Complaints

This profile includes complaints for S & S Healthcare Strategies, LTD's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  S & S Healthcare Strategies, LTD

  1385 Kemper Meadow Drive Cincinnati, OH 45240

• 

  S & S Healthcare Strategies, LTD

  PO Box 46511 Cincinnati, OH 45246

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:11/07/2024

  Type:Billing Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  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.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  S&S Health was our medical insurance company from 2/1/23 thru 1/31/24. I had my annual preventive care physical and lab work ( In Network) on 8/31/23. The original cost was $574.80. Just last week, 14 months after the service was provided, the insursance company paid only $71.00 for the PSA test, nothing else. The provider is now billing us for the balance. S&S has not communicated any reasons. I have called and the only response I get is they are self-insured and they are waiting for payment to be released. My wife has the same situation from her annual preventive care visit in December 2023. We have escalated the issue and asked our agent to do the same. They have either not paid or slow paid every medical billing we had during that year. I personally paid for a $1972.10 CT scan for my heart and over $2000 for an Anesthesiologist billing from a kidney stone procedure during that period. How can they operate an insurance company like this without regulation?

• Initial Complaint

  Date:07/29/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  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.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am writing to uphold promises from my health insurance company, S&S Healthcare to pay my medical bills. This insurance company has processed my claims and deemed that they will pay them, however have yet to do so. My bills have now been sent to collections as S&S Healthcare has not made any payments to my physician’s office. I have 3 outstanding claims. The dates of service for these claims are 10/05/2023, 11/06/2023, and 11/10/2023. The cost of these claims respectively are as follows, $1,240.00, $1,505.00, and $567.00. These bills add up to $3,312.00 of unpaid medical bills that are supposed to be fully covered under the insurance plan that I purchased through S&S Healthcare. I have reached out to S&S Healthcare multiple times via phone and hand written letters. The response I always receive is that they are awaiting funds to pay my bills, and they have no further information at this time. When asked to speak with a supervisor my question is ignored and they always respond with there is nothing else they can do at this time. I fully paid this insurance company each month in order to have these benefits, and they have yet to provide me with any benefits at all. I am asking for the Better Business Bureau to help me hold S&S Healthcare accountable for the benefits that I have paid for through my insurance plan. I have attached my medical bills as well as my insurance plan which is the *** * for review. I hope this is helpful in your investigation.

  Business Response

  Date: 07/30/2024

  Thank you for notifying us of the complaint. S&S HealthCare Strategies ("S&S Health") provides claim processing services to the health benefit plan under which the complainant was covered; S&S Health is not an insurance company. The benefit plan was established and is sponsored by ******** **** ******** ** as a single employer, self-insured health plan. We sincerely regret the difficulty the plan member has faced due to the non-payment of benefits. We are working diligently with the plan to get the claims processed and remit payment as soon as possible. We expect to be able to do so within 45 days.

  Customer Answer

  Date: 08/02/2024

  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, reasons for rejection are included below.

  S&S Health has processed my claims and have stated that they will pay my medical bills in full as per my plan. S&S health is the contact I have on my insurance card in order to follow up on claims, payments, and benefits. I am no longer using S&S health for insurance and they no longer allow me access to my account to assess the status of my claims. They have also never once reached out to me on the status of my claims despite having my phone number, email, and mailing address as well as saying they would do so to update me. Each time I speak with representatives from S&S health they state they will have my payments made within 30 business days which has been an outright lie. It has been 10 months since my claims have been made and processed. S&S Health has reported that they received each of my claims 2 days after my visits to my physician's office. This has allowed them 10 months to "find" the funds to pay for my medical bills. I could have already paid for my medical bills with the money that I spent on my insurance plan. It is inexcusable that my claims have yet to be paid at this time. I fully reject the response from S&S health and I will not be satisfied until my claims and bills are paid in full as promised.
  
  Regards,
  
  ********* *******
  

• Initial Complaint

  Date:04/18/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  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.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I had to go to the Emergency room in ****** ********* on 9/23/2024 due to experiencing a possible stroke. Since then I have been continuing to receive bills from the ER in excess of $3,700. We have made 5 phone calls to S&S health for status on check being sent to the provider. Each time I have been told it is in process and could take 30 days. Fortunately for me i was able to get an extension early on. However, as of 4/16/24 I started a payment plan to begin 5/1 to avoid collections. This type of service is inexcusable and should be against the law. Important to note that the claim was not denied.

  Business Response

  Date: 04/22/2024

  April 22, 2024 
  
  
  ***** ********
  Cincinnati Better Business Bureau
  1 E 4th Street, Suite 600
  Cincinnati, OH 45202
  
  Re: ID ********
  
  *** ********,
  
  Thank you for notifying us of the complaint received regarding billing for a healthcare claim. S&S HealthCare
  Strategies, Ltd. (“S&S Health”) is a third-party administrator that processes claims submitted to group health
  plans, including the plan under which the complainant is covered. That plan is a self-insured plan sponsored
  by ******** **** ******** **. Under a self-insured arrangement, the plan sponsor is responsible for
  payment of the claims.
  
