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:06/02/2025

  Type:Sales and Advertising 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 ******** provider and recently took on new ******** patients. Shortly thereafter I received a letter from *** stating that I had 30-days to confirm my credentialing or they would close out my credentials. I called to confirm but they had already closed it out prior to sending the letter and said they couldn't/wouldn't help, and to reapply. I did so, and sent all documents, but the application was rejected for missing documents. I did it again, and the ***** website says everything is turned in, but I am getting warning emails that documents are missing, but to ignore the messages if I turned everything in (which obviously is not good advice). It says to contact the represented "above" but there is no contact info except Novitas Solutions physical address. I called and cannot get through to anyone. They are barring an underserved population from care.

  Business Response

  Date: 06/12/2025

  This is in reply to your inquiry received by Novitas Solutions, Inc. (Novitas), on June 5, 2025, pertaining to ******** provider ******** **********.
  
   
  
  Novitas appreciates the opportunity to review and research a complaint from a ******** provider in our jurisdictions.  **** **********, of Novitas Critical Inquiries Unit, contacted Mr. ********** on June 12, 2025, to review the status of his ******** application. Because Dr. *********** complaint requires our office to directly communicate with him or a deemed authorized individual, Dr. ********** was provided with Ms. *********** contact information if he has additional questions or concerns regarding his enrollment in the ******** program.
  
   
  
  Novitas respectfully requests the closure of Mr. *********** complaint pertaining to Novitas.

• Initial Complaint

  Date:03/04/2025

  Type:Service or Repair 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.

  In December 2024 my employee was checking on a ******** claim and we couldn't get into the ******** website because our eligibility to bill ******** was revoked. I contacted Novitas Solutions right away and they stated I had to wait for my certified letter to come in the mail. The after Christmas I got the certified mail and it stated it was revoked because of my surety bond was no longer good. I immediately mailed, faxed and emailed everything they requested I needed to send. On 2/28/25 I receive a letter in my email stating that they are upholding the revocation because I didn't supply my certificate of limited liability insurance. They received everything from me but even if I didn't send my limited liability insurance, ******** wasn't revoked for that insurance it was revoked because of the surety bond. I also have everything on ***** waiting for them to upload it and it has been almost 60 days.

  Business Response

  Date: 03/19/2025

  Thank you for reaching out and allowing Novitas Solutions the opportunity to address your concerns. Provider enrollment appeals are an independent review conducted by a person not involved in the initial determination, so Novitas Solutions was not involved in the appeal decision dated February 27, 2025. The unfavorable appeal decision was made by **************************************** (C-HIT) and has since been revised and reissued on March 10, 2025 to a favorable decision. Novitas Solutions is in receipt of the favorable decision and we have reinstated your billing privileges. I trust this information is helpful to you.  If you should have any additional questions or concerns, please feel free to reach out to us directly at ************.

• Initial Complaint

  Date:07/29/2024

  Type:Service or Repair 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 have tried several times to get Novitas to give my reimbursement request due consideration. I'm certain that my latest submission gave Novitas precisely the information that they needed. I followed the procedure mandated by Novitas regarding submission of receipts by an out of network provider. They are persisting in saying that my provider needs to submit the paperwork and that the needed information was not given to them by me. That's not ******* one point they even said that I needed to submit the paperwork directly to ********. I had a chat with a ******** representative, which transcript I have attached. That representative said that Novitas was mistaken and that I needed to submit the paperwork to Novitas. Novitas needs to do the right thing and pay me what I am owed.Thanks.

  Business Response

  Date: 08/08/2024

  Your inquiry has been forwarded to the Novitas Solutions, Inc. Critical Inquiry Unit (***). We have assigned your case tracking number L151357. The *** team member assigned to your inquiry and corresponding contact information is outlined below:
  
   
  
  Name:  ******* Davis      
  
  Number:  ************
  
  Email:  ****************************************************************************************************************************
  
  Fax:  *************
  
   
  
  Please allow our representative approximately 12 to 15 business days to research and respond to your request. When communicating on this case, please refer to the case number assigned and address your correspondence to the *** member listed above as well as the Critical Inquiries Mailbox (********************************************************************************************************************).
  
   
  
  In order to ensure that we are able to research your inquiry to the fullest extent possible, please supply examples or documentation of the issue described in the referral to the representative and the Critical Inquiry Unit by emailing or faxing the information to our attention as soon as possible.  If this information has already been supplied to Novitas, the *** team member listed above will contact you if additional information is necessary to research your request. Please be advised, if PHI or PII is listed on the documentation provided, it is best to fax the information to the fax number listed below.
  
