Complaints
This profile includes complaints for The Rawlings Group's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 40 total complaints in the last 3 years.
- 13 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe 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.
Initial Complaint
Date:11/25/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
Keep sending bill saying I owe for prescription of 311.04. If I had no coverage on July 8,2024 then how did it get approved by insurance 8 days later. This is the insurance fault and ******* not mine. I would like it to be resolved. This company should look into things more closely and get on insurance companies asses like the do to the American people.
Business Response
Date: 12/03/2024
This
response relates to the Complaint filed with your organization bearing #********.
Rawlings Financial Services, LLC (“Rawlings”) provides data mining and claims
recovery services to health insurance companies and administrators, including
the Complainant’s prior health insurer. As part of its work, Rawlings seeks to
recover payments which were made by its clients for prescriptions filled by a
pharmacy after an individual’s coverage with that insurer has ended. Rawlings
is contracted with the Complainant’s prior insurer to provide these services.In this instance, a prescription was
filled for the Complainant by the pharmacy on 7/8/24, after his coverage with
Rawlings’ client (the prior insurer) had terminated. Rawlings has re- confirmed
that the policy end-date was 6/30/24.
Rawlings’
client was billed by the pharmacy which filled the prescription, and it paid
the pharmacy for that prescription. Hence, the prior insurer paid for claims it
had no obligation to cover. Rawlings has correctly sought to recover the
amounts paid by the prior insurer because there was no coverage in effect at
the time the prescription was filled.
Rawlings
has sent three letters to the Complainant without any response. These letters
indicate the balance due and the various methods of providing payment,
including using the credit card portal referenced in the letters. The
Complainant is encouraged to contact Rawlings at the number provided in the
letters to discuss payment options.
We certainly regret any
inconvenience that this process may have caused the Complainant. Please do not
hesitate to let us know if additional information is needed. Thank you.Customer Answer
Date: 12/03/2024
Complaint: ********
I am rejecting this response because:
It doesn’t say what they are going to do about it they should go after *****r not me
Sincerely,
******* ******Business Response
Date: 12/09/2024
We
are in receipt of the Complainant’s response to the Complaint bearing #********.
We have confirmed that benefits were mistakenly paid on
the Complainant’s behalf after the termination of his coverage with his former
insurer, Rawlings client. The coverage end date was 6/30/24, and the Complainant
filled a prescription on 7/8/24. The Complainant is thus responsible for
reimbursing the health plan for benefits it paid after the expiration of his
policy.
As stated before, the
Complainant is encouraged to contact Rawlings at the number provided in the
letters sent to him. We will be happy to discuss with him payment options and
answer his questions.Customer Answer
Date: 12/09/2024
Complaint: ********
I am rejecting this response because:
It should have never went thru if coverage was terminated it should have been denied the refill this isn’t my payment responsibility and I’m not paying it. Insurance is at fault I knew when my insurance ended and I didn’t request this fill from *****r they do automatic fills which again should have been denied.
Sincerely,
******* ******Initial Complaint
Date:08/06/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 was in an accident in may 2024 and I am due a settlement however the railing group put a lien on my settlement and has not responded to the insurance adjuster request for the amount owed. My claim has been pending for almost 3 months due to this company. I have not received any information regarding my claim and can not move forward until this company complete the process on their end. This is cleverly frustrating and nonprofessional.Business Response
Date: 08/14/2024
Ladies
and Gentlemen:
This
communication is in response to the Complaint filed with your organization
bearing # ********. For over forty years, Rawlings has provided claims recovery
services to health insurance companies and health plan administrators
throughout the country. Rawlings seeks to recover through subrogation and/or
reimbursement payments made by the health plan for medical claims which should
have been paid by other parties, such as in the case of an accident caused by a
third party. Rawlings is contracted to provide these recovery services on
behalf of the Complainant's health plan. The health plan paid on behalf of the
Complainant medical claims that allegedly resulted, in whole or in part, from
such an accident.As
part of its efforts on behalf of the health plan, Rawlings notifies the member
of the plan’s claim. In some instances, Rawlings notifies the responsible property
and casualty carrier and provides information regarding claims for which
recovery is sought by the plan. Prior to doing so, and as was the case here,
Rawlings first obtains a signed authorization from the Complainant permitting
it to provide such information to the responsible carrier. Rawlings sent to the
Complainant the medical authorization form to be completed and a list of the
claims Rawlings intended to send to the insurer. The Complainant responded with
additional information regarding the claims and the accident in which she was
involved.
