Wageworks / Inappropriate denial/suspension
Most of the claims I submit to Wage Works is denied for supporting documentation. These bills were for a Radiology Dept, Radiologist, ER room, ER Physician and an eye doctor. My insurance company sent me duplicate EOB's which I submitted to Wage Works. They state 1. that they did not receive all EOB's (eventhough I faxed together with my claim form) 2. They are not sufficient because does not show the amount I would have owed. Only that my insurance processed as a medical expense.
Since they can not be sure that non cosmetic medical care was rendered by these providers I must provide additional proof or my card will be suspended and the employer can request that we pay back the amounts paid.
The customer service department is no help. The do not attempt to obtain any information. They have paid, but pended all but one claim I have ever submitted. These denials are inappropriate and unfounded. I feel Wage Works is in the habit of denying claims and making it difficult to use so that members give up and do not use the funds.
The one claim that I paid out of pocket and submitted to Wage Works was not paid back to me but credited to my Wage Works available funds. How does that help when they will not accept the claims when submitted through the provider of service.
I am very unhappy with the service. Will be reporting them to the employer and would like to know what government agency I can also report them to.
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