   
  
  To serve you better, please use the following methods of contact for future referrals:
  
  Jurisdiction L (JL)
  
  Please call ************** during the business hours of 8:00 AM - 4:00 PM EST or submit your question as a General Inquiry on the Novitas website at *****************************************************.
  
  Jurisdiction H (JH)
  
  Please call ************** during the business hours of 8:00 AM - 4:00 PM CT and MT or submit your question as a General Inquiry on the Novitas website at *****************************************************.
  
  Thank you,
  
  Critical Inquiries Unit
  
  Novitas Solutions, Inc.
  
  Email: ********************************************************************************************************************
  
   

  Customer Answer

  Date: 08/16/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 22063390
  
  I am rejecting this response because: although it does indicate that Novitas is finally doing something to investigate my dissatisfaction, the matter is far from being dealt with to my satisfaction. Their response indicates that they will investigate the situation within ***** days. That after my having spend many hours and several months of  trying to get them to properly deal with my medical expenses submissions. 

   

  If ******** will not reimburse for neurofeedback at any time, as I have recently been told by a mental health provider, why was I not just told that a long time ago? That would have saved me and your employees a whole lot of time. 
  
  
  Regards,
  
  ******* ******
  
  
  
  
  
  
  
  

  
  

  Customer Answer

  Date: 08/28/2024

  I have not heard anything new from Novitas. Do they want additional information? I don't know.

  Business Response

  Date: 09/10/2024

  Novitas appreciates the opportunity to review and research a complaint from a ******** beneficiary in our jurisdictions. Novitas contacted Mr. ****** on September 6, 2024. Upon further review of Mr. ******* claim, Novitas informed Mr. ****** the claim would be reprocessed. Mr. ****** will receive a new ******** Summary Notice (MSN) for the dates of service in question when the claim has finalized. 

  Customer Answer

  Date: 09/12/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 22063390
  
  I am rejecting this response because: my claim hasn't been finally decided upon. I do appreciate the detailed response but I do not want my case closed yet. Thank you.
  
  
  Regards,
  
  ******* ******
  
  
  
  
  
  
  
  
  

  Business Response

  Date: 09/20/2024

  This is in response to your inquiry received by the Novitas Solutions Critical Inquiry Unit on September 12, 2024, related to a follow up statement submitted by Mr. ******* ****** regarding the reprocessing of a ******** claim.

   

  As expressed to Mr. ****** on September 6, 2024, Novitas has submitted the claim at issue for reprocessing. Mr. ****** will receive a new ******** Summary Notice (MSN) for the dates of service in question when the claim has finalized, which may take up to four weeks. Novitas is monitoring the status of the reprocessed claim and maintains contact with Mr. ****** regarding the reprocessing.

   

  I hope you find this information helpful. If I can be of further assistance regarding this inquiry, please contact me using the information below.

                                                                                                                                                                                                                                                                                                                                    

  Sincerely,

   

   

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

  Provider Relations Research Specialist

  Critical Inquiry Unit

  Customer Answer

  Date: 09/25/2024

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  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. I may wish to refile my complaint should the business's final response, i.e its ruling on my reimbursement request, prove unsatisfactory to me. 
  
  Thank you,
  
  ******* ******
  
  

• Initial Complaint

  Date:03/01/2024

  Type:Service or Repair 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.

  My revalidation, with Novitas, was due in 2023. I completed the paperwork and paid the amount needed to have my ****ing rights to Novitas ********** to continue for the next three years. I thought I had everything completed and when Novitas came to do my sight survey the gentleman stated everything looked good and he didn't see an issue. Two weeks later 11/09/23 I receive an email stating my ability to **** ******** claims to Novitas was deactivated. At first I thought it was scam until 11/21/23 I found out that the deactivation wasn't a scam. I never received my letter explaining my ******** will be deactivated. I submitted all my information that day and I was told it could take 100 days. I went online and it stated that a revalidation will take 80% completed 15 calendar days and 100% completed in 50 calendar days. When I contacted them they stated some will take the 100 days. Beginning of February I contacted them and they said someone is working on it. I contacted them 2/29/24 and now they state they are so far behind and it could take another 20 to 40 days. I explained to them that I am a very small mastectomy boutique and not being able to **** over 100 days is causing me to be late on my ****s and providing the proper service to my clients.

