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:04/15/2025

  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 an reaching out to BBB to formally express my deep frustration and concern regarding my experience with WebTPA.Despite submitting all required documentation for a valid medical reimbursement claimnot once, but multiple timesmy case has been subjected to months of delays with no resolution. As of today, my healthcare continuity is at risk due to WebTPAs failure to process and fulfill their financial responsibility in a timely ********* February 2025, I submitted a complete reimbursement package, including provider approval letters, detailed invoices covering multiple dates of service, a completed reimbursement form, and an organized breakdown to assist with processing. This submission was acknowledged and tracked. Still, nothing has moved forward. For further context, I also submitted a prior claim in November 2024, fully within the allowable window for reimbursement. That, too, remains ************* is unacceptable that such a critical component of health care accesstimely reimbursement for approved medical serviceshas been stalled by inaction and disorganization on the part of WebTPA. The lack of accountability and communication has left me without the confidence that this company will meet its obligations.I urge others to proceed with caution when dealing with this organization, particularly when it comes to matters involving health and reimbursement. No one should have their medical care delayed because of an insurers administrative failure.

  Business Response

  Date: 04/30/2025

  Hello,

  Our **************** team has worked directly with Mr. ******* to resolve the complaint filed.  As of 4/28/2025, Mr. ******* has received the outstanding claim payments.

  Thank you,

  WebTPA

   

• Initial Complaint

  Date:12/03/2024

  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.

  This complaint is regarding incorrect payment for a patient's dental claim. On 05/13/** the patient was seen in our office for a *************** ($173) & WebTPA was billed. On 06/04/** the insurance incorrectly processed the claim as the provider being in-network (he wasn't/isn't) & issued payment for $101 (check not cashed). The *** said she would send the claim back for ***rocessing, "allow 30 days" ref #**-000813708. On 07/18/** follow up on claim ***orted the *** had sent the claim to the provider maintenance department, which agreed the claim had been incorrectly processed but they didn't ***rocess the claim. *** said would send claim back for ***rocessing "***** days" ref #**-001005549. On 7/30/** *** said the previous *** had sent the claim to provider maintenance as closed & they had sent the claim back unprocessed. The *** said the claim would be reopened & marked "open/urgent" & we should have payment "within 30 days ref #**-001058935. On 9/11/** *** said the other *** had attached another date of service in error. WebTPA "had a change in ************ now takes ***** business days to ***rocess a claim." The *** will send the correct date of service for ***rocessing ref #**-001250440. 9/18/** a *** called to ***ort "provider maintenance will ***rocess the claim at correct fees." On 11/4/** the ***resentative ***orted "nothing had been done since the last call 9/11/**." *** will send claim back for "***ricing configuration which takes 45 business days." The main error is that WebTPA is the administrator for claims, the payment is issued by *****. WebTPA says ***** told them we were in network, Aetna told WebTPA we are NOT in network (have never been) & did not tell WebTPA we were in network. This is actually the second time WebTPA has made the same ********** took 6 months to receive full payment. Now we have a claim for 11/11/** to file for the same patient & must hold onto the claim because we don't wish to start the same process again. Please help us.

  Customer Answer

  Date: 12/03/2024

  The treating dentist in this case was ****** ******, DMD Tax #**********, NPI **********.  ***** ******* is the practice administrator & handles the insurance billing.

  Business Response

  Date: 12/03/2024

  Good afternoon,

  I'm sorry you are experiencing issues with this claim.  In order for me to begin investigating the issue, I need additional information in order to locate the member in our system.  Can you please provide the member ID, Group number, copy of insurance card or copy of EOP.  I'm not currently pulling up a member by the name of ****** ***-******.

   

  Thank you, 

  WebTPA Claims 

   

  Customer Answer

  Date: 12/03/2024

  Attached please find the *** for ****** *** ****** DOB ********** ID #*************  DOS 05/13/2024

  Business Response

  Date: 12/05/2024

  Good morning,

  Yes, I understand that it is the provider that has submitted the complaint, unfortunately, I'm not able to locate a member in our system by the name of ****** ***-******.  Can they please provide me with the insured member ID, Group Number, Copy of Insurance Card the patient provided them, Copy of EOP, or social security number of the insured.

  Thank you,

  Darra

  Customer Answer

  Date: 12/05/2024

  ****** *** ****** (NO HYPHEN)
  
  INSURED MEMBER ID #*************
  
  GROUP NUMBER 2018HL
  
  PATIENT DID NOT POSSESS A DENTAL INSURANCE CARD TO GIVE US TO COPY
  
  COPY OF EOP PREVIOUSLY FURNISHED WITH ALL REQUESTED INFORMATION BUT WILL ATTACH ANOTHER COPY
  
  SOCIAL SECURITY # ***********
  
  DOB **********
  
  Its interesting how we have been talking to WebTPA for *over a year* regarding this patient (call reference numbers furnished previously)but suddenly **** from WebTPA cannot locate the patient in the system????
  
