Complaints

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.

• Initial Complaint

  Date:08/06/2024

  Type:Sales and Advertising Issues
  Status:

  ResolvedMore 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.

  The end of June early July I basically received a card for party partners in reference to me having my son and April really they said if you went to your postpartum check up you would get a gift card for $150 well it's now August the 6th that never happened I have contacted party partners several times every time I've spoken to different people they tell me the same thing oh there's a problem with the vendor nobody is getting a gift cards basically that scamming a customer you're having them they're going doing what they supposed to do and then when it's time for you to honor what you owe them you not giving it to them basically you telling people to go there the insurance company getting all this money from the doctors and women going to their postpartum when they could really kill us some going and you do all that and then they supposed to give you what you you know agree you all agreed that she was going to get but yeah you not trying to fix the issue every time you call them oh it's a problem with the vendor something need to be done about priority partners that is scamming people they need to stop lying to patients and give them what they entitled to and what they said that they were going to give the $150 gift card

  Business Response

  Date: 08/15/2024

  Ms. ******** has contacted the health plan on 8/13/2024 and was advised that ***** is experiencing a 3rd party vendor that processes the vslue based purchasing of the member's gift card. This matter has been escalated to the appropriate department to determine an ETA  in this matter 

  Customer Answer

  Date: 08/15/2024

   
  Complaint: 22101541
  
  I am rejecting this response because: I shouldn't even had to really go through you guys because of them basically lying to people getting a gift card telling them to send them a letter out once they go to their postpartum check up that they would send them a gift card then every time you call it's a problem with the system but yet nobody's trying to fix the issue
  
  Sincerely,
  
  Keyonyae ********

  Business Response

  Date: 08/19/2024

  This issue was escalated to Priority Partners leadership. As a result of this issue, the Priority Partners leadership team has approved for a gift card to be sent to the recipient for $150. The member should expect to receive the gift card in 5/10 business days.

  Customer Answer

  Date: 08/19/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  Keyonyae ********

  Business Response

  Date: 08/23/2024

  Good Morning, 

  The delay in the recipient receiving their gift card was due to an issue with an external vendor that processes these requests. The health plan after an investigation was complete discovered challenges that were faced in getting the member this particular gift card. Once the case was received it was escalated to the leadership team within Priority Partners to resolve this matter internally. At the conclusion of this investigation, it was determined that the gift card would be sent internally to resolve this recipient's complaint. We apologize for any inconvenience this recipient experienced in the delay in receiving her gift card.

   

   

  Thanks

  *** Morrison 

   

• Initial Complaint

  Date:07/08/2024

  Type:Billing Issues
  Status:

  UnansweredMore 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.

  We are a medical providers office that saw patients in a behavioral health hospital. The hospital bills ***** which is the mental health coverage for all Maryland ******** and ***** while as the medical provider we bill ******** directly or the appropriate ***. last year Priority Partners started sending retraction letters for going back to 2020 for each and every single patient we ever saw for them. So we reached out and were told to email proof ofthe visits (hospital face sheets) to a specific department by email **********************. Which we have done over and over again and received confirmation that is was all accepted and resolved. Yet we still continue to receive more letters, money actually retracted from future payments on patients where it was already stated as resolved and it is continuing to re requested over and over on already "resolved" cases and we have not received any recent payments due to this. I have tons and tons of files and emails (over 35 at this point just counting the once i have sent with the requested proof) Help!! Maryland Insurance commissioners were contacted as well but we were told they don't have jurisdiction over ******** companies.

• Initial Complaint

  Date:01/30/2024

  Type:Customer Service Issues
  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.

  Priority Partners Reference: *** *******
  
  As a recent stroke patient under the care of GBMC and Priority Partners, I've faced significant challenges in accessing timely neurological care. Scheduled for a crucial follow-up appointment on 1/29/2024, it was disheartening to find it canceled due to a lack of referral from Dr. ******** ******* at GBMC. Further complicating matters, obtaining a new referral through Priority Partners' primary care providers has proven to be a lengthy process, with months-long waits for an initial visit.
  
  This experience raises serious concerns about the efficacy of Priority Partners in managing the healthcare needs of patients relying on Federal or State programs. The delays and barriers encountered in receiving essential post-stroke care suggest a systemic issue that undermines the very purpose of such programs, which is to provide timely and adequate medical care to all.
  
  Given these experiences, it's worth questioning whether Priority Partners is equipped to effectively participate in Federal healthcare programs. If they are unable to facilitate prompt and efficient access to medical services, especially for critical follow-up care like neurology visits post-stroke, this could significantly compromise patient health and recovery.
  
  It is crucial for healthcare providers participating in these programs to prioritize patient needs and ensure that bureaucratic processes do not hinder access to essential medical services. The health and well-being of patients should always be the foremost concern.