  Business Response

  Date: 03/12/2024

  Thank you for bringing this matter to our attention.  We fully reviewed the chronology of events related to the customers ******** revalidation application.  Upon receipt of the required information following customer interactions in early March, the application was finalized on March 6, 2024.  While we acknowledge some processing delays, we were also dependent on receipt of timely and complete information from the customer.  We take our responsibility seriously to ensure businesses who provide important services to ******** beneficiaries do not experience disruption to cash flow. This matter has been fully resolved.

• Initial Complaint

  Date:05/24/2023

  Type:Service or Repair 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 was trying to find a telephone number for Novitas Solutions to check on the status of a ******** claim they were processing and for which they had requested more information from the relevant provider. There are two phone numbers listed on their site per information from the BBB. ********** and **********. Upon dialing the first one, I got a recorded announcement that the number was not in service. Upon dialing the second one, which is designated for those with disabilities who might need assistance (I am not such a person but thought the number would get me farther than the first one) and it was answered by "************ Human Resources Department,  which presumably refers to ************ *************** ******.

  Business Response

  Date: 06/01/2023

   
  Thank you for contacting the Novitas Solutions, Inc. Leadership Team.  Our ultimate goal is to assist you.  Due to the nature of your inquiry, your correspondence has been escalated to the Critical Inquiry Unit within the Novitas Solutions Customer Contact Center.  Your case has been assigned tracking number *******.  The research team member assigned to your inquiry and corresponding contact information is outlined below:
  
  Name: *********************************
  
  Number: ************
  
  Email: ************************************@novitas-solutions.com
  Fax: ************
  
  Please allow our representative approximately eight (8) to ten (10) business days to research and respond to your request.  When communicating on this case, please refer to the case number assigned and address your correspondence to the CIU member listed above as well as the Critical Inquiries Mailbox ([email protected]).
  
  In order to ensure that we are able to research your inquiry to the fullest extent possible, please supply examples or documentation of the issue described in the referral to the representative and the Critical Inquiry Unit by emailing or faxing the information to our attention as soon as possible.  If this information has already been supplied to Novitas, the CIU  team member listed above will contact you if additional information is necessary to research your request.  Please be advised, if PHI or PII is listed on the documentation provided, it is best to fax the information to the fax number listed above.
  
  Thank you,
  
  Critical Inquiries Unit
  
  Novitas Solutions, Inc.
  
  Email: [email protected]

• Initial Complaint

  Date:09/03/2022

  Type:Customer Service 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 accessed the BBB website in an attempt to resolve my issue with Novitas Solutions, and discovered an experience very similar to mine. (See Novitas Solutions 01/18/2022). Because of his expertise, I was referred to a dental pathologist for treatment of a medical, not dental, condition in my mouth. The pathologist does not submit claims to ******** for medical services (only dental insurance providers for dental services). However, I was advised I could submit the claim to ******** myself. As directed by ********, I submitted my claim 05/20/2022 to Novitas Solutions on the appropriate form, along with a letter providing details regarding my medical condition and explaining why I was submitting the claim instead of the service provider. On 06/08/22, Novitas Solutions requested additional information (a **** Number) and instructed me to resubmit all documentation related to this claim. On 07/11/2022, the entire packet, with the newly-requested information, was resubmitted for a second time. Per ******** Summary Notice dated 08/08/22, the claim for services rendered on 09/28/2021, 11/09/2021, and 02/08/2022 was denied. “Routine care is not covered” was the reason given. I have been unsuccessful in my attempts to communicate with Novitas Solutions via telephone or email. Trying to resolve the issue directly with ******** has proved equally futile. On 08/26/22, I filed an appeal for the denied claims and submitted the entire package to Novitas Solutions for the third time. In addition to the previous submissions, I included the pathologist’s extensive summary of my visits and another letter providing a more detailed description of my medical condition and the necessity for the treatment rendered. Any assistance you can provide would be appreciated.

  Business Response

  Date: 09/29/2022

  This is in reply to your inquiry received by Novitas Solutions, Inc. (Novitas), on September 12, 2022, pertaining to ******** beneficiary ****************************************
  
  Novitas appreciates the opportunity to review and research a complaint from a ******** beneficiary in our jurisdictions.  Tamara C******, of Novitas' Critical Inquiries Unit, emailed ************ on September 27, 2022, and reviewed the reasons why **********'s claims were initially denied. Additionally, ************ was advised that her September 2, 2022, appeal request was reviewed and it was determined that her services were payable.   ************ was provided with **. ******* direct phone number and email address,  Ms. C********'s; direct phone number and email address, ************; *************@novitas-solutions.com, should she require any additional assistance.

  Customer Answer

  Date: 09/29/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  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. 
  
  Regards,
  
  ***********************