Rawlings
received from the Complainant the requested medical authorization form. On 8/6/24, Rawlings
provided the information to the property and casualty insurer. As of 8/12/24,
we understand that the Complainant will contact the property and casualty insurer
to determine the status of her accident claim with it.We certainly
regret any inconvenience or concern that this process may have caused the
Complainant.Initial Complaint
Date:07/29/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 received a bill stating I owe $695.77 (Reference #: ********) for prescriptions filled after coverage ended. I used Online order and payment at pick-up time order with ********* coverage. The prescriptions were filled 5/13/24. Coverage ended 5/3/24. Online Order would have had to get approval from ******* ******** & ********* to fill PRIOR to filling the prescription. The fill dates are when the items were filled, when did ******* ******** request approval to fill these? If ******* ******** failed to get approval to fill, this is their fault not mine. ******* ******** has a duty to get insurance providers approval and pricing PRIOR to filling the prescriptions. The demand for payment sent is conveniently vague with dates and threatening in nature for a first request. I want to see verification of ******* ******** requesting approval to fill the prescriptions along with the date. Sending me an unacceptable and ridiculous bill is irresponsible billing, they have a fiduciary responsibility as a debt collector to verify all information prior to demanding payment.
******* ******** in Evansville, IN had to get insurance approval prior to filling prescription. If they performed their responsibility as prescribed and requested and received approval prior to expiration and I showed up to pick up after expiration and then tell me the amount without coverage, I would rejected it at the pick-up time, this is ******* ********’s fault. I placed an online refill request and it took 3 days for them to fill and get approve from *********, they should have the Coverage end date from ********* and give me the full amount on my description.
I paid for the amount but I would like a refund because it is not my Fault in the first place, ******* ******** and ********* has enough time to give me the right total value of my prescription before they filled it and gave it to me.Business Response
Date: 08/08/2024
This
response relates to the Complaint filed with your organization bearing
#********. Rawlings Financial Services, LLC (“Rawlings”) provides data mining
and claims recovery services to health insurance companies and administrators,
including the Complainant’s prior health insurer. As part of its work, Rawlings
seeks to recover payments which were made by its clients for prescriptions
filled by a pharmacy after an individual’s coverage with that insurer has
ended. Rawlings is contracted with the Complainant’s prior insurer to provide
these services.
In this instance, a prescription was
filled for the Complainant by ******* ******** on 5/13/24 , after his coverage
with Rawlings’ client (the prior insurer) had terminated. Rawlings has
confirmed that the policy end-date was 5/3/24. The prescription was picked up
by the Complainant.
Rawlings’
client was subsequently billed by the pharmacy which filled the prescription,
and it paid the pharmacy for that prescription. Rawlings then correctly sought
to recover the amounts paid by the prior insurer because there was no coverage
in effect at the time the prescription was filled. Hence, the prior insurer
paid for claims it had no obligation to cover.
We certainly regret any
inconvenience that this process may have caused the Complainant. If the
Complainant had any other applicable coverage at the time the prescription was
filled, Rawlings can assist the Complainant in processing the claim under the
new coverage.Please do not
hesitate to let us know if additional information is needed. Thank you.Customer Answer
Date: 08/08/2024
Complaint: ********
I am rejecting this response because:Accroding to you "In this instance, a prescription was filled for the Complainant by ******* ******** on 5/13/24 , after his coverage with Rawlings’ client (the prior insurer) had terminated. Rawlings has confirmed that the policy end-date was 5/3/24. The prescription was picked up by the Complainant." My policy end-date on 5/3/24 and ******* ******** filled it on 5/13/24. It is 10 DAYS, they have 10 DAYS to double check my policy end-date and simply reject or cancel my request. This is on them not on me, ******* ******** needs to take responsibility on this matter. They have more then enough time to check my policy and give me the right total amount of the prescription.
