ComplaintsforWoman Wise Nutrition
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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
12/07/2022
- Complaint Type:
- Billing Issues
- Status:
- Answered
Dear: To whom it may concern My name is ***************************** and I am reaching out in regard to issues involving a claim that began last year in July/August 2021. I have reached out to ********** Blue Shield-*************** (BCBS) multiple times over the last 18 months. Just today, December 6th, 2022 I was informed I should pursue legal action and contact the BBB. BCBS has not resolved the concern and issue that is described in this letter. Please find a general overview below: My concern is that I paid a provider out of pocket, $6,000.00 for a covered service, although the provider is located in ***** and I am located in ****. BCBS confirmed I would be reimbursed. My provider (***********************) stated I should submit claims to my insurance (BCBS of ****) to be reimbursed. The concern is that I have not been fully reimbursed by the provider and the provider then submitted claims without my knowledge to be reimbursed for a second time although they had already been paid by me. This was only brought to my attention after hours spent contacting BCBS to be reimbursed initially. I then informed BCBS that the provider was acting fraudulently and claiming insurance reimbursement for already paid-for services. This has been financially difficult as I have waited for the return of these funds and have not had any resolution as I have waited. I have documentation of payment and documentation of services. I can provide an explanation of benefits and all receipts as well. I was refunded $2400.00 by the provider in March 2022, but the provider is still claiming and writing off the other funds I paid to them per my insurance. I would like help in the resolution of this issue. At this time I am still owed $3,600.00 in specific funds by the provider. I look forward to hearing from you in regard to these issues.Business response
01/11/2023
Hello,
I was contacted by ****** today in regard to this complaint and have responded via voice message.
I have attached a few documents related to topics discussed in the message.
Document #1: The invoices the patient was charged and reimbursed.
Document #2: Insurance claim payment list showing partial coverage of services.
Document #3: Email chain with BCBS confirming that the member complaint was closed.
You'll see that row 2-4 on the insurance claim payment list was covered, totalling a reimbursment of $3600 show in the patient's invoice. The rest that was not covered was not reimbursed.
Please let me know if there is anything else you need from me. I am more than happy to hop on a call to further discuss any details or misunderstandings. You can contact me at ************.
Thank you,
***********************
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BBB Rating & Accreditation
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Customer Complaints Summary
1 total complaints in the last 3 years.
0 complaints closed in the last 12 months.