Complaints
Customer Complaints Summary
- 11 total complaints in the last 3 years.
- 6 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe 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:02/21/2024
Type: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 paid for my first health care premium on 12/15/23 for coverage to start on 1/1/24. my payment was taken but not credited to my account I paid for February coverage on 1/12 once again my payment was taken but not credited to my account. I have called ambetter fifteen times with most calls taking 45 minutes to an hour or more per call and they won't fix the billing discrepancies. I have been lied to repeatedly and told things like a team will fix it and someone will contact me etc. I have about 12 different reference numbers from all these calls. I have been trying to resolve this issue for over a month. their online payment system is messed up it takes your money but does not credit your payments. when you call the people you talk to can't resolve the problem and no one ever does. my original coverage was not activated because they never credited my first payment to my account my second payment activated it but now they are sending me emails saying my account is delinquent due to non payment. I don't want to keep having to call and keep paying more than i owe and continue to have the issue remain unresolved. I have had multiple ambetter reps say my December payment was for december coverage I didn't have insurance with ambetter in December.
Business Response
Date: 02/06/2024
Thank you for forwarding the complaint you received from *******************************, dated 2/6/24, BBB ID number ********. By reviewing the data you submitted, we believe you may have contacted the wrong health plan. It appears this member resides in Oklahoma state and we have forwarded this complaint to the Ambetter health plan in *******. Please let the complainant know that they should contact ** directly if they believe they have coverage through Ambetter from **************** in ****************. 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 to the BBB.Customer Answer
Date: 02/06/2024
Complaint: ********
I am rejecting this response because: ok how do I send this complaint to ambetter of Oklahoma instead of *******?
Sincerely,
*******************************Business Response
Date: 02/26/2024
February 7, 2024
Better Business Bureau
P.O.Box 191279
*****,** *****
Re:*******************************
Complaint **: ********
To Whom It May Concern,
Ambetter of Oklahoma received your grievance on February 7, 2024, concerning ******************************* BBB Complaint Case# ********. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives.
An Ambetter representative attempted to contact ****************** on February 7, 2024, to discuss the details and resolution of the complaint; however, was unsuccessful in reaching her. An Ambetter representative is actively working on continuing efforts to establish contact with ******************. We will be sending a detailed response directly to ****************** addressing the BBB complaint Case # ********. If you have questions, please call us at **************.
Respectfully,
*****************************
Member Relationship Liaison
AmbetterInitial Complaint
Date:08/11/2023
Type: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.
Ambetter of Oklahoma owes me a premium refund of $523.22. They have attempted to refund my money via ach to an invalid bank account. I have called in 4 times to request a paper check in the mail yet they refuse to do so.Business Response
Date: 08/14/2023
August 14, 2023
Better Business Bureau
17 ***********************
Oklahoma City, ** 73102-2400
Re: *********************
Complaint ID: #********
To Whom It May Concern,
Ambetter of Oklahoma received your grievance on 08/11/2023 concerning *********************, BBB Complaint Case# ********. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including eligibility, claims,and billing information, with anyone other than our members or their authorized representatives.
An Ambetter representative spoke to *********************, on 08/14/2023 and advised they will be assisting him with his concerns. We will be sending a detailed response directly to ********************* addressing BBB Complaint Case # ********. If you have questions, please call us at **************.
Respectfully,
*************************
Member Relationship Liaison
AmbetterInitial Complaint
Date:03/10/2023
Type: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.
Made a payment of insurance premium on February 8th. I then received an update saying my policy was suspended due to non-payment. After being on the phone with their customer service for over 40 minutes I was told that the payment would not be updated for a number of days, and this was essentially just how things went. I contacted Ambetter again on March 8th. After demanding to speak with a supervisor, I was placed in contact with their escalation team. I was again on the phone for over 40 minutes. This time after filing a grievance, I was told I would be called by a representative within 72 hours. It is past 72 hours and I have not been contacted, but my notifications on my Ambetter account says I will be mailed an acknowledgement letter in 3-5 business days. this company appears to be a joke. If I was made aware of the fact that they have been in business for less than a year I would've never chosen them as my health insurance.Business Response
Date: 03/14/2023
To Whom It May Concern,
Ambetter of Oklahoma received your grievance on 03/13/2023 concerning ***********************, BBB Complaint Case# ********. Due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims,and billing information, with anyone other than our members or their authorized representatives.