Sincerely,
***** **Customer Answer
Date: 08/09/2024
Rawlings Group needs to firgue this one out, they are collecting money on ********* behalf and the problem is from ******* ********, they will have to tell ********* and ******* ******** about this problem. They are the one that send out the collection letter to collect the money. I tried to contact ******* ******** and ********* but it did not go anywhere. That's why I filed this complaint against Rawlings Group.Initial Complaint
Date:06/12/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
If I could give them "0" stars it would be a ZERO!! This company apparently contracts to investigate insurance coverage and alerts them when clients may have duplicate coverage. Some sort of 3rd party investigation. Well let me tell you they do not investigate. Kept insisting I had active coverage with **** and notified ***** of this finding. My **** was termed on 2.29.24 and ***** started on 3.1.24. After emailing them this information they continued to insist I had coverage with **** and ***** sent us a letter they were going to deny payment unless "Rawlings" cleared it up. Well it takes one phone call by me to **** to clarify my benefits were actually termed 2.29.24. When I asked what kind of investigating they did to come to the finding the policy was still active "***" did not really have any answer and deferred that it was not her job to investigate. What ended up happening is I did the work for them and they get paid by *****. Corporate America at its finest. I have filed a complaint with them and notified *****. I deserve the fee for clarifying this not Rawlings. Stay clear from this company.Business Response
Date: 06/21/2024
This
is in response to the Complaint filed with your organization bearing #********. The Rawlings Company LLC (“Rawlings”)
provides data mining and claims recovery services to health insurance companies
and administrators, including the Complainant’s health insurer. As part of its
work, Rawlings seeks to recover from providers payments which were made by its
clients for claims that should have been paid by another carrier.
In
this instance, *** ****’s prior insurer had not updated the termination date of
her policy at the time of Rawlings’ initial review. The termination date was
later updated to state 2/29/24 with her new coverage beginning on 3/1/24. It is
Rawlings’ standard procedure for coverage dates to be verified by its analysts
where possible without the involvement of the member. Rawlings’ analyst did not
follow these procedures in this case as she should have. (Rawlings has
separately re-verified the relevant coverage dates.)
The
analyst has received management counseling and retraining regarding these
procedures. Rawlings’ file has been closed. Rawlings apologizes for the
frustration and inconvenience that this process has caused *** ****.Customer Answer
Date: 06/24/2024
Complaint: ********
I am rejecting this response because: You did not do your due diligence. A simple phone call at anytime to **** would have prevented this occurring. I was able to verify my term date in March of 2024 via phone and your staff should have too. When someone does not do their job appropriately a plan of action should be presented and followed thru on. I would like to see this plan of action for said employee *** ******.Thank you in advance.
Sincerely,
***** ****Business Response
Date: 07/01/2024
We understand your
frustrations pertaining to this situation. Rawlings would like to re-emphasize
that our employee has received management counseling and retraining on this
matter. We greatly appreciate your feedback as it helps our employees and
organization improve in providing our services.Customer Answer
Date: 07/02/2024
Complaint: ********
I am rejecting this response because: It is not a resolution to the time and effort I spent doing her job. I expect restitution for the 2 hours time I spent which would have taken her 1 phone call.at 30.00 per hour as a RN you can mail a 60 dollar check to me at *** ******* ******* ***** ** *****
Sincerely,
***** ****Initial Complaint
Date:05/02/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
Received a bill stating I owe $1,219.51 for prescriptions filled after coverage ended. I used *** mail order with ***** coverage. The prescriptions were filled 7/03/23 and 7/07/23. Coverage ended 6/30/23. *** Mail Order would have had to get approval from ***** to fill PRIOR to filling the prescription. The fill dates are when the items were filled, when did *** request approval to fill these? If *** failed to get approval to fill, this is their fault not mine. *** has a duty to get insurance providers approval and pricing PRIOR to filling the prescriptions. The demand for payment sent is conveniently vague with dates and threatening in nature for a first request. I want to see verification of *** requesting approval to fill the prescriptions along with the date. Sending me a BS bill is irresponsible billing, they have a fiduciary responsibility as a debt collector to verify all information prior to demanding payment.Business Response
Date: 05/09/2024
This
letter is in response to the Complaint filed with your organization bearing #********. Rawlings Financial Services, LLC (“RFS”)
provides data mining and claims recovery services to health insurance companies
and administrators, including the Complainant’s prior health insurer. As part
of its work, Rawlings seeks to recover payments which were made by its clients
for prescriptions filled by a pharmacy after an individual’s coverage with that
insurer or plan has ended.
