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Today's Options Pyramid / They say they never receive claim forms

1 United States Review updated:

Todays Options - www.todaysoptions.com

PLEASE stay away from Today's Options. It is a nightmare. I have mailed and faxed at least 10 copies of claims that had never been paid and every time I call they have no record of them. They say they will check into it and call back and never once have I received an update. I am still trying to get claims paid for my Father from 2006.

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Ji
  18th of Oct, 2007
Agree Disagree 0 Votes

I am having problems with Today's Options too. However you must be persistent and document all of your efforts with unpaid bills. As soon as they do not pay a bill, I immediately sent a complaints letter to the appears and grievance desk in Houston, Texas.

They are processing bills which are sent to the Cambridge, Mass address. Biggest problem may be that they have changed both of their addresses for the claims office and their appeals desk in Houston. I am calling once a day and tomorrow I am starting to call 2x a day. Person in India or Pakistan finally gave me a referral number and again told me she was going to send the matter to their claim dept.

I told the responder that she should request a transfer to her claim department as they desperately need help---if the claim department in in her same country. Responders are always quite polite and perhaps my 2x daily calls which start tomorrow will eventually get through to somebody that will take action.

I can't argue with their cost which is zero $$$ a month for 2007.

Te
  26th of Dec, 2007
Agree Disagree 0 Votes

I have been in health care for over 25 years and I have never seen such poor quality service. My parents have been lied to by several of the "Todays Options" agents, and I use the term loosely, for over the past 6-8 months. They make appointments and never show up. They give them phone numbers and they are out of service. They misrepresent the services which are covered, and look you straight in the eye and lie to you. I have never seen anything like it in my life. Lower cost does not make up for poor service. You always get what you pay for!

Vi
  30th of Dec, 2007
Agree Disagree 0 Votes

Wow, right on the nail head. Todays Options, is Houston Based and is a "Service FOR Profit" Medicare company..They have a clear track record of denying claims -for any number of reasons, knowing full well that if they deny the claim and retract the funds from your providor that- they have the funds to invest again for ---let's say---6 months or however long it takes you, the patient, to get the issues resolved---and they eventually pay the claim.

In my case nearly $24,000.00 - HOW MUCH MONEY DID THET MAKE RE-INVESTING YOUR CLAIM funds? Now multiply that amount by ---say 1000 claims. It really adds up. I'm in the process of again calling them (in the Philipeans) and contacting the Home office in Houston. Maybe if someone like Glenn Beck or Rush Limbaugh gets the word, 20 million people will be aware of their tactics and Pyrmid Today's Options will be out of business.
This is no Joke, and probably borders on FRAUD.

Please E-Mail me with your story at---> vicjillson@msn.com.
You haven't heard the last of this issue.

Th
  2nd of Jan, 2008
Agree Disagree 0 Votes

You are totally correct when you say they do not know what they are doing. I was on the phone today from 9 AM until 2:00PM and talked to about 30 different people and each one of them told me something different.

I problem is: I have been taking a generic drug called oxycodone for 9 months and it has been covered all this time as a generic, which it is. Now they tell me that they no longer even cover this drug and want me to change to something that I have been proven to be allergic to (morphine).
They argued with me that oxycodone is not a generic drug and that I never paid 7.00 generic price for it which I did until I went into the donut hole and had to start paying in august 126.00 for 30 days, then Sept it went to 235.00, then October it went up again, and then in November it was even higher. Now the price has gone to 302.00 today. This is a 180.00 price increase in 4 months.

I verified with my pharmacy that this is indeed a generic drug and even then Todays Options told me that it was not a genric. I told them that they could not make this NOT a generic just because they said that it was not.
After much time spent I finally got someone that told me that if I would have my Doctor fax them they would take it under consideration and then make a consideration. I told them that I had been out of this drug since December 20th and the pain from my back and knees were so severe I could not stand it and I could not wait for 3 to 6 months for them to decide that it was a generic and they would or would not cover it.
They told me about 1,000 times that they apoligized for any inconvenience they had caused me. I finally told them that they did not need to apologize to me any more that I was getting sick of hearing it but instead just do the job that they promised in the first place and give me the genric drugs for 5.00 and not count them toward the donut hole. They told me that they could not because it was not a generic and even if it was that they did not cover it.