An Ambetter representative spoke to ***********************, on 03/14/2023 and advised they will be assisting him with his concerns. We will be sending a detailed response directly to *********************** addressing BBB Complaint Case # ********. If you have questions, please call us at ************ (TTY 711).
Respectfully,
*****************
Member Relationship Liaison
AmbetterInitial Complaint
Date:01/20/2023
Type: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 have been trying to make my premium payment for about a week now so first I went to my online profile and try to make my payment there only to see an error when I try to process the card, ok so I tried a different card same outcome so then I tried to do it with my routing and baking number same outcome. So I get on the phone spend 15 minutes waiting giving all the information and they tell me an error is coming up and to try and call back the next day. I call back the next day this time I spend 20 minutes just for the same result but I tell them I need to talk to someone that can tell me what is happening I get put on hold and then magically the call goes dead. I called again 5 more times just for the same result. At this point I have spend about 3 hours of my life trying to make a payment. Each time I explain my situation and frustration and no one seems to know what is going on but the operator wont let me speak to a supervisor or someone that can offer me an explanation as to why I CANNOT pay my premium. It should not be this difficult for customer to make a payment. The website offer no help on who to reach out to for help solving the issue.Business Response
Date: 02/06/2023
To Whom It May Concern,
Ambetter of Oklahoma received your grievance on 01/30/2023 concerning ***********************, BBB Complaint Case# ********. Due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives.
An Ambetter representative reached out to **************** on 01/30/2023 and left a voicemail with their direct contact information. This liaison will be assisting her with her concerns. We will be sending a detailed response directly to **************** addressing BBB Complaint Case # ********. If you have questions, please call us at ************** (TTY 711).Initial Complaint
Date:12/15/2022
Type:Status:ResolvedMore 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 was considering changing from BCBS to an Ambetter of Oklahoma policy through the healthcare marketplace here in oklahoma. I started researching doctors I could switch to due to my current doctors not being in Network with Ambetter. I chose some that were listed in Ambetters in Network list on their website. When I called those doctors they had never heard of the company. I called 6 different doctors in my area and none of them had heard of Ambetter of Oklahoma. I then called Ambetter to ask what the issue was and how I could find a doctor if their list is that inaccurate and they said they didnt know what to tell me. Something should be done about our choices here in oklahoma and Ambetter should not be misrepresenting themselves in such a matter. How many people take them for their word and sign up with their plans just to find that they are being deceived! Immoral and unethical company in my opinion. tBusiness Response
Date: 01/10/2023
Response in attached file.Customer Answer
Date: 01/12/2023
Complaint: ********
I am rejecting this response because:It won't be resolved for me because I chose to go with another company but for everyone else who are being deceived by them it won't be resolved until they start being alot more accurate on their list of participating providers. They did call me but like I said nothing can be resolved for me I just want to make sure no one else is scammed by them or taken advantage of.
Sincerely,
*************************Business Response
Date: 02/06/2023
To Whom It May Concern,
Ambetter of Oklahoma received your grievance on 01/03/2023 concerning *************************, BBB Complaint Case# ********. As stated previously, due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information,with anyone other than our members or their authorized representatives.
We are also in receipt of ******************** rejection of our initial response, which she submitted to your agency on 01/12/2023. An Ambetter representative spoke to ****************** on 01/04/2023. Unfortunately, at that time ****************** informed our representative that she had selected another insurance carrier,and our representative was unable to assist her further. ****************** was asked to forward the names of providers who had informed her they were not participating with Ambetter to our representative for follow-up; however, as of the date of this letter we have received no further communication from *******************
We sent a detailed response directly to ************************* addressing BBB Complaint Case# ********. If you have questions, please call us at ************** (Relay 711.)
Respectfully,
*************************
Member Relationship Liaison, AmbetterTell us why here...
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