  Based on the information provided, we believe the claims to which the complainant refers are the following.
  These are the only claims in our system for the date of service.
  
  Claim Provider Date of Service Billed Amount Claim Status
  Number
  ******** ****** 09/23/2023 $5,034.00 The claim has been processed but
  Health payment has not yet been authorized
  by the plan sponsor.
  ******** *********** 09/23/2023 $196.00 The claim has been processed but
  Radiology payment has not yet been authorized
  by the plan sponsor.
  ******** ************ 09/23/2023 $922.00 The claim has been processed but
  Emergency payment has not yet been authorized
  Medical by the plan sponsor.
  ******** ****** 09/23/2023 $341.00 The claim has been processed but
  Health payment has not yet been authorized
  Urgent Care by the plan sponsor.
  
  We will release payment for the claims as soon as we receive the funds from the plan sponsor. We regret the
  difficulty the complainant has experienced as a result of the delay. Please let me know if you have any
  questions.
  
  Sincerely,
  Melissa C**
  

  
  

  Customer Answer

  Date: 04/22/2024

  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, reasons for rejection are included below.
  
  Regards,
  
  ***** *****
  

  Customer Answer

  Date: 05/01/2024

  I had to start a payment plan with the medical provider due to delay of payment from S and S health.  This is putting a financial strain on my family.  They have been saying the claim is processed and payment is in process since last September.   This amount of time is unacceptable.   

  Business Response

  Date: 05/06/2024

  Apologies, but we did not see any additional information to which we are to respond. We certainly sympathize with the member's situation. As explained in our initial response, S&S Health processes claims on behalf of its clients but does not provide the funds for payment and cannot control that payment. When we receive funds from the employer/plan sponsor, we release payment but are unable provide any better information to the member.

  Customer Answer

  Date: 05/06/2024

  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, reasons for rejection are included below.
  
  Regards,
  
  ***** *****
  

  Customer Answer

  Date: 05/06/2024

  I am not satisfied that the repayment takes close to a year and was paying for insurance to handle expenses in a timely matter.  They should also be able to communicate with the financial institution responsible for sending the check to the health provider.  

  Business Response

  Date: 05/16/2024

  Thank you for your message and we do sympathize with and regret the difficulties you have encountered. As previously explained, your plan is a self-funded plan and we can take no action without authorization from the plan sponsor. We will notify the plan sponsor of the situation.

• Initial Complaint

  Date:04/07/2023

  Type:Billing Issues
  Status:

  UnresolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  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.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My medical insurance company is delaying payment to the medical provider for my husband's colonoscopy from 8 months ago. This is the third such issue we have had with them not paying a medical provider for a covered service. I have documented over a dozen phone calls to the insurance company regarding this bill, with no resolution. The date of service was 8/16/22. The medical provider told me they submitted the first claim to S & S Health on 9/26/22. By January, S & S Health was claiming they did not receive anything from the medical provider. At that point I asked the billing department at **** ******* ********** ********** (med. provider) to resubmit the claim. They did so on 1/9/23. S & S Health acknowledged receiving the bill on 1/17/23. Meanwhile, every month I receive another bill from ****. On 3/13/23 Kate from S & S told me that the claim had been "processed but not released," stating that the approved amount was $1170 (bill is $1440). I asked her what it means to be "processed but not released," and how to get from "processed" to "released." She said "The funding may not be there." (!!) I have never received an EOB (although I was told on 2/3/23 that it could take up to 14 days). I spoke to a supervisor, Judy, on 3/24/23, who told me that this is in the "final stages of completion," and to allow two more weeks. I said I would be calling on 4/7/23 to find out if the payment has gone out, or I would be submitting a BBB complaint. I called today, 4/7/23 and spoke to another supervisor, Christine, who told me it is in the "voucher status," which she explained meant that they are waiting for the check to be printed. Some of the tactics they have used with me on this issue have been: (1) putting me on hold for approx. an hour every time, even though I am "next in queue;" (2) telling me they will check into this and call me in a couple days, but never calling back; (3) having my phone calls cut off. The REFERENCE # is ********.

  Business Response

  Date: 04/25/2023

  Thank you for sending the notice to us. I did not receive an earlier copy, so apologize for the delay in responding.

  S&S HealthCare Strategies, Ltd. is a third-party administrator for group health plans. That means we process the medical claims submitted to the plan or insurer but are not responsible for providing the funds to pay the claims. Either the insurer or plan sponsor provides the funds. In this case, the plan is self-funded by the employer/plan sponsor. We regret the difficulty the member has experienced and are working diligently with the plan sponsor to secure the funds and remit payment as soon as possible.

  Customer Answer

  Date: 04/26/2023

  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, reasons for rejection are included below.

  Their acknowledgement of the problem did not pay the medical provider.  Their hope to secure the funds and remit payment to the medical provider as soon as possible is not an adequate response.  Their reply to BBB is merely what they repeat to me on every correspondence.  The date of this medical service was over eight months ago.  I am still receiving bills from the medical provider, urging me to pay the balance out of pocket.  
  
  Regards,
  
  ******* ******