We have confirmed with the
Complainant’s prior insurer that its coverage ended 6/30/23. We have also
confirmed with *** that one of its retail pharmacy stores in Palm Springs filled
prescriptions for the Complainant on 7/3/23 and 7/7/23. These same
prescriptions were picked-up at that store on 7/8/23 at 3:03 pm. These were not prescriptions filled using ***
mail order. The prescriptions were filled after the Complainant’s coverage had
terminated. Rawlings’ client was then billed by the pharmacy and paid for these
prescriptions.
Rawlings will submit these claims to
the Complainant’s new carrier and attempt to obtain on behalf of its client the
reimbursement that has been sought.
We trust that this will help to resolve
the Complainant’s concerns. We certainly regret any inconvenience that this
process may have caused. Please do not hesitate to let us know if additional
information is needed. Thank you.Customer Answer
Date: 05/10/2024
Complaint: ********
I am rejecting this response because: *** Pharmacy in Palm Springs HAD TO GET INSURANCE APPROVAL PRIOR TO FILLING PRESCRIPTION. I ASKED AND THEY DID NOT PROVIDE DATE *** REQUESTED AND RECEIVED APPROVAL TO FILL PRESCRIPTIONS, OBVIOUSLY IF THEY PERFORMED THEIR RESPONSIBILITY AS PRESCRIBED AND REQUESTED AND RECEIVED APPROVAL PRIOR TO EXPIRATION AND I POCKED UP AFTER EXPIRATION, THISIS ***’s FAULT. I AM AGAIN REQUESTING PROOF OF DATE APPROVAL FROM ***** FROM *** APPROVAL TO FILL SAID PRESCRIPTIONS, I KNOW WHEN I PICKED THEM UP. DID *** REQUEST AND OBTAIN APPROVAL TO FILL PRIOR TO EXPIRATION OF ***** INSURANCE. SIMPLE QUESTION IF YOU CAN SAY WHAT TIME I PICKED THEM UP. I WILL NOT PAY UNTIL I RECEIVE WRITTEN PROOF, NOT JUST YOUR WORD, I WANT TO SEE PROOF, COMPUTER PRINT OUTS OF WHEN APPROVAL WAS REQUESTED AND APPROVED.
Sincerely,
**** ******Business Response
Date: 05/20/2024
To better address the Complainant's concerns, Rawlings will telephone the Complainant to discuss the refund process in these situations and to discuss the available information.Initial Complaint
Date:04/24/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
To Whom It May Concern:
Myself and family including two minors were involved in a car accident on 02/12/2023, Sunday on our way to Church worship. The accident was not our fault and we have come to a settlement offer with at fault driver's Insurance ******* for the amount of $50,000. We have learned that *****, through Rawlings company has a lien of $8430.12. I attempted to negotiate with the subrogation analyst assigned for this case which is ********* ******* and so far it is not successful. She is so adamant and shows no effort to work with me. I contacted and emailed multiple times and her answers are different each time. She stated that you got large amounts and more than the lien amount and the money The Rawling's claiming is not yours , it is ****** So I contacted ***** on 04/18/2024 and they stated that I don't have to pay for this amount. Hence they connected with Rawlings company in a three way with a different analyst and they provided a supervisor name and I emailed the supervisor Gavin on 04/18/2024 but I haven't heard back from the supervisor, but ********* called me on 04/18/2024 and stated that the supervisor answer will be same as mine and there won't be any benefit reaching out to him. I have cited to GA law - O.C.G.A. § 33-24-56.1(b)(1) but she hasn't responded for that citation.
I don't have ***** health insurance anymore and we believe it is not fair to collect these amount from the offered settlement amount. Hence we do request hereby to have some one from The Rawlings company conduct a research on the subject and provide us a resolution,
Sincerely
**** ******** * ***** ********* ******* ******** *** ********* *********Business Response
Date: 05/03/2024
Ladies
and Gentlemen:This
communication is in response to the Complaint bearing * *********
For over forty years, Rawlings has provided claims recovery services to health
insurance companies and health plan administrators throughout the country.
