Complaints

• Initial Complaint

  10/20/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Acct. #***** I called my insurance provider Piedmont Community Healthcare HMO and was informed that my first visit with a provider in network named **** *******, PA would be covered 100% and there would not be any cost to me. I had paid $46.22 every month for my plan. I just received a bill from 3/8/2 for $164.58. I called Piedmont Community Healthcare and spoke with ******. She stated that there was nothing that could be done about the cost because she said a representative name ***** had told me on a recorded call about the out of pocket cost for the first time visit. This is not true and was told there would be no cost for my first visit. I am a senior and I feel like I am being taken advantage of by this office. I would like this bill to be reduced to $0.00.

  Business response

  10/26/2023

  At Piedmont, we are focused on providing our members with the best possible experience in obtaining their health insurance benefits.  There is a great deal of complexity in the health insurance industry, which can cause much confusion.   Regarding this complaint, Piedmont has communicated directly with the member and addressed her questions and concerns through our internal grievance (complaints) process. The member was provided with direct contact information for Piedmont should she have any further questions or concerns.

• Initial Complaint

  08/14/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  •I gave birth 10/17/2022. •** *** *** *********** ** ********** •My son’s insurance on his father’s plan was effective 10/17/2022. •The company immediately started taking payments out of my husband’s pay check. Each claim that has been sent to this company the have denied for different reasons each time the claim comes in. The first reason was that the charges needed to be billed to the mother’s insurance and the second reason that I needed to have a pre-authorization completed prior to having my son circumcised which it is impossible to get a pre-authorization on a child whom has not even been born yet. Every time I have contacted the *********, ** office I am told that there is not a manger to speak to me because they are in meetings. Then when I request someone higher up in the chain speak with me, I am shut down and the conversation is rerouted to avoid giving me the contact information of a cooperate office professional. Myself and the OB office have been calling for almost one full calendar year to try and resolve this issue.

  Business response

  08/17/2023

  At Piedmont, we are focused on providing our members with the best possible experience in obtaining their health insurance benefits.  There is a great deal of complexity in the health insurance industry which can cause much confusion.   In regard to this complaint, Piedmont has communicated directly with the member and addressed her questions and concerns through our internal grievance (complaints) process.  The member has indicated she is satisfied with Piedmont’s response.  The member was provided with direct contact information for Piedmont should she have any further questions or concerns.

*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. ↩