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  • Report:  #1480309

Complaint Review: GEHA

GEHA Aetna Government Employees Health Association, Inc. United Healthcare Options PPO Network GEHA Connections Federal Dental GEHA lies, then lies some more, won't pay Eagan Minnesota

  • Reported By:
    Herb — Anthony United States
  • Submitted:
    Thu, June 13, 2019
  • Updated:
    Thu, June 13, 2019

Many of my health care providers have stopped offering insurance filing services, so after a doctor visit, I must file the claim with the insurance company myself. I have filed numerous claims for direct member reimbursement and GEHA has refused to pay many of them. This is insurance fraud.

The most recent example is when I filed a claim for a dental visit. I mailed the claim to the address listed on the recently issued ID cards. After a month of not hearing from GEHA, I telephoned. GEHA told me they did not have the claim. After questioning them for several minutes, I determined that they had changed the address where claims are mailed to, without notifying me or anyone else.

My HPPA confidential information contained in the claim was not returned to me, was not forwarded to the new address, and I have no idea where my personal identifying information is.

I resubmitted the claim, waited a week, and called to determine the status. They said it was pending. A week later I called and was told they had never heard of the claim. I next e-mailed the claim to the address they gave me. A few days later I received an e-mail stating the claim was received. A week later, I called to determine the status. I was told the check was in the mail. I called again today and now they state they have never heard of the claim. 

Additionally, I have claims pending from 8 months ago that they have refused to even acknowledge receiving. Then they play the game of sending my doctor a letter requesting information that has already been submitted to them.

They delay, then lie, then delay some more. This company should not be allowed to sell insurance and should be prosecuted for fraud, as they do not pay valid claims.

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