Mail Handlers Benefit Plan - MHBP - Denial of Payment for Covered Services
MHBP Health Insurance - Complaint
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 aggregious 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 with in-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.