Coventry:

[policy doctor]

I thought I would start a new thread specific to Coventry sales, claims, problems,, etc. THis way we all can pitch in to share our experience with this particular compay.

Watch those Part D claims!! I had a client call me because her prescription claims were not being processed, even after 3 separate mailings, phone calls,( including a certified receipt proving she sent something to them). By now these claims are 5 months old.

Bottom line: they had sent her a form with an address to San Antonio, Texas for processing. Problem, TX handles commercial accounts.

Individual claims should be sent to Phoenix, Arizona. The brain-dead over there never bothered to research her ID # and forward to the appropriate place.

Ask them to send you a couple claim forms..keep in your file as needed.

 

[midwestbroker]

In Kansas City, they have gotten some bad press over claims as well, but for medical procedures. One hospital here has a lawsuit against them for unpaid claims.

But I have talked to the Medicare sales director out here and he said that all the plans are designed and pretty much maintained at the local level. Kind of like BCBS, there is BCBS of Kansas and BCBS of Kansas City, same mothership, different management.

 

[Crabcake Johnny]

Have an extremely good friend of mine on the group side of things who will no longer sell them. Too many unpaid claims and failing to authorize treatment for illnesses. He claims in MD it's apparantly they are trying to under-cut the competition in rates yet are making up for it on the claims side.

 

[maryjd123]

I have had no complaints here in wyoming as of yet with claims

keeping my fingers crossed

 

[policy doctor]

Whew...i've been trying to fax in apps all day today.....with Coventry lines busy all the time !! Anyone else have this experience?

I even got alternate #'s......at this point, would it be better to just mail in the suckers..... Any tips would be appreciated.

Guess they're just jammed .....

 

[maryjd123]

Hey Doc

i do all of mine online at the website

its much easier

 

[sman]

Whew...i've been trying to fax in apps all day today.....with Coventry lines busy all the time !! Anyone else have this experience?

I even got alternate #'s......at this point, would it be better to just mail in the suckers..... Any tips would be appreciated.

Guess they're just jammed .....

I'm with mary, I do my enrollments online.

 

[policy doctor]

Well./....I was never told I could enroll clients online.

Good to know. And just shows why this forum is so needed.

Looks like the FMO was derelict in this dept, but thanks to the respondents.

When i called Coventry, it took 3 reps and 3 diff depts to give me the link. LOL....hope their claim handling is better.

 

[midwestbroker]

Ask North Kansas City Hospital. They have a $5 million lawsuit against them for unpaid claims.

But people love the $0 premium they have out here...

 

[policy doctor]

Coventry is wearing me down with their mishandling of my clients' advantra rx.

Since my last post about the 3 reps, let me add I spoke to another 5. Nobody seems to know anything, the claims are not in the system, they have been mailed to 2 different addresses, (1 in TX, 1 in Az) plus I just faxed in claims yesterday to Penn as requested by another rep.

Today, nobody knows anything, . I even asked to speak to someone higher up, and when she started that the claims needed to be mailed to San Antonio, (which is where they were mailed...certified, receipt request in front of me),I blew my cool.

I'm ashamed to say that I asked if they were hiring the mentally disabled for tax credits, instead of being concerned for the client. I'll prob get s*** canned. Called Mutual of Omaha also, and left message for their Part D coordinator to call me...which he hasn't yet.

Spoke with Medicare, and they informed me 'THIS IS NOT UNUSUAL" . What????

Seems they are having problems with all of them on timely claim filing. So folks, wishing you a claim free year.