what. If you do not pay they will ruin your credit rating. Of course, everybody has the right to cancel any contract at any time one wants, especially if it is done during the "Special Enrollment Period." MVP is engaged in a despicable business practice, which makes me wonder how many people are forced to pay until they "accept" that one cancels. Disgusting!
  
  Regards,
  
  ***** *****
  
  
  
  
  

*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. ↩