Coventry Health Care

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Coventry Helped lower my premiums and helped me survive Cancer
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URBANDALE, IOWA -- January of 2009 My employer changed from Wellmark Blue Cross Blue Shield to Coventry because "The savings was unbelievable". One Month later I found that I had testicular cancer. I went to a specialist and they recommend a procedure to remove the cancer and still be able to possible have more children with my wife. Coventry got an authorization from the Dr. just one day before the surgery and then called me to tell me that they denied the procedure because it was considered experimental. They said that they had evidence from other specialists across the country that the procedure my first Dr had recommended often times did not effectively treat the cancer and it came back twice as often as it would with other treatments. I was taken aback at first because "How could a Dr ever recommend something that wasn't the best for me?" Coventry said they would pay for me to have a second or even third opinion but they wanted me to have the best outcome for my health. I then went to the MAYO Clinic for the second opinion and they recommended another procedure because of the same reason that Coventry had told me they denied the first one. I was astonished. Six months later I saw an article in the paper that my first doctor was being sued for malpractice. Almost two years later I am in complete remission and Coventry saved my life by caring enough to deny a procedure that was not in my best interest.
     
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Venice09 on 2010-10-17:
This really is a great story. How often do we hear of health care providers that actually care about someone's health?

Thanks for sharing this. I enjoyed reading it. Here's to long-lasting good health!
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Questionable Actions
Posted by on
SAGINAW, MICHIGAN -- 3 Month old fever of 99 with a bit of a cry. Found low sugar of around 40ish. Multiply attempts at a IV in arm all fail, IV inserted in temporal vein. This was done to raise sugar. After being a bit of a hard head with the doctor I called the childs main physician. After the office called emergency to get details I got back in contact with them and was told " it is common practice to move from arm to head for IV in young patients".

Then was told (mind you they called the hospital for the numbers so to speak) "the steps taken were not necessary they could have placed the child on his back(!!!!!) Or gIVen a oral dosage of ___?___."

Does this sound like professionals to you?
     
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Anonymous on 2009-08-20:
...?
I have no clue what you're talking about... so, I can't give a yes or no as to if they were was professional or not.
chris513 on 2009-08-20:
I know what they are talking about
Anonymous on 2009-08-20:
Well, Chris... were they professionals?
goduke on 2009-08-20:
Sounds like medical professionals who probabaly know what they are talking about.
chris513 on 2009-08-20:
no, they were pigeons
Anonymous on 2009-08-20:
But, I don't like pigeons... they poo on your heads.
Ponie on 2009-08-20:
'After being a bit of a hard head with the doctor...' I know it's difficult to see your own child in distress, but was it necessary to take on the doctors? My brother spent a few times in that same hospital before he died, and every bit of his care was very professional. I'd go as far as to say outstanding as he was a very difficult case.
goduke on 2009-08-20:
They let pigeons perform medical procedures in Michigan? Wow. I knew it was a goofy state, but that's amazing. Maybe it's a union rule.
Anonymous on 2009-08-20:
Chris513, not ghetto pigeons?
old fart on 2009-08-20:
My daughter and My future grandson's wife both work at covenant... I will pass this on to them for their opinion.. if it makes any sense to them..My daughter has worked in prenatal and the kiddy ward for many years...
goduke on 2009-08-20:
My understanding from the MD folks I know is that veins on an infant are often easier to get at in the head than in the arm. So they usually go for the veins in the head.
Disaster Worker on 2009-08-20:
Yes, as a medic I can tell you this is the best way to get fluids into an infant. That way they can't accidentally pull out the line. It looks horrible, but quite harmless. It's hard to be objective when you're the hysterical mother (I know; I've been there), but all of us hospital and EMS workers really do try to do the best for the patient even if the family doesn't see it that way. Remember that you're our SECOND concern; your baby is our FIRST.
goduke on 2009-08-20:
Excellent words, DW!
old fart on 2009-08-20:
I meant to say neo-natal, not pre-natal...
old fart on 2009-08-25:
A "temp of 99" is not an elevated temp. It is common practice to place IV's in head veins of infants. A blood sugar of 40 is low and needs to be treated. If you felt this child was not "ill" enough to require IV fluid/glucose replacement, why did you take him/her to the hospital rather than your physicians office? Sounds like the infant was not taking anything oral or his/her blood sugar would not have been 40. If you couldn't get the child to take anything by mouth, the "professionals" needed to intervene and place an IV.
Anonymous on 2009-08-25:
My daughter had an IV in her head when she was 6 months old. Then they put a paper cup around it to protect it. (It looked like she had a clown hat on.) After a couple of weeks she was fine. The infant can't even feel the IV from what I understand and they tend to pull on the ones in their arms, as DW said. Our daughter never seemed to notice it.
Kevin Ward on 2014-04-26:
Coventry sent me a letter advising me to get a colonoscopy as part of their preventative health care program. I went to my PCP and got a referral. Then I went to the specialist referred by my PCP and submitted insurance information. Weeks later the procedure was scheduled and, a compliant insured and patient, I had the procedure done. What did Coventry do? Paid $365 on a $2,150 bill leaving me with a claim by the provider for the balance. I provide Health care for nearly 40 people with this kind of coverage and I am definitely going to change carriers. It's one thing to deny a claim, it's another thing altogether to induce the insured get a procedure and then deny the claim. Can't wait until we can cross state lines to shop for real coverage at a fair price. Oh yeah. Coventry raised our prices substantially this year to get one last push in before small businesses can take advantage of the exchange under the affordable care act. At least I was anesthetized when I got the colonoscopy.
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Coventry Health Care
Posted by on
TEXAS -- My daughter and I go to the DR. about once a year. Coventry of which we have had for over 6 months now has denied our yearly Dr. visit claims.