Rawlings seeks to recover through subrogation and/or reimbursement payments
made by the health plan for medical claims which should have been paid by other
parties, such as in the case of an accident caused by a third party. Rawlings
is contracted to provide these recovery services on behalf of the Complainant's
prior health plan. The health plan paid on behalf of the Complainant and his
family members medical claims that allegedly resulted from such an accident. The
Complainant has requested that the health plan waive its claim with respect to
any settlement from the at-fault party’s insurer.
In April, Rawlings participated in at least 3 phone calls with the Complainant
(or a family member) and exchanged an e-mail. It has been explained to the
Complainant that because the health plan is a self-funded ERISA qualified plan
Georgia state law is pre-empted and does not apply. Rather, federal law and the
language of the health plan controls. The health plan which provided benefits
specifically provides the plan with the rights of recovery being pursued. Based
on upon the information gathered to date by Rawlings pertaining to the accident
and the resulting claim with the insurer for the at-fault party, waiver of the
health plan’s claim is not agreeable.A member of Rawlings’ management
team, *** ***** ******* will contact the Complainant to attempt to resolve this
matter. Despite statements in the Complaint to the contrary, *** ****** has not
received any communications to date from
the Complainant. (*** ****** can be contacted at ************.) We look forward
to working toward a resolution and certainly regret any inconvenience or
concern that this process may have caused the Complainant.Initial Complaint
Date:04/11/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 had been seeing a doctor since 2019 every month it's from my injury that I got put on disability I have a dramatic brain injury and then I had an automobile accident April 21st 2023 and I went to thieves chiropractic only and they never build nobody or nothing and you could see the disbursement check cheat that only thing chiropractic got 39.37-38 in money Rollins company said that signal paid money on my automobile accident ***** is my health insurance they did not pay a dime and I've been trying to contact them since January 2024 and they will not reply I've said five letters and I have proof that they received them I've emailed several times The specialist name in the letter that you were getting a copy of ***** ******* and she will not reply at all I spoke with left a message with her supervisor ******* **** at ************* I've called ***** insurance my health insurance spoke with ***** have a reference number of **** of my complaint and my question if they paid and he says they have never paid a dime on my automobile accident they have only paid injuries medical bills that I received from my traumatic brain injury but they will not reply and I need your help please better visit you I've read their reviews and everything and they've done this to several people and they're in Lagrange Kentucky could you please helpBusiness Response
Date: 04/19/2024
This is in
response to the Complaint filed with your organization bearing #********. The Rawlings Company LLC (“Rawlings”)
provides claims recovery services to health plans, including the Complainant’s
insurer. It is our understanding that the Complainant may have been involved in
an accident. In some cases, many insurance plans have a claim to be reimbursed
for the benefits it paid on behalf of the member as a result. Rawlings was also
informed that the Complainant was represented by counsel with respect to his
accident.
The Complainant’s
attorney was notified of the insurer’s potential recovery claim. In response,
counsel requested an itemization of claims paid on behalf of his client. Such a
listing was provided, and counsel sent a check to Rawlings.
Subsequently, the
Complainant contacted Rawlings. After discussing the matter with the Complainant,
Rawlings has agreed to refund the monies it previously received. Rawlings is
processing this refund and will mail the proceeds to the Complainant.
We certainly
regret any inconvenience that this process may have caused.Customer Answer
Date: 04/22/2024
Complaint: ********
I am rejecting this response because:
Sincerely,
*** *****Initial Complaint
Date:03/26/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
5 months after picking up a prescription I received a demand from Rawlings Financial for an amount due. It would appear, after the expiration of my coverage with ****** *** errantly billed the old insurer. Rawlings, in the name of ***** *it appears* now is claiming I owe a balance of money resulting from coverage they provided to ***, something which occurred when I no longer was a member. Essentially the long and short is that they are saying I shouldn't be covered because I'm was no longer a covered member, but also since I once was a covered member I need to pay for their error. The real issue is that the amount being demanded is significantly more than the amount I would have paid *** cash on the day of pickup.
I am more than happy to have to pay a balance to *** for the amount that should have been due and would also consider paying ***** directly with admission of error on their part and clear indication that this isn't a "settlement" and that you aren't doing me any favors - something which Rawlings seems to be implying. In a detailed call with ***** - who apparently has contracted with Rawlings, ***** was unable to see any balance due and also unable to provide any support for the amount despite 3 way calls both with my former employer who provided ***** as well as with Rawlings itself.