I asvised that that the last explanation of benefits that I got from them dated 11/26/07 said that there was not any change in my drug formulary and if there was a change that they would give me a 60 day notice before the change was made. I am sure that this is one of the rules set forth by the Government.

I am calling them back tomorrow and telling them that i want to file a grievience and be heard by the Govt. grievience board.

I would like to hear from anyone that has had a simular problem with them.

Thanks
Tom

Ev
  4th of Jan, 2008
Agree Disagree 0 Votes

Today's Option has been a nightmare for me. I learned from my Dermatolist office after treatment of skin cancer, they did not file with Medicare Advantage Plans. There fore I paid the bill from my own pocket.

I sent the reciepts into Today's Option 4 times,twice by mail and twice by fax, and each time they would tell me something different. Usually it was they did not recieve the reciepts. I have talked to so many people there in Cambridge, MA. I feel for the most part they do not know what they are doing.

I recieved a cover sheet yesterday from them, and it states that I am not their member and they are disregarding this claim. I have sent photo copies of my member ship card.

I am dropping them, and will let everyone know how they operate. I will call the SS office and Medicare as well. I have sent a grievance letter to Houston also.

El
  24th of Jan, 2008
Agree Disagree 0 Votes

My dad got involved with this company and he didn't even sign the paperwork. Does anyone have the number in houston? I just found out about this. My sister was handling it. How do you get out? They say he is no longer a member but they keep taking money out of his social security check. If you can. Someone please help. Thank you.

Da
  28th of Feb, 2008
Agree Disagree 0 Votes

I participate in this insurance and I talked to a lady who gave me a gentlemen's named Dana Adams about these problems and he's working on getting customer service moved back to USA.

Ta
  7th of Mar, 2008
Agree Disagree 0 Votes

These people are horrible! I have worked as a medical insurance biller for over 15 years and usually can work, and solve any issues, with the insurances. These people are dragging their feet and making excuses! With today's medical insurance reimbursements being so poor, a small practice needs every penny and I shouldn't need to spend most of my day trying to collect what should have been paid correctly the first time! I will make sure that I put the word out that this insurance should never be bought by unsuspecting medicare patients. It is not worth the hassle for them or for us!

Ne
  5th of May, 2008
Agree Disagree 0 Votes

Multiple problems with Pyramid: 1st mistake - someone sign my mother up, door to door salesman, 2nd problem - nursing home says Pyramid is slow or no pay, but they will try again, 3rd problem - Pharmacy starts getting paid for drugs, then the payments stop, they say Pyramid’s telephone number is always busy, I give them a Pyramid telephone number to call off my mothers paper work, they finally get through, Pyramid says my mother is not a member-customer, I call as her son, Pyramid says my mother is a member, Pharmacy must be making a mistake in how they file. Pharmacy finally gets some one on the phone at Pyramid. Pyramid tells the Pharmacy they need to reenroll my mother. I call to try to straighten out the problem; Pyramid now says my mother is not a member and I’ll have to send them my Power of Attorney papers to discuss the problem. Pyramid gives me a fax number, after 30 minutes I can call back and straighten out the problem, fax number is no good, I call back, now they say it will take 30 days for the faxed info to get in the system and I’ll have to wait 30 days to straighten out the problem.

All the above problems lead me to believe Pyramid is a very poorly run company that is having money problems. They put everyone off that is requesting payments, to keep their money longer.
How do I get my mother off Pyramid and who do I need to sign her up with.

An
  1st of Jun, 2008
Agree Disagree 0 Votes

They re-enrolled my father without his permission and so his current insurance called us today to inform us that medicare called them and said they had to dis-enroll him because he had Todays Options. My father got so upset. He got off their plan in November of 2007 because they did not have any local providers that he was already using.

