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CareCentrixunethical behaviour

G Nov 13, 2018
This review was posted by
a verified customer
Verified customer

Centrix customer service is HORRENDOUS. They are completely unprofessional. They are good at giving you the run around and excellent at escalating the complaints to the next level of incompetence It's unfortunate that their customer service employees come across as having no desire to resolve patients' issues.
I have been personally driving the process since October 19, 2018 and, as of this writing, I keep getting different excuses and finger pointing without a concrete resolution. I have spoken to at least 15+ individuals and have around 22 pages of correspondence while getting different versions on the approval process. I have communicated with two supervisors and as today (11/13/18) I am back to square one…This is completely unacceptable.
Centrix has constantly lied to me, not called me back when they said they would. I have provided Centrix representatives with two doctors' authorizations as well as suppliers that carry the device and apparently it is not enough.
I was told that a peer to peer review was no longer necessary, now it is back on the table. I was told that all required information was available and that the issue would be escalated once again. I was told a medical supply was contacted and that they would call me. I am still waiting.
I will continue to contact as many people as I can regarding the inappropriate and irresponsible way that care Centrix operates. I am sure that your employees' version of events will prevail, however, please review my files and hopefully you'll see the big picture.
It is beyond me how a team of your people deny approving the up walker and labeling it as "not necessary". They have not seen me and have no clue as to how I feel and walk. Their primary answer seems to be a non-approval methodology without heeding my doctors' prescriptions and are hoping I go away.
I will keep at it until this is resolved.

RESOLVED

Ken and his team were instrumental in resolving my issue. Ken should be recognized for the work he did in leading the team to a happy outcome. They never gave up. Thank you!!! Gus S [protected] Case 0091

  • CareCentrix's response · Nov 14, 2018

    Hello,
    We are sorry to hear that you are experiencing difficulties. In order to help us best serve you, we ask that you email us at [protected]@carecentrix.com, with the following information: your full name, your health plan, a phone number that we can best reach you at, as well as a brief description of the issue you are experiencing.
    Please be sure to include Reference Case #0091 in the subject line.
    Once we have this information, a member of our support team will reach out to you directly.
    Thank you.

  • Updated by Gus S · Nov 29, 2018

    REPLY
    Thank you for your response.

    I am filing an appeal with the insurance company and hopefully I'll get resolution.

    In the interim, I will proceed, and get the issue resolved on a timely basis.

    My concern with Centrix was that they lack credibility and that nobody was empowered to tackle the opportunity and make a difference in the life of a patient.

    Perhaps they need refreshing training in “customer care” or to take the initiative to lead the process.

    Thank you again for your concern. I am sure that once I resolved the issue with my insurance company, I would revisit my complaint in a more positive light.

    I am sure that your staff will be part of the solution.

    Gus Suarez

    Florida Blue

    [protected]

    Customer service below par --- Case #0091

    New update 11/29/18 ********Inefficiency at its best

    I am sorry to report that my frustration level has reached new heights.
    At this juncture, I am back to square one even though I did put in an incredible amount of time and effort and nothing happens. A supervisor was due to reach out to me and I am still waiting. This is not the first time they "forget" to call me back.
    I was optimistic that this request would've been a non-issue. I received approval on my appeal within 72 hours from Florida Blue. It has been 8 days since then, and I see no end to this process. The flavor of the day is: "we will escalate this to the next level" and nothing gets resolved.
    My optimism has gone by the way side and I am once again wrong in my assumptions.
    I am time and time again get the run around and the solution is far from being had.
    It seems to me that I am the only one leading the process and no one is following.

    I am having a hard time understanding as to why this process is taking so long. Your lack of action appears to adhere to a convoluted bureaucracy, a never-ending delay in the process and I am being penalized.
    It's been over a month...and serious action needs to be addressed...the timing this is taken is unacceptable.
    Regards,

    Gustavo Suarez

    [protected]@gmail.com
    [protected]
    Florida Blue

  • Updated by Gus S · Nov 29, 2018

    As I was sending a disappointing review, I received a couple of phone calls from Centrix.
    The second call was from Darriele who was very pleasant with a high professional attitude and a sincere asset to your organization. I often wonder why this type of employees are not assigned to train those that drag down the true spirit of service. This was a refreshing experience.
    Next time I call, I hope to get her or someone that adds the same value to the process as she did a moment ago.
    People like Darriele make a difference in this chaotic world.
    Thank you
    Gus Suarez
    Case 0091

  • Updated by Gus S · Dec 12, 2018

    Case #0091
    I would like to acknowledge and applaud certain Care Centrix employees that were driven to make things happen and deliver positive results. A good example of true resilience to satisfy the customer/patient.
    Rebecca (don’t know her last name) was very instrumental in following up and coordinating.
    Ken H. (don’t know his last name) was very helpful in keeping me fully informed on the status of my claim.
    What a difference these two individuals made in the quest for fairness and honesty. I had written a complaint a while back, but their commitment changed my opinion. Their turn around approach was second to none.
    I would like to express my gratitude to Ken who never gave up and met what he set out to do….take care of the patient. Ken’s professionalism and resilience shown is admirable and unquestionable.
    Ken and others - too many to mention - displayed a true desire to help. After such a long process and against the odds, they never faltered. Their excellent customer service was beyond my expectations.
    Their commitment to work hard and deliver unparallel results made a huge difference.
    Thank you all

    Gus S

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