It would appear that Rawlings, under threat of credit harm, is trying to collect on a debt which they do not own, while the owner is telling me that there is no debt at all. At this point Rawlings, using the language "settlement," offered to take 50% off the balance, which is about what we would have paid to *** had the error not occurred, however I have become extremely distrustful of what is going on and have no interest paying Rawlings, a company I have absolutely no relationship with. I have also filed notice with the Virginia Bureau of Insurance as the way this is being handled and detail (complete lack thereof) provided obviously is not in line with the laws here.Business Response
Date: 04/05/2024
Ladies and
Gentlemen:
This letter is in response to the
Complaint filed with your organization bearing #********* Rawlings Financial
Services, LLC (“Rawlings”) provides data mining and claims recovery services to
health insurance companies and administrators, including the Complainant’s
prior health insurer. As part of its work, Rawlings seeks to recover payments
which were made by its clients for prescriptions filled by a pharmacy after an
individual’s coverage with that insurer has ended. Rawlings is contracted with the
Complainant’s prior insurer to provide these services.
In this instance, a prescription was
filled for the Complainant after his coverage with the prior insurer had
terminated. Rawlings’ client was subsequently billed by the pharmacy which
filled the prescription, and it paid the pharmacy for that prescription. Rawlings
correctly sought to recover the amounts paid by its client because there was no coverage in
effect with the prior insurer at that time. Hence, the prior insurer paid for
claims it had no obligation to cover. (The prior insurer’s system would not
reflect the recovery efforts of Rawlings in this regard.)
Rawlings properly mailed to the
Complainant’s address letters detailing the claims paid by the prior insurer after
the recorded termination date of the health policy. These letters correctly included
the amount paid by the insurer and the date the prescription was filled. Rawlings
has previously spoken by telephone with the Complainant.Rawlings will not send any
additional letters to the Complainant related to this matter. We certainly regret any inconvenience that
this process may have caused. The Complainant is certainly welcome to telephone
Rawlings to again discuss the details of this matter. Please do not hesitate to let us know if
additional information is needed. Thank you.Customer Answer
Date: 04/05/2024
Complaint: ********
I am rejecting this response because:
I have CONFIRMED with the previous employer - who is trying to now return the premiums to me - that premiums for the period covering the prescription and November were in fact withheld from my paycheck paid! Rawlings and apparently ***** who has contracted them is welcome to confirm with ******** ****** that premiums were in fact withheld from my paycheck and thus ALL of the previous error documented above are further made moot by the fact I had paid for full coverage anyways. In a phone conversation with ***** that ultimately was expanded to include both Rawlings and the previous employer ***** confirmed they could see no balance due.
I don't doubt that these issues often involve consumers upset, but also in the wrong....that is not the case here and I encourage interested readers to be aware that this company is actively attempting to demand something and causing tremendous hassles that they ultimately are not entitled to and will not get. The response above from Rawlings though typed matter of factly is both ethically and now objectively false. I will not be pay $1,000 for a $500 medicine after I already paid $600 in premiums for for coverage for the period in question and paid my appropriate share of $40 at time of pick up (Even though we never intended to pick up the medication.) It would serve Rawlings well to actually confirm the facts before attempting to bully and grab cash. The issue has been forwarded to the *** ****** of Insurance for examination on multiple accounts.
Sincerely,
***** *****Business Response
Date: 04/15/2024
Rawlings has re-confirmed
with the prior insurer that the termination date of the Complainant’s coverage
was in fact 10/31/23. Hence, there was no coverage in force through the prior
insurer when he filled a prescription on 11/3/23, and Rawlings correctly sought
to recover the amounts paid by its client. (As stated in the previous
response, the prior insurer’s system would not reflect the recovery efforts of
Rawlings.)
The timing and manner of
paycheck withholdings by the Complainant’s previous employer is likely an issue
to be resolved between the prior employer and the Complainant.Initial Complaint
Date:03/25/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
Rawlings Financial services is acting as collection agency and is charging me for prescriptions bills that does not exist. I contacted pharmacy and insurance agency and they do not have record that these debt exist.Business Response
Date: 04/04/2024
Ladies and
Gentlemen:
This letter is in response to the
Complaint filed with your organization bearing #********. Rawlings Financial
Services, LLC (“Rawlings”) provides data mining and claims recovery services to
health insurance companies and administrators, including the Complainant’s
prior health insurer. As part of its work, Rawlings seeks to recover payments
which were made by its clients for prescriptions filled by a pharmacy after an
individual’s coverage with that insurer or plan has ended.