  Business Response

  Date: 02/13/2024

  hello 

  This member complaint have been escalated to you leadership. 

  thank you 

  Business Response

  Date: 02/23/2024

  hello 

  I have tried contact the member couple of time as well left message but I was unable to reach member. I was able to obtain a copy of the members referral. 

  After conducting a comprehensive review of the complaint, it has been determined that an authorization was sent to your neurologist's office on January 29, 2024. We have been informed that you were able to reschedule another appointment. We apologize for any inconvenience this may have caused you and the office regrets the inconvenience that you may have experienced.

• Initial Complaint

  Date:12/22/2022

  Type:Product Issues
  Status:

  ResolvedMore 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 prefer to be contacted via email so I don't miss any calls. I have been trying to redeem a $50 gift card for the wellness checkup but I keep being told my member ID is not valid despite being verified and the claim going through on my doctor's end. I've been getting the runaround from Priority Partners and Blackhawk from card services. Nothing is being done to resolve this and no one seems to have adequate information on the matter so I'm thinking this is fraudulent on the part of Priority Partners to dupe patients into visiting a doctor. Last important info I was told from a representative via phone was the system was not recognizing our new member IDs. My doctor visit was November 2, 2022. I can provide you with my member ID if needed. I've called numerous times and Priority Partners tell me to call Blackhawk and vice versa. I've called both numbers on that email. Utterly useless.

  Business Response

  Date: 01/10/2023

  We are working very hard to resolve this member's issue. At the time when the gift card was requested the organization was in the middle of system changes, which created complications for our vendor to disperse the gift cards. We are working feverishly to correct the problematic glitches. We did acknowledge the member is entitled to a gift card for her successful completion of her medical care and a card will be mailed as soon as the correction has been updated. Unfortunately, at this time we do not have an ETA from the vendor, but will contact her once we have an update. We apologize for her inconvenience
  
  Priority Partners ****** Services Manager
  **********************
  

  Customer Answer

  Date: 01/11/2023

  
  ******************************* <*******************************************>
  3:18 PM (5 minutes ago)
  to Better
  
  Hello and thank you for actually getting any kind of semi-informed response from them.
  
  Is there an option to temporarily accept the response, to not have the case closed until I actually receive the gift card? I've been at this since November 2022 and if they have not worked out their issues, thus far, I have zero confidence they ever will. I also know they will not keep me informed of anything. I never requested a physical card, I selected the virtual one for faster delivery. They do not seem to be concerned about this issue.

  Business Response

  Date: 01/13/2023

  We completed a new submission for the member and will be monitoring the tracking to ensure the gift card is received. We appreciate your patience in this matter.

  Customer Answer

  Date: 01/18/2023

  (The consumer indicated he/she ACCEPTED the response from the business.)
  There were a couple of resubmissions Priority Partners did (at least one was rejected) but I finally received my reward card. I'll never use this "incentive" from Priority Partners again. Hopefully the vendor issues have truly been resolved.
  
  I tried for months to get this resolved and I know I'd still be trying be it not for the help of BBB. Thank you!

• Initial Complaint

  Date:09/14/2022

  Type:Billing Issues
  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 am a physician and have been trying to get a medication approved for a patient for the past month. The only reason I prescribed this medication is because the insurance plan mandates it prior to approving the actual medication I would like to use for my patient. It has now been over 30 days And I have faxed several forms they have asked for as well as called an uncountable number of times only to be told the same thing which is "call another number" or "we need this faxed" or "we have denied it and now you need this". Despite sending all the information several times I am now at a loss about what to do as I can't speak to a single soul that actually can help. This is a terrible situation for my patient as they are the one who is suffering and also this amount of time that is going into this which seems futile at this point is taking away from other patient care that is also crucial (and much more manageable than dealing with insurance company)

  Business Response

  Date: 11/02/2022

  Business Response /* (1000, 11, 2022/10/18) */
  RE: Caution External Email: BBB Complaint Case# ******** (Ref#XX-XXXXXXXX-XXXXXXXX-XX-XXX)
  External
  Inbox
  
  ppcustomerservice ****************************
  9:54 AM (3 minutes ago)
  to me
  
  Good morning!
  
  
  
  Thank you for your email inquiry.
  
  
  
  So that I may assist you further, please provide the details for the member that this complaint refers to and the complainant.
  
  
  
  For HIPAA verification purposes please provide the member's name, date of birth, complete address, and Priority Partners ID # and the provider/complainant's full name, complete address, NPI and/or Tax ID #.
  
  
  
  Have a great day!
  
  
  
  
  
  Regards,
  
  
  
  Lora **
  
  Correspondence Specialist
  
  Johns Hopkins Healthcare LLC
  
  **** ******* *** *******
  
  ******** ** XXXXX