  

  Customer Answer

  Date: 12/09/2024

  The patient was able to send us a copy of her medical & dental card.

  Business Response

  Date: 12/16/2024

  Thank you for providing the additional information.  This complaint has been forwarded to the Account Executive for Hobby Lobby for a response to the situation.

  Regarding your comment, "It's interesting how we have been talking to WebTPA for *over a year* regarding this patient (call reference numbers furnished previously) but suddenly **** from WebTPA cannot locate the patient in the system????"  This client has dedicated teams within WebTPA for their services and only those within the team have access to any information of their members for confidentiality purposes.  Therefore, without the Group Number or Group Name, anyone outside of the dedicated team is not able to help direct you to the right person.  I hope this clarifies my request for additional information.

  I will provide an additional response upon review of the management teams.

  Regards,

  Darra

  WebTPA

• Initial Complaint

  Date:11/12/2024

  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.

  On 3-21-24, I completed a routine colonoscopy screening because I have MEC with my insurance. I used in network providers by verifying on ********************. WebTPA refuses to pay me $2,072.85 that I paid out of pocket because they initially denied coverage for this procedure that I verified was covered. I keep getting a standard form letter with the same date saying my coverage is denied not because I was not eligible for the procedure but because the ambulatory surgical center was out of network. I sent them a screen shot showing the facility is in network. One of their customer service **** took the time to log onto First Health network to verify they are in network. I called First Health to also get a verbal confirmation. Yet, Im still being told that I cant get reimbursed because I used an out of network provider. I have provided them with copious amounts of supporting documentation, all via fax or mail and called them over 40 times. Ive been working on this for 9 months. Some of the ** agents have been helpful and nice. But I have a feeling that the claims/appeals department has an agenda to stall and continually deny until the patient gives up. I would imagine it is part of their business model which is atrocious. Why do we have to put up with this in our country? Regulation, especially for insurance is weak, at best. I also submitted an *** with TX Divison of insurance. But thats also a joke. I demand resolution of this and will continue to complain until its taken care of. ****************.

  Business Response

  Date: 11/19/2024

  This is in response to your recent correspondence regarding the above case.

  WebTPA is the third part administrator on behalf of ***************** for The Container Store. The is a self-funded preventative treatment benefit plan that pays certain benefit for services. This is not a major medical plan and it does not pay a percentage of all medical expenses. Please be advised that, pursuant to the Privacy Rule requirements of the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), effective April 14, 2003, The Container Store Self-Funded Preventative Treatment Benefit plan is not at liberty to disclose protected health information regarding an insured to any party not expressly authorized by the insured to receive such disclosure. The Container Store Self-Funded Preventative Treatment Benefit plan has no HIPAA compliant documentation to indicate that the Better Business Bureau is authorized to receive information related to the policy. Nevertheless, please be assured that we have responded directly to our insured regarding this inquiry. 
  

  Again, The Container Store Self-Funded Preventative Treatment Benefit plan regrets that we are unable to provide a comprehensive response to the Better Business Bureau regarding the above inquiry. However, we take the privacy of our insureds very seriously and are obligated to protect PHI in compliance with federal law. 

  We will send a separate response to the member.

  Best regards,

  WebTPA Claims Department
  
  

  
  

  Customer Answer

  Date: 11/19/2024

  I would like to keep this complaint open until WebTPA responds to me in private per their message to resolve this health claim denial for a routine screening covered as a Minimal Essential Coverage (MEC) procedure that I am eligible for.

• Initial Complaint

  Date:05/20/2024

  Type:Customer Service 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 received a generalized letter dated May 8th 2024 of a data breach of all of my personal information: name, contact information, date of birth, and social security number. I called the company and provided them with my identification number: EKNJ93677-P who has contracted a third-party center (won't disclose the name of their business) and they will not provide me information on what insurance carrier my information was with in where they provided administrative services. I have since experienced in my dental office people calling using all of my personal information from the state of ********** and I live in *********** and receive services here stating they are me to the dental provider billing staff. Since it is a small family practice the billing staff know me personally and reported to me these occurrences. I want to know what insurance company they administered the plan for that had my personal information so that I may follow up legally regarding this matter. I am being given the run around. They released a generalized letter notifying me of a data breach and vague information of a failure of protection of my personal health information, social security and personal information and I cannot believe the treatment that I am receiving from the employees of this company. This company has to provide me with the information I am requesting and it is not just brushed under the rug their inability to adequately protect the personal and credit information of individuals. This is unacceptable, unprofessional, and their treatment of me in my inquiries is further victimization.

