Complaints

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:01/22/2025

  Type:Service or Repair 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 seeking counseling from a provider who is out-of-network. I am in crisis. Every single phone number I can find to reach someone at Providence Health Plan either FAILED or leads to SILENCE. I've made dozens of attempts to reach someone from the phone numbers listed on my insurance card & the phone numbers listed on the website. I have no way to talk to a benefits specialist to request approval to get the help I am seeking. This is a disgrace. A travesty. This unacceptable obstacle to receive the care we PAY FOR & ARE ENTITLED TO IS UNFAIR, UNREASONABLE & UNETHICAL. We have paid into this insurance policy for years! Yet, when I need mental health help, I cannot reach a person to request out-of network coverage. Please help me contact this insurance company. Thanks,*****

  Business Response

  Date: 01/27/2025

  Dear BBB,

   

  Providence Health Plan (PHP)  is unable to identify ***** ****** as a member with the information provided.  We to strongly encourage all of our members to contact PHP directly via phone, ************, email, **************************************************** or by US mail as listed on the back of the member identification card.   This will allow us the opportunity to fully research and reply to all concerns our member(s) may have.  We understand from the concerns addressed to PHP that there has been attempts to contact PHP.  We are unable to provider any further communication without being able to identify ***** ****** as a PHP member. 
  
  Some general information, all PHP members have the right to request to obtain an authorization for services with a nonparticipating or out of network provider.     The information provided in a written request will be submitted for that review.  If a member disagrees with a decision made by ***, the member has the right appeal the denial.   All appeals are thoroughly reviewed, and a written reply is sent with the determination and any further rights to appeal if needed. 
  

  Please let us know if you need anything else.

  Sincerely,

   

  Providence Health Plan

• Initial Complaint

  Date:12/15/2024

  Type:Service or Repair 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.

  On October 3, 2024 at ***** PM, my son (who helped me with all the phone calls below due to my difficulty hearing, and with my verbal permission each time) and I called Providence Health Plan (***) and talked to a representative about my eligibility to be imbursed for Jabra Select hearing aids. She checked and said I was eligible to obtain new hearing aids and that *** would reimburse Jabra Select hearing aids if I were to buy them. I explained that this was an almost $1800 major expense for me, and would she please double-check. She did so, and reassured me that: 1. the deductible was waived 2. that 90% of the cost was covered 3. I would be responsible only for 10% co-insurance and 4. I would be reimbursed for the 90% of the $1795 if I completed the *** form. We reviewed this form together, and I explained I did not know the diagnosis codes and procedure codes which the form had spaces for. I was told these codes were not necessary for reimbursement of hearing aids. Based on this phone call, I purchased the Jabra Select hearing aids on-line, and then faxed and mailed the reimbursement form with my **** receipt confirming payment to *** on 10/30/24. There was no communication from ***, so on 11/21/24 I called them again. They confirmed the documents had been received and registered in their network (reference#************), and their review would be completed by mid-December. There was no communication from ***, so on 12/10/24 I called *** again. At that time they told me the reimbursement request was not processed because the procedure and diagnosis codes were missing. Later in the same call they said that I was not eligible for reimbursement because I could only get hearing aids every three years. I asked to speak to a supervisor. They told me she was not available and so I left a voice mail requesting a call back asap. Once again, there was no further communication from *** and the supervisor has not returned my call as of 12/15/24.

  Business Response

  Date: 01/03/2025

  Dear BBB,

   

  Thank you for this notification. Providence Health Plan (PHP) is reviewing this case and will reach out to their member once the review is completed.

   Providence Health Plan requires their members to follow their escalation process that in provided to them in their member materials.   We encourage the members to follow those processes to ensure that all concerns are addressed in the required timeframes.  

  PHP apologizes for any inconvenience to their member in the resolution of this concern.

  Please let me know if you need anything else.

  Sincerely,

  *** *******

  Customer Experience Manager

  ********************************************* and Services.

• Initial Complaint

  Date:10/31/2024

  Type:Service or Repair 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.

  1. Issues of denial of services.2. Refusing to pay providers for services.3. Refusing to provide services that physicians order.

  Business Response

  Date: 11/21/2024

  Dear BBB,

  Thank you for this communication. A Providence Health Plan (***) representative recently spoke with their member. During the call, the *** representative did inform the member that the notes submitted by their provider did not indicate criteria requested was met.  A case manager is to contact the member in approximately seven days with an update.

  The *** member indicated they were thankful that their concerns were being addressed.

  We apologize for any inconvenience to the Health Plan member in the resolution of their concerns.

  Please let me know if you need anything else.

   

  Sincerely,

   

  *** *******

  Customer Experience Manager

  ********************************************* and Services

   

  Customer Answer

  Date: 11/21/2024

   
  Complaint: 22499635
  
  I am rejecting this response because: I have not heard from the company.
  
