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Ambetter from Buckeye Health Plan complaints

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4349 Easton Way, Suite 300
Columbus , OH 43219 | Get Directions

(877) 687-1189

http://www.ambetter.buckeyehea...

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Total Amount in Dispute:
$919.00

Total Amount Settled:
$0.00

Complaint Experience

100%

Complaint Resolution Index (CRI)

Complaint Resolution Index (CRI) Explained The Complaint Resolution Index (CRI) is an indicator on how responsive a company is in addressing and resolving customer complaints brought to their attention by BCA. If they are considering doing business with the company, consumers can use this indicator to forecast the likelihood of having their issues addressed if a problem arises. CRI measures the company's customer satisfaction abilities through BCA’s complaint mediation process.

A variety of factors are considered when calculating CRI. This includes how quickly a company responds to complaints, the number of complaints against a company, whether the company addressed complaint allegations, and the outcome of the complaints. CRI is just a subset of the overall rating for the company. Consumers are encouraged to take into consideration the company's CRI, their overall BCA letter rating and other relevant information about the company so they can make a well-informed purchasing decision.

BCA's Summary and Analysis:

Our complaint history for this company shows that the one complaint brought to the company’s attention was responded to and given proper consideration.

Complaint Closing Statistics

1 complaints against Ambetter from Buckeye Health Plan closed in last 3 years.

Complaints	Type of response
0	Making a full refund, as the consumer requested
0	Making a partial refund
0	Agreed to make an adjustment
0	Refusing to make an adjustment
1	Refuse to adjust, relying on terms of agreement
0	Unanswered

1 complaints against Ambetter from Buckeye Health Plan

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4/25/2022

RESPONSE: Refuse to adjust, relying on terms of agreement Amount in Dispute: $918.87 Amount Settled: $0.00

Customer Complaint

3/4/2022

No one can ever answer questions or help you with a problem. I was transferred by via benefits for help getting a letter of coverage no one could email me a copy or update the one online I was on hold for an hour and a half waiting to speak to a supervisor whom told me to make a copy of my profile and use that as proof I was told that was not acceptable by via benefits. The letter on line should be updated right away and I should not have to wait for paperwork that never shows up had the same problem last month never received the letter. Very unhappy with this company The web page is always down also Resolution Sought I would like for the web page to be updated right away with payment information and things be available and easy to find also for customer service representative to help and not hang up and stop giving misinformation.

Company Response

4/13/2022

Dear Member, Buckeye Health Plan (Buckeye) received correspondence from you on April 4, 2022. We are not able to process your request further at this time. Your request did not include one or both of the following: There was no member identification number listed in the appeal request. Please see your member's identification card for the complete number we need to process your appeal. I have attached a copy of the Authorization Representation (AOR) form. Please ensure all sections are signed and completed in full. Please then re-submit the form along with your appeal. Please refer to Buckeye Health Plan website www.bchpohio.com for the guidelines and a copy of the Provider Manual. If you have questions about this decision, please call 866-296-8731 to speak with a buckeye.

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