  Business Response

  Date: 06/04/2024

  Good morning ********************,

  I'm sorry you are experiencing this issue.  A WebTPA **************** Manager has reached out to you to provide you with additional information.  ***** has left you voicemails with her direct phone number.  If you could please return her call, she will be able to further assist you.

  Regards,

  WebTPA

• Initial Complaint

  Date:03/22/2024

  Type:Customer Service 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'm a chiropractor in WI and this company is illegally discriminating against chiropractors. They are saying a specific procedure code that chiropractors use requires us to get pre-authorization for treatment. This is illegal in *********. I called 3 separate times and asked to get a copy of a provider's agreement so that I can provide that to my state association. They cannot or will not provide it.

  Business Response

  Date: 03/25/2024

  Good afternoon,

  In order to further research this issue, I will need the following information to ensure that we are providing accurate benefits based on the group's benefit structure.

  Patient Name and Date of Birth:

  Employer the coverage is offered through:

  Date of Service for the denied claim:

  Upon receipt of this information, WebTPA will be able to research and provide a response.

  Thank you,

  Darra

  WebTPA

  Customer Answer

  Date: 04/05/2024

  This does nothing. There is no contact info for ***** How am I supposed to get her the information? 

• Initial Complaint

  Date:12/01/2023

  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.

  Professional ****************** has submitted claims to ******* and has consistently received erroneous denials to date. I have contacted ******* multiple times and receive the same message every time which includes a denial reason which is not valid for this circumstance. These claims are behavioral health claims and every date of service submitted was denied stating that "***** sent to incorrect payor. Provider: refer to *****'s national ancillary guide and submit claim to proper payor." Each representative I have spoken with, including a supervisor, has told me that these claims go to ASH (American Specialty Health) which only services therapies such as chiropractic, physical therapy and occupational therapy. Again, these claims are behavioral health and were sent to the correct payor. 10/10/**: spoke with ***** REF# **-001317926, 10/24/**: spoke with ******* **-001384079, 11/07/**: spoke with ***** REF# **-001451361, 11/10/20**: spoke with ***** REF# **-001471339, 11/27/**: spoke with ***** - informed me a supervisor will call me back, 11/28/**: spoke with ****** (supervisor) who informed me she would call me back that same afternoon REF# **-001538378. I have received the same response on all of these calls with NO resolution. These claims were sent to correct payor, authorization is on file and these claims should be processed and PAID. I will provide provider TAX ID, NPI # and each and every claim number once a response is received. Thank you.

  Business Response

  Date: 01/02/2024

  My apologies this has not been resolved.  If I'm understanding the complaint correctly, you are a provider, and your claims are being denied.  In order to further assist you, I will need the following information in order to research. 

  Patient Name

  Patient Date of Birth

  Employer Name the coverage is through.

  Once I have this information, I can escalate the review.

  Thank you,

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

  WebTPA

   

  Customer Answer

  Date: 01/08/2024

  Patient Name:  ***********************

  Date of Birth:  08/05/2011

  Insurance:  ******* ID:  *********** (Prudential)

  Customer Answer

  Date: 01/09/2024

  I am rejecting this response because:   

  Patient Name:  ***********************

  Date of Birth:  08/05/2011

  Insurance:  ******* ID:  *********** (Prudential)

  Business Response

  Date: 01/10/2024

  Good afternoon,

  Thank you for providing the additional information.  I have escalated this matter to our dedicated operations team for this client.  I will be able to provide a detailed response upon their review.

  Thank you for your patience and I will get back to you soon.

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

  WebTPA

   

  Business Response

  Date: 01/16/2024

  Good afternoon,

  Our Operations and ****************** team have reviewed this complaint.

  The provider, ********************************* is a Cigna OAP contracted provider. WebTPA was advised by ***** that per their contract with ********************************* all claims must be submitted to Cignas ancillary network, *******, for repricing and therefore were denied as such.WebTPA has been working with ***** since November on getting these claims reviewed and corrected. At the end of November, ***** responded that upon their review, they identified the issue that caused the error and an adjustment was needed. ***** stated that WebTPA would receive corrected repricing for all claims for this provider. On January 3, we reached back out to Cigna as we had not received the corrected repricing. Pricing was received on 1/4/24 for 2 of the 18 claims, followed by the remainder of the repricing.  All claims are being reprocessed at this time and should be completed within **** business days.

  Regards, 

  WebTPA

• Initial Complaint

  Date:07/26/2023

  Type:Billing 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.

