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:11/26/2024

  Type:Order 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 been battling with Ameriben for 2 months now trying get them to approve a procedure that now 4 different doctors tell me is medically necessary. I am in pain every day and Ameriben is refusing to cover it. The medical policy that they are using to deny this procedure doesn’t even include my primary diagnosis. How is this ethical? I have already had one appeal denied and i know they didn’t even review my medical records. This has caused me so much stress. I can’t believe an insurance company is allowed to go against the medical advice of 4 different doctors. They should be ashamed.

• Initial Complaint

  Date:01/15/2024

  Type:Customer Service 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 am writing to express my extreme dissatisfaction and frustration with the recent experience I had with your customer service. On ThursdayJanuary 11, 2024, I found myself in a medical emergency, experiencing severe abdominal pain and vomiting. In my desperate situation, I called Ameriben insurance for assistance.
  
  To my dismay, I was left on hold for hours, enduring intensified pain and weakness. Despite my urgent need for medical attention, the delayed response compelled me to drive to an urgent care facility without the necessary insurance information. This, in turn, forced me to proceed to the Emergency Department, knowing that the cost of my visit would significantly increase.
  
  Even after driving 45 minutes to the Emergency Department, I was met with further frustration as I finally managed to get someone on the phone, only to be placed back on hold. It took a total of 2 hours for an Ameriben worker to address my concerns. This lack of timely response in a critical situation is not only unacceptable but also reflects poorly on the reputation of a company as prominent as Anthem.
  
  I implore you to review and improve your customer service protocols to prevent such distressing experiences for your clients in the future. The delay in assistance during a medical emergency is not a standard that should be tolerated by a healthcare insurance provider. I sincerely hope that my ordeal serves as a catalyst for positive change within
  
  Ameriben's customer service operations.
  
  Sincerely,
  
  ****** **

• Initial Complaint

  Date:12/20/2023

  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 was made aware in May of this year that Ameriben, the benefit service provider in 2021 for my company, had still not paid a hospital bill from 2021 for my daughter. Since May, I have spent hours and hours on the phone with the Ameriben to correct a claim that was incorrectly denied. The hospital visit from 2021 was for my daughter for a suspected allergic reaction from a new formula (she was 7 months old at the time). We immediately called our doctor (it was after 5pm and the office was closed but their paging service called us back with the doctor) who told us to go to the emergency room. Ameriben has been trying to deny this claim as "not an emergency" and has delayed months by trying to get additional information that was funneled through my company's current benefits administrator. Months have been spent requesting medical records from Anthem (the current administrator) as evidently the records requested of the hospital were sent there. I finally provided unofficial records I received as a visit summary and have now been told that the claim is still considered not to have been an emergency. I have gotten on the phone numerous times with Ameriben and the hospital and EVERY TIME the hospital validates that this was an emergency visit. Ameriben is again trying to avoid paying this claim and, in the meantime, the claim has been sent by the hospital collections agency. Which impacts me. This is surely why my company dropped Ameriben and found a new benefits administrator as this company is a complete scam. I have paid every single medical bill my entire life but this claim was an emergency and must be paid by the company. I cannot believe the hiding, deceit, delays Ameriben has taken part in. I stand firm that the hospital deserves to be paid by Ameriben in full. I can share medical records and bills at a separate request. It doesn't seem secure to provide here. $964.55 is owed to the hospital.