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HCCMIS Atlas America Travel InsuranceFraud?

Review updated:

My father-in-law (patient) for whom I purchased this policy had to visit urgent care because of fever and cold. The date of service was 06/02/2014. The urgent care directly billed HCCMIS. Around 10/25/14 (first communication) we received a mail in our letter box stating explanation of benefits with reason code 130 that the claim has been closed because we failed to submit requested documents to them. The reality is, we never received any documents from them and they don't have any evidence of proof of delivery etc. On 10/27/14 after talking with their customer service representative we submitted the claimant authorization form and requested them to reopen the case.See Top 10 Worst Companies in Cleveland, OHToday, 12/1/2014 we received a letter stating that our appeal to consider this case is rejected because we failed to originally submit documents within 60 days after date of service which is 06/02/2014, but as mentioned above, we never received the documents and we had no clue what documents need to be sent, the agency from which we purchased this Insurance called InsuBuy.com said that we don't have to worry if the medical provider directly bills but that's not the case at all. Now the claims appeal is cancelled and looks like I have to pay for the medical expenses out of my pocket after spending hundreds of dollars in the comprehensive insurance premium, this is shocking and financially very troublesome for us, the entire family and we never expected to get cheated like this.
Can someone help here, please?

Am
Dec 01, 2014
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Comments

  • Sc
      Apr 08, 2016

    Your comment about what Insubuy.com representative said is completely false. Even if you visit a provider in the PPO network and they bill directly, you still have to fill a claim form as claim form is not only for reimbursement but also for other purposes such as privacy release authorization, medical records collection etc. It is described clearly at http://www.insubuy.com/visitors-health-insurance/ and that is what each representative in Insubuy would answer.
    If you are indeed Insubuy customer, contact our office at (866) INSUBUY and provide your details. We will try to find the phone conversation to see if anyone really said anything like that. In any case, if you face any claim problems, you should call our office immediately at (866) INSUBUY and speak with Claim Resolution Specialist. We will definitely help you with your genuine claim issues.

    -1 Votes
  • Sc
      Apr 08, 2016

    Your comment about what Insubuy.com representative said is completely false. Even if you visit a provider in the PPO network and they bill directly, you still have to fill a claim form as claim form is not only for reimbursement but also for other purposes such as privacy release authorization, medical records collection etc. It is described clearly on our web site under Guide --> In Network Claims and that is what each representative in Insubuy would answer.
    If you are indeed Insubuy customer, contact our office at (866) INSUBUY and provide your details. We will try to find the phone conversation to see if anyone really said anything like that. In any case, if you face any claim problems, you should call our office immediately at (866) INSUBUY and speak with Claim Resolution Specialist. We will definitely help you with your genuine claim issues.

    -1 Votes

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