ComplaintsforAltrua HealthShare

• Initial Complaint

  03/02/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  My husband and I were members of Altrua HealthShare with the Diamond plan until 12/15/21. I had notified Altrua that after a job change we would be cancelling our membership. However, on 12/3/21 I visited an Emergency Room.At this time, I was covered by new primary insurance and Altrua. I was certainly not feeling well and provided the hospital with my primary insurance information, but did not remember to provide them with my Altrua HealthShare information. I paid the outstanding balance at the hospital. However, within 72 hours of my return home, I filed for reimbursement with Altrua. At this time, 3/1/22, my case is still unresolved. I am doggedly attempting to reach resolution, and we are well outside of the 45 day window for response from my initial submission. Since my initial submission, I have received additional bills and only the barest communication from Altrua. I received one written request for additional documentation from Altrua, and promptly submitted the requested documentation. I then awaited response. No further communication was issued, and I called Altrua for a status update. At this point I was notified that still more documentation was required. This process repeated 3 additional times, each requesting more documentation (more than the documents listed on their submission forms). No one contacted me to request this information, I called them! On the third request for additional documentation, I finally asked, via email, for the reason that these new documents were required. I received no answer. There is no way to track a case other than calling with a case number, and Altrua does not provide any communication, proactive or otherwise. Each time new documentation is submitted they claim that the 45 day window restarts. How is a member ever to receive the funds due to them if Altrua does not communicate proactively what is needed to make a determination?

  Business response

  06/21/2022

  **************,

  Thank you for bringing your reimbursement processing issues to our attention.  We apologize for any frustration or inconvenience that *** have been caused by the delays in processing your eligible medical needs for sharing.  We have reviewed your file and we did indeed go over 45 days to process your reimbursement.  However, the guidelines Section 4.1 clearly state that it is the goal to have eligible needs shared within 30 to 45 days. However, there are times medical records requests take longer and there are some medical needs that require a more extensive timeline in order to procure all needed information and documentation.  Medical records are always required to be reviewed for an ER visit and your medical records were received on 2/4/22.  Your reimbursement check was issued on 3/21/22, which was 29 days from the date of receipt of your medical records.  I do understand that you were very proactive getting your information to us, and we greatly appreciate your diligence.  We do apologize for any lack of communication on our part.  We wish you the best.

  
  

  Many Blessings,

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

  Director of Compliance and Regulatory Affairs

   

  
  

• Initial Complaint

  02/21/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Around 1/24/22 I switched jobs and was on my 90 waiting period to receive health insurance from my employer. So I signed up with altrua and was told that so many things are covered for my family and myself which was not true at all. There hasnt been any supporting documents of what was covered. My wife had to go to her provider for a pinched nerve and come to find out providence hasnt even heard of altrua. When we signed up with altrua they told us over the phone that providence (where our healthcare provider is) was covered. We are stuck with the cost of these appointments including the ones I have gone to. My family and I payed $1082 for the first month with altrua and nothing is covered for our medical needs after paying that ungodly amount. Ive tried reaching out to altrua to cancel and get a refund for this scam they pulled on my family and I and have not received a call back or any emails from them. Paying $1082 for something we were told was something completely different than what their services offer is totally unacceptable. My family and I are out over $1000 for a service that doesnt cover anything for our healthcare needs. I want my money back for this scam and for being told their services are something they arent. This experience was horrible and will never recommend nor use altrua in the future. I really hope BBB can help my family and I resolve this issue. I would provide supporting documents if altrua would have sent me some. My family has been completely ripped off by altrua and I just hope this can get settled and taken care of before they take advantage of some other family.

  Business response

  03/17/2022

  ******************,
  We are in receipt of your complaint and have done an investigation into your claims.  Our research shows that you enrolled in an Altrua HealthShare membership on 1/18/22 with an effective date of 2/1/22.  You cancelled your membership within 30 days and all amounts contributed by you were refunded in full.  Your membership ended 1/31/22.
  You claim that there have not been any supporting documents of that was covered by Altrua.  However,the Membership Guidelines are available on the Altrua HealthShare website and could be easily accessed at any time at https://altruahealthshare.org/resources/guidelines.  Additionally, Altrua HealthShare has an App that can be downloaded, where you can see details about your membership, find a provider, access virtual health, and view your membership card to name a few.  If you were not provided with this information, we apologize.
  In your complaint you also state that the provider hasnt even heard of Altrua.  Altrua HealthShare members have access to the MultiPlan/PHCS Network, as is stated on the back of your membership card.  The MultiPlan/PHCS Network is a large provider network, whose clients include a diverse base of health care solutions.  It is unfortunate that your provider did not verify that you had access to the MultiPlan/PHCS network.  Your provider was listed as participating in MultiPlan/PHCS network and  could have easily verified your Membership through the contact information on the back of your membership card. 
  You called us a scam, however, in 2014 Altrua Ministries, dba Altrua HealthShare (Altrua) received its recognition as a **************************** recognized by the Centers for ******** & ******** Services (CMS). As a result, the members of Altrua HealthShare have the security of being members of a recognized ****************************.  Altrua HealthShare is a **************************** that is a 501(c)(3) non-profit organization that facilitates the sharing of eligible medical needs between members.  Our membership opportunities are developed and based on Biblical principles established for living a healthy and honorable lifestyle and members must believe in and follow our Statement of Standards to join any Altrua HealthShare membership.
  We regret the circumstances surrounding your experience.  It is our sincerest hope that you have found the appropriate fit for you and your familys medical needs.

