My daughter got an urgent vaccine treatment at her college in Spring 2018. Later, I got a bill statement from the college heath center. But, I was told by the health center that the bill could be waived if my insurance did not cover for the service.
I then called Allied Benefit Systems for advice and confirmation of coverage. I was told by the office staff that my insurance covered this vaccine service for which I can pay first and then get reimbursement from Allied Benefit system later (there is a reference number to the call attached as a photo). As long as there are service code and diagnosis code and the amount in the bill statement, I should be able to get reimbursed. I was even provided by the office staff with their fax number for reimbursement submission - 312-261-9363
Unfortunately, I followed the Allied Benefit Systems' advice and paid for the bill out of my pocket. I then faxed the receipt together with the bill statement to the Allied office. After waiting for 2 months, the claim was rejected by the allied benefit systems because the college health center is not in the network of my insurance. Moreover, there is one sentence written under this claim by Allied Benefit Systems -"this claim has no service reason codes". This is wrong, because the service code was provided in the bill statement (see the attached photo).
I called today 8/3/2018 after receiving EOB on 8/2/2018, and spoke to the supervisor for resolving this issue. She simply said to me that the reimbursement was rejected correctly based on my insurance policy, because the provider is not in the network. I asked her why nobody told me this when I called for confirmation prior to paying for the bill which could be waived by the provider. She simply said -sorry. Then she said that her staff's advice was correct - I can pay first and later apply for reimbursement at Allied Benefit Systems. As of approval or not, it depended on my insurance policy. Nonsense! Shame on her, as a supervisor at Allied Benefit Systems. She even said to me that I should check through online and find out if the provider is in network or not by myself. This does not make any sense at all. As I know, Allied Benefit Systems always advise patients to contact the office directly if unsure the coverage of insurance for confirmation.
Apparently, she simply does not want to take this responsibility for solving my issue. She is very unprofessional as a supervisor. At this point, I could hardly saying anything but hang the phone up to end the conversation!!! What a careless staff! what an unprofessional supervisor at Allied Benefit systems!
Reason of review: Poor customer service.
Monetary Loss: $194.
Preferred solution: Full refund.