Allstate Health SolutionsP.O. 0000046966 00000 n The ******************** representatives I have talked to on the phone all say this provider is indeed in network and they supposedly to send it back to Cigna for reprocessing as well. 2023 Allstate Insurance Company. Monterey Park, CA 91755 We would need the member ID to investigate further. We have investigated this complaint and no documentation was found to support the allegation or situation. I did a **** pay for the difference. 0000005960 00000 n It is terrifying to me that this company is allowing unqualified doctors to hand out prescriptions and give medical advice. 0000001060 00000 n Visit the websites below for more information on each IPA. I have had four or five calls to service reps to make sure my claims are received and processed with no resolution except being told to send in the claims paperwork yet again. Groups. Before the visit I confirmed with Allied Health that both the provider, physician, and facility my appointment was scheduled with were in network and covered. Hb```f``Qa`e`b`@ 6 8"sF00*ii2(?c ~FNN2a`Q }#%E54>`2c-L@ ` Sl"5 endstream endobj 45 0 obj 159 endobj 17 0 obj << /Type /Page /Parent 12 0 R /Resources 18 0 R /Contents [ 23 0 R 27 0 R 29 0 R 31 0 R 33 0 R 35 0 R 37 0 R 39 0 R ] /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 18 0 obj << /ProcSet [ /PDF /Text ] /Font << /TT2 19 0 R /TT4 25 0 R >> /ExtGState << /GS1 40 0 R >> /ColorSpace << /Cs6 20 0 R >> >> endobj 19 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 122 /Widths [ 250 0 0 0 0 0 0 180 333 333 0 0 250 333 250 0 500 500 500 500 500 500 500 500 500 500 278 278 0 0 0 0 0 722 667 667 722 611 556 722 0 333 0 722 611 889 722 722 556 722 667 556 611 722 722 944 0 722 0 0 0 0 0 0 0 444 500 444 500 444 333 500 500 278 0 500 278 778 500 500 500 500 333 389 278 500 500 722 500 500 444 ] /Encoding /WinAnsiEncoding /BaseFont /GEOHMB+TimesNewRoman /FontDescriptor 21 0 R >> endobj 20 0 obj [ /ICCBased 42 0 R ] endobj 21 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2028 1007 ] /FontName /GEOHMB+TimesNewRoman /ItalicAngle 0 /StemV 94 /XHeight 0 /FontFile2 41 0 R >> endobj 22 0 obj 1449 endobj 23 0 obj << /Filter /FlateDecode /Length 22 0 R >> stream Request help with your log in, registration or other technical problems. Learn more about Multi-Factor Authentication. Mr. Unfortunately my insurance company at the time, Allied Benefits Systems refused to cover the cost even if the doctor issued a ****** of Medical Necessity and considering my age and the diagnostic of Fragile X pre-mutation carries, I understand that these tests are very common. Mail the claim form and the itemized bill to the address listed on the back of the Employee's ID card. "Your Rights and Protections Against Surprise Medical Bills". and Allied cannot get me a solution to this issue leaving the $1207.44 balance MY responsibility when it shouldn't be. Global Care IPA Health Care LA, IPA * Omnicare Medical Group Physicians Healthways Pomona Valley Medical . I have been told 10 times that I would receive a call, and have only received the call I was promised 3 times.They requested a call from my *******************, and received the call - then said their was still an issue with medical necessity. There was no way for me to know that the visit and affiliated tests would lead to a condition that wasn't covered by my insurance or that the exact same test could have led to a different diagnosis that would have been covered by my insurance. 0000012294 00000 n Monterey Park, CA 91755. This same provider/office provided prenatal care and labor/delivery services in the year 2021, and all those visits were billed through my insurance as in network. Our system records every call through our contact center. *******,We have received your complaint which is currently under review. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. This is a very serious problem. The following is applicable to all Allstate Health Solutions Short Term Medical products. Need further assistance? View reference guide for Blue Shield providers (PDF, 3.0 MB), View reference guide for Blue Shield Promise providers (PDF, 2.6 MB). Allied team members are problem-solvers, innovators and collaborators. Systems 200 W. Adams, Suite 500, Attn: NGBS Eligibility, Chicago, IL 60690 Contact Info for. There was no way for me to know that the visit and affiliated tests would lead to a condition that wasn't covered by my insurance or that the exact same test could have led to a different diagnosis that would have been covered by my insurance. Allied Benefit Systems, Inc. PO Box 90978660690 Chicago, IL 60690 Phone: (800) 2882078 Fax: (312) 9068359Medical Claim FormEmployer Information Employer Numerous NumberEmployee Information Employee. Independent Physician Associations | L.A. Care Health Plan Below you'll find contact information for our various departments. On these dates I spoke with representatives of Allied Benefit Systems after multiple denied claims through caremark for pharmacy benefits over a 2 week period. This complaint has been resolved. SEND ALL CLAIMS TO:Allied Benefit Systems, Inc. P. 0. Please have the member call our ****** Services Team. I was told by the original representative that my doctor's ****** would need to complete a prior authorization form and that they would need to mark it as urgent and my claim would be reviewed and processed in ***** business hours after I advised I only had 4 daily pills left. Elite Experience Team 866-332-1987 Email: elite@alliednational.com El Segundo, CA 90245 For billing inquiries and questions on premium payments. Additionally, during one phone call with an Allied representative, I was told that the claims would not be covered because they were billed as an outpatient hospital visit rather than an in office visit, so the answers that I am getting don't even line up. Please submit your inquiry using the form below and we will route your request to the appropriate contact. My next step would be legal action at this is a HIPAA violation as from Quest I have seen the address and through Allied a diagnosis. 0000005982 00000 n I am looking for help coming to a resolution, as the costs affiliated with this visit were unexpected even after doing my due diligence ahead of the visit. When the claim was processed, it was denied because the diagnosis of TMJ joint disorder was not covered by the plan. Fill & Sign Online, Print, Email, Fax, or Download. Please check your spelling or try another term. 100 North Sepulveda Blvd. Mailing Address. DRG Contracted Hospitals: To determine the specific claims address, please select the appropriate Employer Group from the list under the "Groups" tab.