Complaints

This profile includes complaints for Detego Health's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Detego Health

  2301 N 117th Ave Ste 200 Omaha, NE 68164-3484

• 

  Detego Health

  759 N 114th St #300 Omaha, NE 68154

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:05/08/2025

  Type:Billing 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 signed up with Detego Health on April 16 and I am in the waiting period of 30 days to May 16. I can no longer afford the insurance and need to cancel. I called to cancel and they tried to keep me in the insurance. I cannot afford it.
  
  I paid $618.00 on April 16, 2025. We are in May now and I cannot afford the insurance monthly which will be $518.00 a month. I need to cancel the insurance.

  Business Response

  Date: 06/03/2025

  *** ********

   

  First
  and foremost, I sincerely apologize for the delay in our response. For some
  reason, we have not been receiving notifications from the Better Business
  Bureau when complaints come in as of late. In addition, I am sorry that you
  were kept on your plan when you called and attempted to cancel. We have issued a refund on the premium.

  Customer Answer

  Date: 06/03/2025

   
  
  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 although I have not seen a refund yet.
  
  
  
  Sincerely,
  
  
  
  ***** *******

• Initial Complaint

  Date:04/21/2025

  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.

  They failed to pay my emergency room bill claiming it was during the waiting period, even though the waiting period clearly has an exception for emergency services. They were all incredibly rude when I spoke with almost anyone on the phone and had no knowledge of what providers my policy covered, even claiming covered providers were not covered and stating it was my responsibility to confirm it. However, I was right. Every provider I went to was listed as a covered provider. They were wrong.
  Whenever I said they got something wrong, they blamed someone else and said we must have spoken to the wrong department. But if it was the wrong department, why not tell us instead of giving false information to my and the providers' detriment.
  
  They also at one point, claimed they weren't an insurance company. The amount of lies, misinformation, and rudeness they provided was out of hand.

• Initial Complaint

  Date:04/18/2025

  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.

  My daughter fell and needed emergency services on 12/15/24. We were seen at ******** ******* ****** ** and transferred to **** ** that same day as care needed to be escalated to ****** orthopedic team. We were transported via ambulance per the physicians request. Since, we have been receiving numerous medical bills (>$9,000 thus far and these do not include all medical claims still pending which Detego Health told me they are denying ALL of these claims as well). Detego Health has denied every single claim processed thus far providing zero coverage with their reason being "out-of-network". After endless hours of calling Detego Health, one agent admitted
  that both providers (******** ******* ****** *** ****) are in fact in-network. The member portal provider directory also lists both facilities as in-network. They asked that an appeal be submitted. The appeal was submitted, and again denied .I called Detego Health and requested to speak to a supervisor. She again told me the claims were denied due to OON. I asked her to look up if Detego Health is in-network with **** and ******** ********* ******). She said **** is in-network but she can not tell me if ******** is in-network. I told this supervisor that her employee confirmed that it is in-network on my last call. I asked her to go back and listen to the conversation as she admitted they are recorded. She then tried to come up with several other reasons to not cover the claim. None of these reasons were listed in the denials. The one reason listed was "out-of network". Another excuse given by the supervisor was that our coverage doesn't go into effect until 1 year after securing insurance. I advised the supervisor that this was an emergency visit which is covered immediately under the policy. She then continued to come up with other reasons/excuses to not cover any portion of the bills.

• Initial Complaint

  Date:04/08/2025

  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.

  I have contacted Detego Health member services on multiple occasions: 1/15/25, 1/17/25, 2/27/25, 3/4/25 & 4/8/25 to resolve issues as a result of their errors.
  Detego continues to deny payment of my claims because they state I am not enrolled in their health plan.
  Yet verified on each call that I am a member & all premiums were paid in full from my account in advance of each billing month-no issues with Detego taking my money. Detego continues to reject payment of my claims.
  
  I have two claims date of service 11/20/24 & 12/24/24 that are still being rejected. Please note I’ve been enrolled in this plan from 1/1/24 to 12/31/24. All of my claims were processed business as usual until ~9/27/24.
  
  Detego states they have escalated internally with the billing department, but yet I can’t speak with anyone directly in billing. I spoke with a supervisor named Adam on 2/27/25 & he promised he’d work directly with billing & then get back to me. Never heard from him.
  