  Sincerely,
  
  ***** *****

  Business Response

  Date: 12/12/2024

  Dear BBB,

   

  Providence Health Plan has sent a communication to the complainant acknowledging their request. Providence has requested notes for our patient's Specialist however they have not by provided yet by the Specialist's office.  Providence Health Plan will render a decision as soon as possible, with or without requested notes.

  We apologize for any inconvenience in the resolution of this concern.

  Please let me know if you need anything else.

  Sincerely,

  *** *******

  Customer Experience Manager

  ********************************************* and Services.

   

   

  Customer Answer

  Date: 12/12/2024

   
  Complaint: 22499635
  
  I am rejecting this response because:
  

   

  Providence has not taking the responsibility to contact me and address any concerns.  Many phone calls go unanswered and there are continuous lies from Providence.  THE WORST HEALTHCARE COMPANY TO WORK WITH. Deny all claims without explanation, wont return calls, and when trying to escalate issues nobody call back.  A company built on LIES and DECEPTION. 
  

  Sincerely,
  
  ***** *****

• Initial Complaint

  Date:08/25/2024

  Type:Service or Repair 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.

  My father was taken to the hospital because he fell. He stayed in the hospital for two weeks without caring for his leg and back. Instead they gave him a colonoscopy because his blood test showed he was anemic and gave him a heavy dose of medicine to keep him sleeping and it made his dementia ***** times worse. He has since been moved to a rehabilitation center and has fallen out of bed and while we were visiting he had a stroke and was taken to the ** still no answer and Providence claimed he came into the hospital weak and unwell. Not the case ! He had fallen and was supposed to be treated for that and now hes at the point of totally bed ridden and full blown dementia!!!! The hospital has been no help what so ever!! Our health care is broken.

  Business Response

  Date: 09/09/2024

  Dear BBB,

  A Providence Health and Services representative spoke with the complainant on Friday 9/6/2024.   Based on their feedback we requested the name and date of birth of the patient so that we could forward the information to our Providence **************************** so they could perform a clinical review.

  Unfortunately, the complainant declined to provide this information during the call and as such we cannot determine the identity of the patient and are unable to review.

  Providence sincerely hopes that upon reflection, the complainant will reconsider and provide patient information so that we may clinically review.

  Please let me know if you need anything else.

  Sincerely,

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

  Customer Experience Manager 

  ********************************************* and Services

   

   

   

• Initial Complaint

  Date:06/27/2024

  Type:Service or Repair Issues
  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.

  In December of 2023, I renewed my insurance with Providence Medical Advantage. In addition, I checked that I wanted an extra dental plan with Providence. I was very careful to do that because the previous healthcare year, Providence Medical Advantage mislead me to believe that I had an additional dental plan. They said I was too late to get a dental plan when I questioned it. So now, I called to make a dental appointment today. I was told I did not have an additional dental plan. They have now denied two years in a row to not get an additional dental plan. I would like a dental health plan as I have intended for two years in a row. This office has been incompetent when dealing with me. I love my primary doctor and love the service. I do not appreciate the office with the health care plans.

  Business Response

  Date: 09/13/2024

  Dear BBB

  .Our review found that our member was previously directed to contact **************** and Membership accounting to request to have dental added. Unfortunately, we have not heard back from our member, We respectfully request that our member follow up with Providence Health Assurance so that dental coverage can be added.

  We apologize for any inconvenience to our member in their resolution of this concern.

  Please let me know if you need anything else.

  Sincerely,

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

  Providence Health and Services

   

  Customer Answer

  Date: 09/14/2024

   
  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.
  
  Sincerely,
  
  ***************************

• Initial Complaint

  Date:05/31/2024

  Type:Product 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.

  acct sent to collections,but paid in full

  Business Response

  Date: 06/07/2024

  Dear BBB,

   

  Thank you for this communication. We were unable to locate this patient/account in our database. A Providence Health and Services representative was able to connect with the spouse of the patient.   We were able to determine this complaint was for a Providence ************** located in ***********, ** and is part of Prime Healthcare. 

  Providence Health Center/Prime Healthcare have no connection or affiliation with Providence Health and Services. We ask that you forward this concern to the correct organization, Providence Health Center, so that they may address this concern with their patient.

  Sincerely,

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

  Customer Experience Manager

  Providence Health and Services

   

   

   

   

• Initial Complaint

  Date:04/26/2024

  Type:Service or Repair 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.

  I submitted a claim for reimbursement for services received from 1/4/23-12/27/23 in February of '24. It was approved for reimbursement on 3/1/2024. March 14th I emailed asking if the check had been issued, it had but it was issued in the wrong name so they were going to reissue it and I should have received it no later than 4/5/24. On 4/14/24 I called member services, and after some digging found out that there was a hang up on their end and that an internal form hadn't been filled out but that now it was resolved and I should get the check in 7-10 business days. I called today on 4/26/2024 and was told that it was still at accounting and that they only cut checks on Fridays so that it should be cut next Friday but that I could call to confirm that. I want to make it very clear that the people who I talked with on the phone were very helpful and I am not frustrated at them. I am however ****** that Providence Accounting has yet to issue a fairly large check and only cuts them once a week. Whomever manages that department should be under review and retraining needs to happen. I was informed my only course of action is to call next Friday or the Friday after that until I receive the check, which seems a **** poor way of operating a business

  Customer Answer

  Date: 05/22/2024

  I have provided my full name above, here it is again. 