In searching on the internet there are several cases in which Coventry likes to deny claims to the customers that pay them so well every month. I am interested in finding more people w/ the same problem.

If you have been denied coverage by Coventry health care AKA Coventryone. Please leave a message here.

Thanks
     
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Suusan B. on 2009-06-01:
Does your plan have an annual deductible? Did you go to a doctor in the Coventry One network? Does your specific plan cover annual physicals? What was the reason you were given for the denial of your claim? There are many reasons why your claim wasn't paid which is not the same as coverage being denied.
kcooper74 on 2009-06-18:
Hi, I am having the same problem with Coventry. My son is supposed to have a surgery in July and they are refusing his surgery. I have known tons of people that are having problems with this insurance company. I went to the insurance commissioner, waiting a call back. You need to make a call and place a complaint as well. Everyone needs to say something so we can get this company shut down.
Bz1 on 2009-06-25:
Hey,
I'm also having problems with Coventry to approve and pay claims for doctor's visits. I'm in process of switching back to Humana, they approved most doctor's visit in just two days.
They do offer great price, but I can't keep fighting with them over something as simple as a doctor's visit plus the fact that they take very long time just to even denied claim.

STAY AWAY FROM COVENTRY!
Disabled Worker on 2012-01-22:
Coventry Health was hired in Chicago to oversee on duty related injuries of Chicago employees. Chicago Police and Fire Depts are battling this company's continued denials of its members physician treatments.
RE on 2012-04-10:
Shortly after receiving coverage, I developed gall bladder issues. The pain and sickness sent me to the ER 3 times before we figured out what it was. I have had zero issues with Coventry paying my claims. It is important to choose a provider from their network. Their benefits were a bit confusing at first for me - however, a quick call to the customer service line cleared things up very quickly for me. I have been extremely please with the speed and reliability of their service. They have done everything they said they would. And the plan is working just as it was described to me.
STP on 2012-12-10:
I had the same problem. At first they denied my coverage by pinning down on my pre-existing condition, which they couldn't find after going thoroughly through my medical records. Then they dug up my application and found something that they said I made a material misrepresentation. I am fighting with them now and my doctor agreed to help me. However, I might need to get a lawyer.
jason on 2013-07-30:
I hate Coventry I am having kidney issues and I checked out all the hospitals they will let you go to in Texas they have only one in a big state like Texas they should have 50 or more . next I asked what if I used another hospital out of network I was told I would have to pay for it out of my own pocket , that's funny 100,000 dollar surgery yea I have that kind of cash in my sock drawer. they are a cheap crapy knock off insurance company I will go back to blue cross blue shield.
Ed on 2014-02-27:
Just signed up with Coventry, needed immediate medical, they sent me a list of Providers. When I called them, they declined. They are not willing to do business with Coventry---I still need immediate coverage
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