  I visited a health care provider on 3/24/23 as a follow-up to a fall/emergency room visit. My copay was $34. WEBTPA is my supplemental insurance. They initially denied payment on 5/2/23 stating that my condition was pre-existing. It was not, so I had them email me forms to hand deliver to my 2 doctors at Covenant Medical Grp to complete. They each completed the ************************************* (provider I saw on 3/24/23) completed this form on 6/2/23 and faxed it to WEBTPA. I called WEBTPA around the middle of June to follow up and was told by "*******" that the case was going to be reopened and processed as they had the documents they needed regarding it not being a pre-existing condition. I called again on July 10 and was told by "******" that the case was never reopened and closed out. I called on July 17 and was told by "*****" that the case was pending but they needed a pre-existing form from my eye doctor. He is not affiliated with my medical doctor and it is completely unrelated to the reason for the office visit on 3/24/23. I asked to speak to a supervisor and was connected to ********* She stated she would send an email to the claims medical examiner to see if this form was needed and if so, she would fax it to my eye doctor. She told me she would call me in 24 to 48 hours. Well 72 hours later, no response. I called WEBTPA again on 7/20 and was told that she was not available and "*******" could not tell if "******" even sent an email to the claims medical examiner. All she could do was tell "******" via email to call me back. This company, WEBTPA just needs to process and pay the $34 to the provider. This bill is 120 days past due now. I am having the provider call as well. The confirmation # is 23-000895231. I am not sure if this is the right address for WEBTPA. The address I have is PO Box ****-********* ** **********. Phone # ************. They are under the **************************** in ********* **. Underwriters are The Hartford. WEBTPA is very incompetent.

  Customer Answer

  Date: 07/26/2023

  The bill in question was reversed finally after all this time and approved. I was informed today, 7/26/23, that the payment is in the finance department for $34 and ready to be paid out to the provider, Covenant Health. They hopefully should receive the payment in 10 business days. It appears that the matter has been resolved at this point and no further action is needed. 

• Initial Complaint

  Date:06/06/2023

  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.

  On 10/27/2022, I requested reimbursement of payments to an in-network provider who requires payment at the time of service. I requested reimbursement of over $850 dollars for a series of appointments during 2022. For several months WebTPA did not process my payment despite repeated follow-up calls where they assured me they had everything they needed to process the claim. Finally in early 2023 they informed me they 'couldn't' process the payment because they needed someone to call in and give them the provider's tax ID number for some reason, even though they stated that they had the tax ID number in their records already. It turns out they had requested the tax ID from the provider, who called back in and left several messages but never received a return call from WebTPA. I provided the tax ID number and they told me they were finally processing the payment on March 15, 2023. I waited and waited, and the check never arrived. I called on May 1 of 2023 and they told me they would cancel and resend the check. As of today, May 31, 2023, they informed me that the check has not been re-issued because they are now waiting for a "check trace" which can take up to 45 days (this check trace consists of asking my employer whether the check has been cashed). Every time I call WebTPA I get incomplete or conflicting explanations; I am always told a manager will call me back, and I have never received a call back. Today, over seven months after submitting this claim for reimbursement, I am still waiting for reimbursement. I was informed today that this claim has been handled in accordance with the company's policies and procedures, which I find hard to believe. If so, I think a policy that results in payments being delayed over 7 months is in extremely bad faith and should be looked at closely by regulators.

  Business Response

  Date: 06/28/2023

  Good afternoon **************,

  I understand your frustration with our claims and customer service teams.  Provider Tax Identification numbers are required to process a claim.  If you asked to speak to a manager, you should have received a call back, and I'm sorry that didn't happen and that has been reported.  The manager did work on your claim in getting the check tracer expedited.  There are internal protocols that we must follow for documentation purposes with the owner of the account, your employer.  The check was reissued on 6/2/2023.  I do not see any calls received from you to our **************** team since 5/31/2023, so I'm hoping that this re-issued check reached you.

  We hope your experience with WebTPA in the future is more favorable.  

  Regards,

  WebTPA

  Customer Answer

  Date: 06/28/2023

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  Date:05/03/2023

  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.

  I had a procedure done on 03/26/23. Claim was submitted to ******* and they dragging their feet paying claim. This is causing me to have to pay my deductible again because it is not showing up as a paid claim. My deductible was met with the 03/26/23 claim. ******* has rude and NOT helpful in resolving this claim/payment.

  Business Response

  Date: 05/22/2023

  Our apologies on the delayed response.  Our Operations team has been researching the issues and is currently compiling their response.  I should have their response to you by mid-week.

  Again, my apologies on the delay.

  Regards

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

  WebTPA

  Customer Answer

  Date: 05/22/2023

  I am rejecting this response because I want to see the final response from WebTPA and their solution.