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Business Profile

Third Party Claims Administrator

Detego Health

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Third Party Claims Administrator.

Complaints

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

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Detego Health has 2 locations, listed below.

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    Customer Complaints Summary

    • 19 total complaints in the last 3 years.
    • 19 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:01/09/2025

      Type:Delivery 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 purchased a health insurance plan through Detego Health to start on January 1, I paid for the first month on 12/21/24. I still have no insurance information. I am unable to fill prescriptions and I’m receiving bills from my doctor that I saw on Jan 2 because I have no proof that I’m insured. Detego health has said it is the fault of **** ****** but then also tells me that I cannot contact **** ***** because they will not have information for me. It is unclear who messed up, but it is ridiculous to pay so much for insurance only to have nothing and have to pay out-of-pocket until this gets sorted out. Completely unacceptable, especially considering that paying for private insurance is obscenely expensive.

      Business Response

      Date: 02/03/2025

      Response is attached.

      Customer Answer

      Date: 02/04/2025



      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,



      ********* *********
    • Initial Complaint

      Date:01/07/2025

      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.
      Member of detego health plan for the year of 2024 , where premiums of 622.79 for health coverage were auto deducted from my checking account from 1-1-24 thru 12-31-24 and they are not paying any of my claims for lab work from *** **** or my primary doctor visits and I’m getting billed for the full amount of claims over a year old and when contacted them they holding the claims and.not processing them

      Business Response

      Date: 01/29/2025

      January 29, 2025

      Subject: Response to Bureau Inquiry Regarding Claims| Mr.
      Abrams


      We would like to begin by expressing our gratitude to the
      Bureau for bringing this matter to our attention. We are committed to fully
      cooperating with the Bureau and assisting *** ****** in any way possible.
      Our internal investigation has revealed that the claims in
      question were either paid or denied due to duplication of submission. The
      specific details are as follows:


      Claim
      ***** for $260.00 paid on 4/19/24 (Date of Service: 1/18/24) – Paid
      $119.44
      Claim
      ***** – Duplicate of Claim 34469 – Denied on 3/22/24
      Claim
      ***** – Duplicate of Claim 34469 – Denied on 3/22/24
      Claim
      ***** for $416.85 paid on 1/14/25 (Date of Service: 7/10/24) – Paid
      $114.40
      Claim
      ***** for $260.00 paid on 10/9/24 (Date of Service: 7/18/24) – Paid
      $117.15


      We sincerely apologize for any inconvenience caused to *** ****** and hope that the resolution provided is satisfactory. We trust this
      response adequately addresses the Bureau's inquiry. Should you require any
      further information, please do not hesitate to contact us, and we will promptly
      assist.
      Thank you for your attention to this matter.
      Sincerely,
      Detego Health

      Customer Answer

      Date: 01/29/2025



      Complaint: ********



      I am rejecting this response because:

      *** **** bill acct# ******** in the amout of $529.20 has yet to be to be paid and processed according to *** ****.  I paid in full the amount of 529.20 on 11/11/24 to keep from being sent to a collection agency.  

       

       

       

       

       

       


      Sincerely,



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

      Business Response

      Date: 02/18/2025

      February 14, 2025
      Dear Member,
      Thank you again for bringing this issue to our attention. We
      sincerely apologize for the difficulties you’ve experienced. We fully
      understand your frustration, especially after you made your payment to *******
      on November 11, 2024, and expected it to have been covered by then.
      The delay in payment is due to the fact that checks made out
      to ******* are sent to a central billing system there, and it seems as though
      the check has not yet cleared the bank. However, we are still having trouble
      determining how you arrived at the figure you did.
      The only claim we have received from ******* was for $416.85,
      and because it was an in-network procedure, it was discounted down to $114.40. That
      amount was paid to ******* on January 13, 2025. This amount (the billed charge
      of $416.85) does not total your response of paying $529.20 to *******, as that
      is higher than the only bill we have received from them.
      Once again, we apologize for any inconvenience caused by
      this delay. Your satisfaction is important to us, and we appreciate your
      patience as we worked through this matter. Should you have any further
      questions or require additional assistance, please do not hesitate to contact
      us directly.
      Thank you for your understanding.
      Sincerely,
      Detego Health 
    • Initial Complaint

      Date:08/20/2024

      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 went to my primary care physician on May 21st (I believe), and did a check-up. I have called their number provided on Detego Health's card, ************* on and off, for 2 months to see if the the claim has posted. They keep replying there is no record of a claim being filed. In early August, I got suspicious that they were not going to pay so I called my doctors billing team and they said they submitted it via Fax, ************, and mail on August the 2nd. I called Detego back a few days later and they claim they have not received a claim from my doctors billing department. So I called billing to send it again to the Fax number they gave me. They sent a fax in a total of 3 times between Aug. 2nd and Aug. 16th and Detego still told me no claim was submitted. It has become clear to me that they don't intend on paying so I canceled the coverage today, 8/19/2024. I have made a total of 1 payment and $380 for May, and $333 for June, July and August. I feel this might be a case of fraud and I would like to report BBB to look into it. My "Member ID" is **********

      Business Response

      Date: 09/16/2024

      Dear BBB-

      Apologies- This just hit my desk this afternoon.  We don't often get emails into *********************.

      I've personally asked our team to review this immediately and respond back to you accordingly.  Member is showing as Active in our system as of 5/21/2024, the date of his enrollment.  Clearly, we have an issue with eligibility files from our Clearing House.

      We'll get the claims from the the doctor's office and manually adjudicate asap.  We'll ensure that the company that collected his payment- First Enroll-- also is notified of this complaint.  Member will be refunded any monies owed.

      All my best,

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

      President & CLO

       

      Customer Answer

      Date: 09/17/2024



      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,



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

      Customer Answer

      Date: 09/17/2024

      I have paid out of pocket $100.87 to ***** *********** as forwarded by my doctors office back in August, not wishing to damage my relationship with my provider.  I would like a refund for that as well.

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