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Business Profile

Health Care Referral

Carelon Medical Benefits Management

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Health Care Referral.

Complaints

Customer Complaints Summary

  • 4 total complaints in the last 3 years.
  • 0 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

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Complaint status

Complaint type

  • Initial Complaint

    Date:05/09/2023

    Type:Order Issues
    Status:
    Unanswered
    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    Answered:
    The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    Location: ******************* ********************************************************** My company has been doing with ******************* for about 1 1/2 years and they have been really slow in paying throughout the time we&#**;ve done business with them. On 1/20/23 they asked for an invoice for South City house pocket folders, and they were supposed to cut us a check upon receiving the invoice that was sent to ***********************. The agreement was that we wouldn&#**;t be able deliver the product until they payed. They were not upfront in telling us that they needed approval from administration first. We would&#**;ve not put the job in production if we would&#**;ve known they needed approval first. They have still not paid the invoice.

  • Initial Complaint

    Date:03/18/2023

    Type:Order Issues
    Status:
    Unanswered
    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    Answered:
    The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    AIM Specialty Health denied coverage stating that my routine health care service provided at *** Health Southeastern was not in the *** system and was therefore out of network. This company routinely has no penalty for denying coverage for desperate people trying to attend to their own health. The insurance was a *** exclusive network and yet they denied coverage at a *** hospital. These routine scans and blood work then led to collection and damage to my credit report. People need to understand the nefarious practices of this company and understand their rights to hold them accountable. Contract number *********.

  • Initial Complaint

    Date:11/30/2022

    Type:Service or Repair Issues
    Status:
    Unanswered
    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    Answered:
    The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    I am a physician conveying a concern that interferes with care for many of my patients. AIM specialty health makes determinations regarding insurance coverage for sleep studies. They repeatedly deny coverage even when there are clear indications based on accepted medical standards. Although they may allow for "peer to peer" review to be conducted between ordering health care providers and physicians on their staff, this process is time consuming and arduous, clearly creating further obstruction to coverage of necessary procedures. Although documentation supporting the need for requested procedures is submitted in advance of the peer to peer review, this is seemingly not reviewed in any meaningful way. There is typically an extended period during which I am kept on hold when waiting for the peer to peer review to take place. Finally, during the peer to peer review there is often a lack of either knowledge or insight, and the sense that the primary goal is to deny coverage. Although this has been a repeated experience of mine when dealing with this organization, the most recent example took place today 11/30/22 at approximately 8:45 am with ************************.

  • Initial Complaint

    Date:08/18/2022

    Type:Service or Repair Issues
    Status:
    Unanswered
    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    Answered:
    The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    My complaint is that i have been unable to get an authorization for DME **** supplies in over a year because i do not meet compliance guidelines. I currently have BCBS of Texas as my Health Insurance and buy **** supplies from AeroCare AKA Adapt Health ************ ( MY oder number is *******. MY Cpa machine was originally purchased by me and Aetna TRS Insurance 3 years ago. I won the machine. BCBS of ***** is requiring that i use machine 70% of the time- my current supplies are dilapidated - tape on headgear - i have no more filters/ nasal pillows worn out/ tubing worn out/ mask worn out. **** is uncomfortable to use. I am currenly at 65% usage and have met my coinsurance and deductible. Starts up on Sept. 2022. I own the **** and do not agree with the compliance use to get new **** supplies. Please advise ID # ************ gROUP# ******

Carelon Medical Benefits Management is NOT a BBB Accredited Business.

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