• Initial Complaint

  02/01/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  -My Business' previous ownership had the Altrua HealthShare account where it paid the **** for the employees -The business was sold to new ownership in 2021 -The new ownership went forward with a legitimate health insurance plan -Reached out to Altrua to cancel company paying Altrua premiums on Jan 10th via email; received a ticket number -No Response so far -Reached out via phone to cancel plan on Jan 18th. Spoke to a representative and accounting and was told that there would be no more billing and they would send notice to the "employees" that are on the plan (which are not employeed by the company any longer)-Asked for an email stating that there would be no further charges per the conversation.-Did not receive the email -Feb 1 received an invoice and charge from Altrua HealthShare Clearly this company is structured in a way to make this as difficult or possible to move on. As such we are going to escalate this issue if we do not receive proper resolution which is Statement Amount for 02/2022: $2,594.00.

  Business response

  02/22/2022

  ********************,

  
  Thank you for bringing your issues to our attention.  We have researched your issues and found that on 1.1.22 an email statement was sent to you regarding January contributions and your account was drafted on 1/6/22 for the month of January.  On 1/10/11 you emailed our accounting department and requested your company membership be cancelled.  You also spoke to our accounting department on 1/19/11 at which time it was verified that the cancellation was being processed and that no future contributions would be drafted from your account.  However, on 2/1/22 an email statement was sent to you in error regarding a February contribution draft.  Although you received the statement via email for February, no contribution was drafted from your account for the month of February according to our records.   We apologize that you did not receive your cancellation confirmation email, there was a glitch in our system which we have now remedied.  The end date of your membership and the memberships of your former employees was 12/31/21.  It is our hope that this information clears up your issues.  If the above information is incorrect, please reach out to me at *********************************** and I will personally investigate this matter further.

• Initial Complaint

  08/04/2021

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  We were members of Altrua in good standing all premiums paid for almost 4 year. My wife had a three day hospital stay in January. The hospital would not **** Altrua so we negotiated a discounted out of pocket payment. We filed with Altrua for reimbursement 02/11/2021. Several other providers from the same stay have billed Altrua. To date the reimbursement nor any related claims have been paid nor do we know which ones have been applied to the *** (deductible). We have called many times for updates and received various case numbers. About three weeks ago we were told our reimbursement claim stood at 38 days out of the required 45 days to process. Today 8/4/2021 we called and were told processing wants more time. There is no escalation process, no way to speak with a supervisor, and no way to determine a date for resolution. The only communication from Altrua to us has been two Explanation of Sharing via mail on 5/21 and 6/21/2021. Web email has not produced any response.

  Business response

  08/26/2021

  **********************,
  First let me say thank you for being a member of AltruaHealthShare since 2017.  We at AltruaHealthShare are very saddened to lose a longtime member such as yourself.  It is unfortunate that the reimbursement foryour wifes hospital stay took longer to be approved than expected.   Unfortunately, when medical records arerequested, it often takes the provider weeks or sometimes months to providethose medical records to us for review.  It does show in your file that your medical need was escalated in May,but if no one followed up with you or responded to your requests, that is unacceptable.  As such, we have taken the example of your caseand are using this to improve our reimbursement processing policies.

  
  Below, you will see that all of your medical needs have beenprocessed for sharing and checks have been issued according to the guidelines ofyour designated membership, to you and your providers.

  
  Again, we at Altrua are saddened that you were unhappy with yourmember experience and hope that you have found a solution for your familyshealth care that is better suited for your needs.

  
  Sincerely,

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

  Director of Compliance and Regulatory Affiairs

  Altrua Ministries dba Altrua HealhtShare

  Customer response

  08/26/2021

  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.

  
  

  This is assuming checks indeed have been sent to the various providers. I have received our reimbursement checks.

  
  

  We feel deeply saddened that it took a complaint to the BBB to resolve this situation as Altrua appeared to offer no escalation path to a resolution. Once the complaint was lodged I have received several communications and updates I had not received previously.

  
  

  Again we regret having to take such action but thank all involved at BBB and Altrua who assisted in the this resolution.
  
  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. ↩