NEW LONDON, KENTUCKY -- MHBP has refused to pay benefits for a November 2011 MRI for my son. We went to an "in-network" provider and obtained pre authorization from MHBP prior to the procedure. After the procedure, MHBP denied the claim and indicated that the MRI was not medically necessary. I appealed the decision and submitted 27 pages of charts notes and letters from two of my son's doctors supporting medical necessity for the procedure. MHBP has denied the appeal. They also failed to respond to our appeal within 30 days and failed to provide copies of documents relevant to the denial (the timeline and copies of docs requirements are outlined in the "Plan Brochure").
Almost 60 days after filing the appeal, we have heard absolutely nothing from MHBP. We learned of the appeal denial by obtaining a copy of the denial from our son's provider. This is most egregious of several MHBP claims denials for routine medical procedures or doctor visits. Thankfully, we have switched to another plan (GEHA) and are having no problems with denied claims.
We continue to struggle to get MHBP to pay for 2011 claims involving covered services within-network providers. We would advise anyone purchasing health insurance to avoid this company. Dealing with them is an incredibly frustrating combination. They refuse to follow their own contract (The Plan Brochure) and are incompetent at the same time.
P.O.BOX 8402, KENTUCKY -- After moving to a new town I consulted the website for the Mail Handlers Benefit Plan, Coventry network, to find an in-network physician. I went to see this family physician in October and all was covered. Now, 6 months later, I went back. I consulted the website before making the appointment to make sure he was still covered in-network. Coventry now says that despite this doctor being listed on their approved website, and despite having covered this doctor as in network previously, this doctor is not now, nor ever has been, in-network. They insist that you must call to confirm any information on the website, because it could be outdated.
I'm not sure what the point of having the website is if you cannot actually count on the information being true. I took my daughter to see a different physician listed on their website as in-network. They covered the doctor's visit as in-network, however the blood test they performed and assessed on-site, within their office, was not covered as in-network. Apparently, Coventry says the doctor is okay, but the labs performed and assessed within the same room we saw the doctor, is not in-network.
These people have given me nothing but trouble and it is expensive insurance!!! I suppose $700 per month isn't enough to buy us 3 simple doctor's visits per year for sinus infections.
I just finally canceled Mail Handlers Health Insurance, and then changed my health insurance. I tried repeatedly to advocate for my necessary medical needs, only to be blown off from the Mail Handlers' customer service. Two MHBP providers have turned me over to collection agencies. Mail Handlers refused an MRI on my ruptured disc and then refused to cover a routine mammogram. Both physicians involved told me this should have been covered. I sent in doctor notes, orders, etc, REPEATEDLY. I am very unhappy and am now struggling to pay $750 to the collection agency. This is a crime.