In this instance, Rawlings confirmed
that a prescription was filled after the Complainant’s coverage with the his prior insurer
had terminated. Rawlings’ client, however, was billed by the pharmacy, and it paid the
pharmacy for that prescription even though there was no coverage.
On or about 3/19/24, Rawlings mailed
to the Complainant’s address a letter regarding the claims paid after the
recorded termination date of the health policy. There was no response from the
Complainant until this Complaint.
Rawlings made a proper request regarding prescriptions filled by the Complainant. Rawlings, however, will not
make any further outreach to the Complainant related to this matter and will
close its file regarding this pharmacy claim.
We trust that this will help to resolve
the Complainant’s concerns. We certainly regret any inconvenience that this
process may have caused. Please do not hesitate to let us know if additional
information is needed. Thank you.Initial Complaint
Date:03/25/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 received a letter from this company over 6 weeks ago stating that I owed them a bill on behalf of ****** **** for a COVID-19 vaccine. At that time, I called the pharmacy that administered the shot and discovered that they had incorrectly billed my previous insurance, as I did not have insurance at the time of the shot, and that's what was still in their system. The pharmacy took the additional steps to complete a request for the billing to be reversed, since these shots are provided for free by the government.
I immediately called Rawlings and told them this. I also let them know that the pharmacy said their paperwork stated it could take up to 12 weeks for this to be fully processed.
on March 19, 2024 I receive yet another bill from Rawlings Financial Services stating that I owe them/their client money that I do not owe them. They have already been made aware of this situation, and that I do not owe them a single penny. Yet they will not stop harassing me for money that they are not owed. I am printing a letter right now to send them demanding that they never contact me again or I will explore my legal remedies for their harassment and the nuisance they are knowing causing over a bill they already know that I do not owe.Business Response
Date: 03/29/2024
This
message is in response to the Complaint filed with your organization bearing #********.
Rawlings Financial Services, LLC (“RFS”) provides data mining and claims
recovery services to health insurance companies and administrators, including
the Complainant’s prior health insurer. As part of its work, Rawlings seeks to
recover payments which were made by its clients for prescriptions filled or services
provided by a pharmacy after an individual’s coverage with that insurer or plan
has ended. As noted in the Complaint, the Complainant’s pharmacy billed his
prior insurer at a time when he did not have coverage. Rawlings’ client was
nonetheless billed by the pharmacy and paid for that service. Repayment of this
amount was therefore sought on behalf of the prior insurer.RFS mailed to the Complainant’s
address two (2) letters regarding one claim paid after the recorded termination
date of the health policy. Each letter provided instructions on the different
methods by which the matter could be resolved.Rawlings has confirmed that the
claim has now been reversed by the pharmacy, and no amount is due and owing by
the Complaint. Rawlings is sending a letter to the Complainant to confirm that
its file on this matter is now closed.
We trust that this
will help to resolve the Complainant’s concerns. We certainly regret any
inconvenience that this process may have caused. Please do not hesitate to let
us know if additional information is needed. Thank you.Customer Answer
Date: 04/01/2024
Complaint: ********
I am rejecting this response because I specifically stated that I want all of my information permanently deleted from this fraudulent bill collectors system, with confirmation of that deletion. Although the response admitted that I in fact own them nor their client anything, they very intentionally did not address thus demand - despite also stating that they are a data mill, and now have all of my personal contact data for no reasonable or legal purpose.
Sincerely,
****** ******Business Response
Date: 04/08/2024
Rawlings properly sought recovery for the amount paid by it’s
client at a time when the Complainant had no coverage. Once confirmation was
received from the pharmacy that the claim had been reversed, Rawlings mailed to
the Complainant a letter stating that the audit had been closed and no refund
was due. This letter was dated 3/28/24.Rawlings cannot to permanently delete the Complainant’s information
as requested. Rawlings is required to maintain the information it has pertaining to this
audit in order to meet contractual and administrative requirements. As a
Business Associate to the Complainant’s prior insurer, Rawlings will securely maintain
and safeguard this information, as well as limit its disclosure, as required by
HIPAA.
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