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

• Initial Complaint

  Date:04/02/2024

  Type:Service or Repair Issues
  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.

  In 2021, my family purchased a health care plan for Providence through the Providence Health Plan website directly. At the time, I was unaware of getting insurance through Healthcare.gov or state exchanges. As a result, I lost a lot of money to Providence through the loss of this tax credit. I filed a claim against Providence through the Oregon ******************************** but it was denied. I had a plan in ****** and in Washington. PHP should have the ability to direct patients/families to state or federal exchanges to assist with their premiums. Providence's "values" on their webpage are Compassion, Dignity, Justice, Excellence, Integrity. The denial of assisting a previous member who paid Providence thousands of dollars during their years of membership isn't serving with excellence or compassion. We would have purchased Providence directly through the exchange anyways because I thought they were a quality organization. I am now past the grievance period (which is extremely convoluted to file anyways). I want assistance with this and reimbursement of the credits I am due but cannot file because of PHP.

  Customer Answer

  Date: 04/03/2024

  This has been resolved. Please close this complaint and let the company know as well. 
  
  Thank you,
  ***
  

  
  

• Initial Complaint

  Date:11/25/2023

  Type:Service or Repair Issues
  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.

  My spouse and I have a Providence employer sponsored health plan. I did not use any healthcare in 2023. I did not go to the doctor. I did not fill a prescription. I got my vaccines from the hospital where I work. I just got a bill from Providence staying I owe $139. Theres no way for me to look up an itemized bill on their app or at the website listed on the bill. I have no services listed for 2023 because I used no healthcare. When I go to the app, it shows that only my husband has used healthcare this year. I think bill might be from using Providence urgent care in Sept, 2022 which I thought was covered. If its from a service thats over a 12 months old, Providence is not allowed to bill me per Oregon state law. Not only is it illegal, but it would be too late for me to claim it on my taxes (which I itemized for 2022 d/t health expenses) and too late to claim on 2022 FSA. *****************************, group # ******, ID # ************, the bill says date issued: 11/17/2023, balance $139. Acct ******** By the way, I tried to see my PCP this year for a check up and she was booked out to May next year. I was unable to find another in network pcp to schedule an annual exam but couldnt find anyone accepting new patients. The Providence rep even told me I should switch to another health plan for ****. (I switched to ******)

  Business Response

  Date: 11/27/2023

  Dear Sirs,

  Thank you for this notification. A Providence Health and Services Representative spoke with our patient today, 11/27/2023. Our representative explained that the delay in billing was due to a credentialing issue with our patient's insurance and the provider who treated our patient on the date of service in question.

  We apologize for the delay in the billing resolution and any inconvenience to our patient. As a resolution, we have made a courtesy adjustment to the patient balance. Our patient indicated they were satisfied with this resolution and will pay the remaining balance due on their Providence account.

  Please let me know if you need anything else.

   

  Sincerely,

   

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

  Customer Experience Manager

  ********************************************* and Services.

  Customer Answer

  Date: 11/29/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********.

  A rep called me. I dont believe her explanation that an in network Providence clinic was considered to be non-PAR with Providence health plan and that it took them 14 months to resolve. I am unhappy that I got a bill 15 months after the date of service. Im not going to keep arguing it because I cant afford a lawyer. 
  I guess for profit health insurance companies and **** are going to keep squeezing their members dry while their CEOs rake in tens of millions in compensation.
  
  *****************************

• Initial Complaint

  Date:10/25/2023

  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.

  Depending on who answers the phone, you get different answers. The number I called for resolution for health insurance information is ************. Providence Health insurance is sending me bills that do not belong to me. I am listed as the guarantor? This problem was taken care of a couple of months ago, but Providence Health Plan is up to its old tricks to get anyone to pay for health insurance bills when other person who is responsible for bills are not paying. Be aware that PHP does not get ahold of your mailing address! I would not give them your address for an identifier ever! They will mail you bills that do not belong to you.

  Business Response

  Date: 11/02/2023

  Dear Sirs,

   

  Thank you for this notification. The complainant has requested that we change the Providence Health and Services guarantor of a minor child from the complainant to the child's father.  On October 25,2023 in a call to the Providence Health and Services business office, the complainant was informed that we are unable to change the guarantor to the father without his permission. Upon receipt of the BBB notification, a Providence representative did reach out to the father, who declined the change of guarantor to him. 

  Payment for services for a minor child does need to be worked out between the parents as we are unable to make this change without permission of the patient's father.

  Please let me know if you need anything else.

  Sincerely,

   

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

  Customer Experience Manager

  ********************************************* and Services