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Review 4/28/2009
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Once you try and file a claim with Cinergy Health, you soon become aware that they are a complete scam!!! I mailed my original claim for an office visit with all the pertinent information and thank goodness, I kept a copy because after finding out that they "lost" or did not receive it I was given a fax number to send it directly to their "claims examiner" third party payer. Once I did that, I called to follow up and was told that it wasn't in the system, if I could re-send the claim again, it would be prcessed right away. I waited a week to check on it once more and was told that the only thing they found in the system under my member number was "correspondence" that was unlegible. I was asked to fax and mail it out again to yet another examiner in the the "preferred care" department of the third party payer. And on...and on...and on...!!! Don't believe the sales hype line of crap they sell you when you call in to find out how wonderfully they treat (mis-treat) you.
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Business's response - by William W.on 5/18/2009
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Lenore M., we sincerely apologize for any inconvenience that you may have experienced due to the delay in processing and adjudication of your medical claim. However, Cinergy Health is only the health insurance agency, and we do not process nor adjudicate any insurance claims. Your health insurance plan, which is underwritten by the American Medical and Life Insurance Company, processes and adjudicates all claims through a third party vendor, Preferred Care Inc. / GetHealth. We have contacted Preferred Care Inc. / GetHealth regarding your claim and they have informed us that they did not receive your claim until April 21, 2009 and thereafter processed your claim on May 1, 2009. Again, I apologize for any inconvenience you have experienced and I hope this has satisfactorily resolved your complaint. If you have any questions or would like to discuss this further, then please call us and ask to speak with the Chief Compliance Officer (x105).
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