His current insurance said call medicare and we did. Medicare helped us file an official complaint through medicare against Today's Options and then said they would re-enroll him to his current insurance with what they called a Marketing SEP misrepresentation. I don't know what that means but it appears to mean that re-enrollment should happen because their was fraud on Today's Options part! Next step since it is a Sunday is to call current insurance back and tell them that medicare has done all this so they can show him re-instated back into his plan. What a nightmare! I would love to sue these people.

Ph
  20th of Aug, 2008
Agree Disagree -1 Votes

I have problems with Today's Options on premium payments. The payments were supposed to come out of my SSI check. I assumed the payments were coming out because that was the set up starting in Jan 2008. Six months later I received a letter saying there was a mistake made on there behalf in the collection department and now I owed back premiums close to $700.00. When you are on a fixed income that is a lots of money at one time. It is my fault for not checking my bank statements closely. However, I hold Today Options at fault more so for waiting so long to inform me. I have never used their services since Jan 2008, do not have more than$700.00 since the last letter in Aug 2008, and do not plan to try to steal, beg, or borrow that kind of money to pay for a mistake they admit they made in the collection department at my expense. I filed a complaint with Medicare in Aug 2008.

Gi
  8th of Sep, 2008
Agree Disagree 0 Votes
Today's Options Pyramid - Claims not paid and will not disenroll members
Today's Options Pyramid
PO Box 64069
St. Paul
Minnesota
United States
Phone: 1-866-568-8921
www.todaysoptions.com

Please stay away from this company. In 2006 after multiple claims being denied, I personally sent multiple claims for my Dad by mail and fax. Each time I was told they did not receive them. In Nov. 2006, nothing had been resolved, so my Dad disenrolled. He was to have Medicare back as his primary ins. and purchased a supplement. Later, we were notified that Medicare was denying claims and after checking into it(through Medicare), we find that Today's Options never disenrolled him. Although, when I talk to them they say they have contacted Medicare to disenroll him, but Medicare says they have no record of them contacting about this issue. When I call, I am never allowed to speak with anyone in the enrollment dept. nor a supervisor, they say they will have someone to call us, don't believe this. No one has ever called back. They have people on the front lines telling you what you want to hear. Please BEWARE! I would hate for others to have to go through what we have. At this point is has been 1 & 1/2 years and is still not resolved. Medicare has now filed 2 complaints for us. If anyone else has had similar problems with this company, please let the public know.

Sy
  23rd of Sep, 2008
Agree Disagree 0 Votes

How can a person get out of this Today's Options program? Can someone please let me know.

Ch
  8th of Oct, 2008
Agree Disagree 0 Votes

I AM A PROVIDER WITH A PATIENT THAT HAS THIS INSURANCE. I JUST CALLED THE INSURANCE COMPANY AND IT IS 2P AND THEIR SYSTEM IS UPDATING SO I CANNOT GET ANY INFORMATION AS TO TYPE OF POLICY THIS PATIENT HAS. UPDATING IN THE MIDDLE OF THE DAY SO WHAT IS EVERYONE DOING WHILE ALL OF THE SYSTEMS ARE DOWN. UNBELIEVABLE. I DO NOT WANT A NIGHTMARE ON MY HANDS AND THIS LOOKS LIKE A NIGHTMARE WAITING TO HAPPEN.

Pa
  12th of Nov, 2008
Agree Disagree 0 Votes

My husband has insurance with Today's Options and every complaint I see above I fully understand.
We picked this insurance up at the beginning of 2008 and what a nightmare. I went to Wal-Mart to pick up a medication prescription in May of this year I was told his insurance ran out the first of April. I called the company and was told, were sorry but no insurance. Premiums were being paid through Medicare. I called Social Security, filed a complaint then call Medicare and filled a second complaint. We received a phone call from Today's Option with-in 12 hours to tell us it was a mistake on their part and that we always had insurance; just a small misunderstanding! all was taken care of and it would not happen again.
Went back to the pharmacy in October and was told again that we had no insurance. I called again and this time not real nice. I talked to a person and I insisted on talking to someone at corporate, I was told that all calls would have to go through the telephone service in INDIA! What a joke, to have a large company source out business to a foreign country that is not familiar with what is going on here in the states.
I will not and have not recommended this insurance company to anyone and will continue to do so; word of mouth goes a long way.
It is NOW new enrollment season for almost all companies. If you are tired of this company now is the time to change.