  In addition, I contacted NaviClaim on 1/27/25 & on other occasions & it goes directly into a voicemail box, yet I have never received a return phone call. (Billing)
  
  The Detego care team has also been on the phone with my medical providers & me on multiple occasions confirming coverage & sending emails confirming my coverage and yet to date, claims are still unresolved. My medical providers have been forced to resubmit claims multiple times.
  
  Meanwhile, I’m locked out of their web portal with no access to my 2024 information, which I believe is against the law. I’ve had no way to follow the status of any items related to my claims.
  
  Can you help in getting my claims paid &
  hopefully make others aware of this TPA’s (Detego) business practices.
  
  Unfortunately, my insurance rep did not make me aware that a TPA/Detego manages the billing & claim process.
  Again, this has been Detego’s error & lack of true action at every turn.
  
  Thank you!

• Initial Complaint

  Date:03/26/2025

  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 have contacted Detego many times since February 11, 2025, to try to get information on when
  Claim #139919 will get paid to my provider (Breast Care Specialists, LLC) for a November 7, 2024 date of service at Breast Care Specialists, LLC. ***** ******* shows that Detego is supposed to pay Breast Care Specialists $873.00. Breast Care Specialists called me on February 11, 2025 and said that Detego was refusing to pay the claim. ***** ******* has shown in my Detego Member Portal as "pending funding" for many months. I called Detego on February 11 and talked to ******** who told me it should be payed by the end of February. Then I talked to a lady at Detego on February 14 who said it would be payed in the middle of February and that the claim was being escalated. On February 14, I received a bill for $873.00 from Breast Care Specialists. On March 10, 2025, I received the bill again from Breast Care Specialists for $873.00. On March 11, 2025, I talked to J****h D. at Detego; he said that he was "expediting" the claim and that it would get paid during that week. Nothing happened. On March 17, I talked to ********* at Detego, and she said that it would get paid in two or three weeks and that she had no record of it being "expedited." On March 17, 2025, I then got my insurance agent to *** ** ******** *** *** *** ******** ** ***** ***** ** *** ****** ** **** ******** *** **** ******* ** ***** *** * ****** ** ****** ** ***** *** ** ***** *** **** ******** *** ***** **** ** *** ** *********** ** ****** ** ***** *** * ****** ** ****** **** *********** ** *** ***** ****** *** **** **** ** ***** **** ** ** *********** * ** ***** *** ***** * ****** ** **** ** ****** *** *** ** ********* ** ** ***** *********** ** ****** ** ****** **** *** ** ******* *********** ** ********** ** *** **** ***** **** ** *** *** *********** *** ***** ****** ********** ** ****** **** **** ** ********* *** ** ******** ******** *** ***** **** ** *** **** ** *************

  Business Response

  Date: 03/28/2025

  Please see attached.

  We thank the Bureau for calling this issue to our attention. We sincerely apologize for any frustration or inconvenience Ms. ***** has experienced, and we appreciate the opportunity to address her complaint. Upon reviewing the case, our Claims Director notified me that a check in the amount of $878.78 was actually issued to Breast Cancer Specialists at 975 Johnson Ferry Road, Suite 500, today (March 28, 2025). I hope this resolves the issue Ms. ***** has been dealing with.

  We are committed to ensuring your satisfaction and maintain the highest standards of integrity. To prevent similar issues in the future, we encourage you to refer to the welcome materials or contact our Claims Administrator directly for any billing or claims-related matters. If you have any additional questions or require further assistance, please feel free to reach out to the Claims Administrator at [email protected], and they will be happy to assist you promptly.

  Once again, we apologize for the inconvenience and thank you for bringing this matter to our attention. We value your membership and are dedicated to resolving any issues to your satisfaction.

  Sincerely,

  ****** ******
  
  ***** ******** ********** **********
  
  ****** ******
  
  *****************************
  
  ***** ********
  
  ***** *** ****
  
   

• Initial Complaint

  Date:03/15/2025

  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.

  On May 6, 2024, I had a mammogram performed at the ***** **** ********* ****** in Brooklyn, NY. The procedure is covered 100% under my insurance plan with no deductible.
  I gave them my insurance information to send the bill to:
  
  DeTego Health
  ** *** ****** Eagan, MN 55121
  
  The insurance did not pay the bill, and I was sent the bill for $986 on 9/26/24
  On 10/9/24 I called the provider ***** **** ********* and gave them the insurance information a second time.
  
