ComplaintsforHealthSmart Benefits Management, LLC

• Initial Complaint

  08/15/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Unanswered

  More info

  I am a dental provider providing services to Kickapoo Traditional Tribe of Texas members. This group has a contract with Healthsmart to administer their claims. For years we have mailed claims to Healthsmart's ********** address until they gave me a fax number to speed up process. I was able to either mail my claims or fax them *************) until 3 months ago. The fax number I was using now goes into a voice mailbox "you have reached dallas claims, leave a message". I can't fax to a mailbox. It is as if it was blocked because I was using it with no problem and have not changed a thing; so, I started mailing them again to Lubbock, Tx. however, ALL my claims have now been RETURNED by ****. NO NOTICE was ever given that PO Box *****, ********************** is no longer valid address, even though it is still published online. HS customer service told me to resubmit them to ********************************. AGAIN ALL those claims have now been RETURNED for past months for this address too. So I called customer service AGAIN, and they said, "oh, why dont you try PO Box ******, *****, MN *****." I mailed all the claims to that address, and still have not received any response nor reimbursements. I am still waiting on claims for services starting **** 3, 2024. **************** offers no solutions for why fax number just quit working one day, and now goes to voice mail. A second fax number was given ************ "please stay on the line while you are connected to fax blue, and it goes to voicemail too, no connection to a fax machine., . I could not find a complaint form or contact us for HS online. I would like for someone in this organization who can reach out to me HOW/WHERE they receive a bill from us, because everything we have been told by customer service since **** is incorrect. We just want payment for our services, but are not able to bill them with the information they give us. Online claim filing is not yet possible. Thank you.

• Initial Complaint

  02/04/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I should've done this last year. This insurance company is a farce. My job got them last year and to date they're not paying or paying what they should be paying on medical bills. I kept getting emails from Drs about the bills for months. You can't reach anyone at their place, you have to go thru a 3rd party to see about any claims or info. about anything. I had a few health problems last year that started with MRIs and ended with a knee surgery. Checking with what they call a concierge on some of the places was told they were fine. Here in Texas there's not much of a choice in hospitals and Baylor is the giant. So is Touchstone imaging. All insurances use them. So unless these guys use charity hospitals and off the alley imaging companies I don't where they're going with it. Like I said you can't talk to them. I can see now part of the problem is the concierge part. I always check with providers when they see insurance to make sure they're in network. These guys are trying to tell me Baylor and Touchstone are not in network and no one has reached out to try and resolve the problem. They're only paying out of network or not at all. Due to both parts of this business I have recently had 2 medical bills go to collections and I didn't know it till I had my last recheck with surgeon. Anyone and anything associated with either of these places is being declined. After over a month trying to get an answer from the concierge she finally today emailed me and said she found alllll my emails in her junk folder. She said they go thru Health Smart Physician/ Ancillary Only group. So this isn't something a normal person would know and the customer reps should tell us this and also tell us if something isn't in network with them. What network is this? Man in the moon network. This guys and their concierge I was told by my union rep are out the door because I'm not the only one they've done this to. They're ruining my credit report.

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