Sl
  12th of Nov, 2008
Agree Disagree 0 Votes

My mom saw this ad for todays option on tv thinking it would be a supplement She had no idea that they would take her and my dad off medicare. When she realized this she pack up all the paper work and sent it back to cancel. Well they took her off and she was put back on medicare but not my dad. We have been fighting with the co. for 6 months trying to get it canceled. At first they said he was canceled but when we tried to get him back on medicare they told us that he was still insured with todays option. So back to round one. When you call you talk to someone different never getting the same answer. We've threatened to sue, called our governer but nothing seems to help. What i want to know is how the heck to you get them to cancel a policy.

Pa
  14th of Nov, 2008
Agree Disagree 0 Votes

open enrollment starts this month for Medicare; change your insurance provider immediatly. The new policy will take affect January 1, 2009. If insurance is being paid directly to the company from Medicare, once you change your insurance provider your insurance premiums will stop going to Today's Option. I am sure if no money is being sent to them the policy will be cancelled.
Have you filed a formal complaint with Medicare. That is the only way I got them to listen to me.

Br
  16th of Jan, 2009
Agree Disagree 0 Votes

I am with all of you. My grandmother was switched to this insurance. We have had nothing but trouble since we filed her first claim. She has had this insurane since 2007. Now its 2009 and we are still waiting on a claim reimburstment from July 2008. How crazy is that. I called them today same as any other day "sorry for the inconvience". WHATEVER!!!They always tell me the samething to we didn't get your claim. It's the same ole garbage every time you call. But I didn't realize until today, I don't think the companies CSR's or in the United States. While being on hold I could still here people talking in the back ground no one spoke any English. When I called on Monday they told me their fax number had been changed. Nice of you to let someone know. Then they argued with me about the address being changed on her new card. He didn't even know the new address. We have decided to cancel this insurance and go with something else. She is due to go to the doctor again at the end of the month I guess we will be reimbursted about December. I thinks its all a scam.

Sq
  13th of Feb, 2009
Agree Disagree 0 Votes

We have had a horrible time with Today's Options, We have been apying since June 08" they have screwed this up so badly. We get letters from S.S. saying we are not covered, when we call Today's Options they always say the same thing " Do not worry you are covered". Yesterday we went to the office they finally looked us up and said you have no insurance, we do not knopw what Happen!!! We will end up in court as, they dropped the ball someplace. We will not pay for all the bills!!!We trusted that we where covered even when they said do not worry! We are so upset!! anyone filing a class action suit please let us know. Where does all our monthly payments go!! Who's bonus are we paying for! At our age we do not need this crap!! I will be contacting GMA.

Na
  27th of Mar, 2009
Agree Disagree 0 Votes

For help try:

Pennsylvania Life
POLICY HOLDER RELATIONS
(JACK) JOHN T. MACKIN, JR
1001 HEATHROW PARK LN,
LAKE MARY, FL 32746
UNITED STATES (407) 995-8000 x8070

Best of luck to you all! I pray that you and your families escape this!

http://www.floir.com/companysearch/each_comp.asp?PREDAY=3%2F26%2F2009+&IREID=101201&AUTHID=101201&FICTNAME=&ADDRTYPE=ALL&CCRCNAME=


ADMINISTRATIVE 1001 HEATHROW PARK LN STE 5001,
LAKE MARY, FL 32746-7625
UNITED STATES (407) 995-8000
HOME 27 NORTH FRONT STREET,
HARRISBURG, PA 17101
UNITED STATES

MAILING PO BOX 958465,
LAKE MARY, FL 32795-8465
UNITED STATES (407) 995-8000 x8268

LOCATION OF RECORDS 1001 HEATHROW PARK LANE, SUITE 5001,
LAKE MARY, FL 32746
UNITED STATES (407) 995-8000 x8268

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