  The bill was still not paid, and was sent repeatedly to my home.
  Then ***** **** ********* took me to collection.
  
  On 3/7/35 I called ***** **** ********* and gave them the insurance information for what I believe to be the 3rd time. They said that they would resubmit the bill but that it keeps coming back "ineligible". We are not ineligible because we pay our insurance every month. It's always paid on time because the bill payment is automated.
  
  On 3/13/24 I got the email address of the claims dept at DeTego Health and emailed them the date of service, the amount of the bill and the ***** **** ********* account number. They requested a copy of the bill and I emailed it to them.
  
  They replied on 3/14/25
  "There is no claim on file for dos 5/6/2024, please contact the provider to send claim to:
   
  Detego Health
  ** *** ******
  Eagan, MN 55121"
  
  I have already contacted the provider and given that information 3 times with no success in having the bill paid.
  
  The provider said that they would re-submit again when I spoke with them on 3/7/25, however at this point, I am sorry to say that I believe that DeTego Health is deliberately avoiding paying this bill, which is their responsibility.
  
  The collection agency has begun calling my home and harassing me.
   
  Please ask DeTego Health to pay this bill for $986. It is completely their responsibility.
  ***** **** ********* Account #************
  Date of Service 5/6/24
  
  Thank you.
  
  DeTego Health contact ****************************************** ************

  Business Response

  Date: 03/20/2025

  Good morning! We are unable to find anyone in our system with this name or phone number. Are you able to provide the last name or Member ID of this individual, so that we can accurately respond to this complaint? Please get back to me at your convenience!

   

  Best,

  ****** ******

  Legal Business Compliance Specialist

  Customer Answer

  Date: 04/03/2025

  Complaint: ********
  
  I am rejecting this response because:
  I do not trust DeTego Health to pay the bill. 

  DeTego Health says that they never received the bill.
  However the bill was sent to them multiple times by ***** **** *********. I find the DeTego Health story hard to believe. 
  The address that DeTego Health says the bill must be sent to is the exact address on the back of the insurance card.
  The address was given to the ***** **** ********* at least three times.
  On 5/6/24, the date of service, the address was given to ***** **** *********, by giving them the insurance card
  On 10/9/24 I gave all this information to ***** **** ********* again, over the phone. They said they would re-submit the bill to DeTego Health. Indicating that they had already submitted it once.
  On 3/7/25 I spoke again to ***** **** *********, and they said that DeTego Health keeps saying that there is an "eligibility issue" - again indicating that DeTego Health was well aware of the bill. 
  So the bill seems to have been submitted to DeTego Health multiple times, and they are either choosing not to pay it, or they are completely incompetent. 

  Meanwhile, I have been sent to collection over a bill that I am not responsible for, since this is a mammogram and is 100% covered.
  Now that I have filed the complaint with the BBB, DeTego Health is finally acknowledging the bill.
  For that, I thank the BBB. 

  ********* ********************, who I am guessing is the DeTego Health Claim processor, requested a copy of the letter from the collection agency, ******** ********** ************
  I emailed that to them, and they have now responded
  From: ********* <*******************

  Sent: Tuesday, April 1, 2025 1:35 PM
  To: ** *************** *******************>
  Subject: RE: Complaint for Reimbursement Member ID: *********
  
  Hello,
  
  We have reached out to ****** **** ********* on 3/18/2025 and was advised they had the wrong claims mailing address.  We provide the correct information and was informed it would take ****** **** ********* 30-45 days to submit the claim.  As of today, no claim has been received by the provider.
  
  I also called ************ - ******** ********** ***********, spoke with ****** advised I contacted ****** **** ********* on 3/18/2025 and provided insurance and claims mailing address since wrong info was on file, advised ****** ****** **** ********* said it would take 30-45 days to receive claim.  She stated that she will put this into an insurance billing status.
  
  Thank you,
  
  *********
  Member Advocate
  
  *** *** ****
  info@*********.com
  *************
  **** ***** ***** **** *** *** ,  Omaha ,  NE ,  68164

  It is unclear why it took DeTego Health almost a year and a complaint with the BBB to begin to process this claim. 
  I do not trust them, even now, to pay it. 

  I thank the BBB for their help in this matter. 
  Truly you are a blessing. If not for the BBB, these businesses might never feel compelled to address customer inequities. 

  They claim it will take 30-45 days to receive the bill, and there is no promise of how long they will take after receiving it to pay it, or whether they will simply lose it again. 
  I request that you keep the complaint open until the bill has actually been paid, which apparently could be at least another 60 days.

  
  Thank you so much.

  Business Response

  Date: 04/10/2025

  As you can see from the screenshot on our previous response, we have not received the claim. Please have it emailed directly to me at ***************************** or to our office address at **** * ***** **** *** ***, Omaha, NE 68164. We will get the refund issued once it is actually received.

• Initial Complaint

  Date:03/13/2025

  Type:Billing Issues
  Status:

  UnresolvedMore 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 writing to formally lodge a complaint against Detego Health regarding deceptive business practices related to their health insurance coverage. When I initially spoke with their recruitment manager, I was assured that my medical and prescription needs would be covered under their plan. We specifically discussed my current medications, and I was explicitly told they were included in the coverage. Additionally, I was informed that procedures such as a colonoscopy were part of my benefits. However, after enrolling in the plan and paying a monthly premium of $483, I discovered that neither my prescription medications nor the necessary medical procedure were actually covered. When I contacted Detego Health for clarification, I was met with indifference—no apology, no explanation, and no attempt to resolve the issue. This misleading representation of services forced me to cancel my plan, leaving me without the coverage I was led to believe I had. I find this practice to be unethical and unacceptable, as it preys on consumers seeking reliable healthcare coverage. I am requesting that Detego Health be held accountable for their deceptive sales tactics. I urge your office to investigate this matter and take appropriate action to prevent other consumers from facing similar issues. Additionally, I would appreciate any guidance on further steps I can take to formally escalate this complaint. Thank you for your guidance. Respectfully, **** ******** 

  Business Response

  Date: 03/26/2025

  Please see attached.
  We thank the Bureau for bringing this issue to our attention. We sincerely apologize for any frustration or inconvenience Ms. ******* has experienced, and we appreciate the opportunity to address her complaint. Upon reviewing the case, we were unable to obtain any information surrounding the specific prescription medications Ms. ******* was interested in having covered. However, we did find two claims made in February 2025:
  
  • ***** ****** *** ** ****** *****
  * ***** ****** *** ******** ****
  
  Based on Ms. *******’s plan, the payments would come out to $121.12 and $142.64, respectively. If the member wishes to obtain a full refund, we will need to deny these claims. If the member wants these claims paid, we will then need to deduct $263.76 from any premium refunds. Ms. ******* is free to choose between these options, and we are willing to fully comply with the decision reached.
  
  We are committed to ensuring your satisfaction and maintaining the highest standards of integrity. To prevent similar issues in the future, we encourage you to refer to welcome materials or contact our Claims Administrator directly for any billing or claims-related matters. If you have any additional questions or require further assistance, please feel free to reach out to **** ***** ** *************************** ** ** ***** ********, and he will be happy to assist you promptly.
  
  Once again, we apologize for any inconvenience and thank you for bringing this matter to our attention. We value your membership and are dedicated to resolving your issue to your satisfaction. 
  

  Customer Answer

  Date: 03/26/2025

   
  
  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,
  
  
  **** *******

  Customer Answer

  Date: 04/14/2025

  Dear BBB Team, This message is a follow-up to my previous complaint regarding Detego Health, to which they initially responded by agreeing to issue me a refund. Unfortunately, since that response, I have not received the refund, nor have I received any communication from **** ***** ** ****** ** ******* ** *** *** **** **** ***** ****** *** * **** ******* *** ******** ***** **** ** ****** ** ** ***** **** ****** *** ****** ** ***** ***** ********** *** *** ********** ******* ** ******* ** ******* ***** * ** ********* ************ ** ***** **** ** ********* *** *************** * ************ ******* **** **** ****** ** ***** ** ** ******** ********** ** * ******* ****** ******* ** ** ***** ** *** ****** ******* *** ******** ************ ***** *** ***** *** **** **** *** ******** ********** **** ******* ***** ********

• Initial Complaint

  Date:02/25/2025

  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 have been YANKED around by 5 different entities, all passing the blame on someone else. This company is doing everything in their power to falsely decline claims with reasons that cannot be classified as anything other than LIES. This has been a full-time job to follow up with this SCAM attempt, and they are currently dodging all of my communication because they have been caught in several lies. They are only hoping that the average person would have given up by now, but I am not your average person. They have declined 3 claims for my infant using 2 different reasons which have all been debunked. Again, they just want me to get tired and go away. They need to be shut down or at the very least, attend integrity training.
  
  Claim ****** * *** ********** – charge 273.62
  
  Claim ****** * *** ********* – charge 168.62
  
  ***** ****** * *** ********** – charge 150.00

  Business Response

  Date: 03/06/2025

  Response is attached.

• Initial Complaint

  Date:02/20/2025

  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 purchased health insurance coverage through a broker under First Health Network, a product of Detego Health. My activation date was 12/9/2024 for a family of 6. On 2/2/25 i was injured in a ski accident and need to have surgery to repair my ACL. My policy clearly states that outpatient surgery is covered and I am responsible for 1,500 up to a max of 4,500 there is a clause for pre-existing conditions of a 12 month wait period. Detego health is stating that there is a 12 month wait period on any surgery need regardless of pre-existing status. My healthcare broker representing “First Health Network”, is stating that that is false and it only applies to pre-existing conditions. The brochure of benefits sold to the health broker and now myself and my family states this nowhere. Detego is refusing to cover and refusing call backs.

  Customer Answer

  Date: 02/24/2025

  HI just updating the status.  Apparently they accidentally cancelled my plan, but the bigger issue still exists.  They are stating that they have a 12 month waiting period for some surgery, although they don’t have them stated.  On their documents.
  Here is the plan document.

  Business Response

  Date: 02/24/2025

  We have not had a chance to respond to this matter. We received a notification from the BBB that the case has been resolved and closed. Has it been reopened?

• Initial Complaint

  Date:01/15/2025

  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.

  This health insurance company ensured my family and I that we would have coverage for our medical appointments having two toddlers and a newborn after facing unemployment and being on leave for child bonding. After obtaining new employment and stable health insurance we began receiving bills from our provider stating that our insurance did not cover us as they said they would. Once we began receiving these bills we called and were sent to voicemail never hearing back. It took weeks to hear back and only hearing back once stating that we were filing a complaint. We were told it would be looked into and information was sent stating it was coded incorrectly and would be resent. I requested an update two weeks after and I have not heard back. I have called once again was sent to voicemail. I called the phone number back that called me and spoke to someone who stated that they didn’t have those claims for the dates I provided even though they were already confirmed and identified done incorrectly. When asked to speak with a supervisor I was told that’s not possible that they would have to call me back. This has been an ongoing concern since November and we have given them adequate time to correct this issue or at least provide a valid reason for the issue.

  Business Response

  Date: 01/29/2025

  January 29, 2025
  
  
  I
  want to start by thanking the Bureau for bringing this matter to our attention.
  It is our intent to cooperate fully with the Bureau and assist *** ******** in any way that we can.  Our own investigation had revealed that *** ********’s
  claims were initially denied in error. Those errors were caught internally, and
  the claims were in the process of being reajudicated and paid when the Bureau’s
  inquiry was received. Specifically:
  
  Claim
  ***** – denied on 9/6/24, reconsidered and paid on 1/11/2025
  Claim
  ***** – denied on 9/12/24, reconsidered and paid on 1/11/2025
  Claim
  ****** – denied on 11/4/24, reconsidered and paid on 1/24/25
  Claim
  ***** – Paid on 10/3/24 with an additional payment due to reconsideration on
  1/24/25
  
  Only claim
  **** was denied as a non-covered service under the terms of *** ********’s plan. If she wishes to appeal that decision, the process for filing an appeal is quite simple and information regarding how to do so have been provided in her plan materials.
  
  We are sincerely sorry for the inconvenience caused to *** ********. We hope that this resolution is satisfactory to her and that this has been responsive to the Bureau’s inquiry. If there is any additional information that we can provide, please do not hesitate to contact us and it will receive our immediate attention. Thank you for your consideration.*
  
  Sincerely

  Customer Answer

  Date: 01/30/2025

  
  
  Complaint: ********
  
  
  
  I am rejecting this response because: they are not telling the truth. They did not catch the error, I did. They provided many difference explanations and have lied. They transfer to different companies and only took me serious once a complaint was filed. 
  
  
  
  Sincerely,
  
  
  
  ***** ********