★☆☆☆☆

William Faulkner

9 months ago

TLDR: If your plan is serviced by Wellspan Population Health, expect poor customer service, delayed care (even routine care like a CMP, lipid panel, or PCP visit) as a result of administrative policies, and erroneous attempts to deny service.-Very poor service. Customer service, especially Kim, will try to turn you away without answers and attempt to ensure no resolution to your problems will be reached. They will do this by either referring you to a different entity, like Quest Behavioral Health, Wellspan Health, or Blue Cross Blue Shield despite the ID card stating Wellspan Population Health is the member services number and stating Wellspan Health has hired Wellspan population health services to process claims and provide administrative services Kim and the other customer service agents will also become combative when asked for solutions to problems Wellspan Health created through the design of their plan and administrative procedures. There are a limited number of customer service agents, so you will normally end up with one of the few combative agents.-PROVIDERS WILL TURN YOU AWAY EVEN IF YOU ARE IN-NETWORK BECAUSE WELLSPAN DOES NOT VERIFY COVERAGE ELECTRONICALLY. Kim and others at member services fail to answer questions like how do providers electronically verify coverage? Kim failed to provide instructions on how to electronically verify benefits and claimed providers can only verify coverage by phone despite the fact that electronic verification of coverage is commonplace in the healthcare industry.-Plan documents distributed to members are patently false. Despite stating providers: file claims with local blue cross and/or blue shield plan on the ID card, providers may have to file with Wellspan directly or with another administrative entity. Despite stating Capital Blue Cross provides administrative services on the ID card, Kim stated that Capital Blue Cross does not provide administrative services. When reminded of what is on the card, Kim stated that that was true, but also false since we operate differently than capital blue cross plans. After being told providers are delaying care due to phone verification requirements, Kim stated no call takes thirty minutes to answer despite the fact that one hour prior to the call to member services by the member a call by a provider to verify coverage took 20-30 minutes to be answered. When told the member was present for the phone call and the wait, Kim verified the time it took to answer the call.-After telling the member the only method of verifying coverage was via telephone, Kim stated the member should put it in a letter to population health, but they won't change anything.

★☆☆☆☆

Janet Vizkelety

2 years ago

This year they are forcing all Wellspan employees to get their prescriptions at Wellspan pharmacies and it is a total disaster because Wellspan pharmacies can't handle the increased volume. It takes days to get prescriptions filled and it is difficult to get to a person by phone. My doctor changed a medication. She sent it to the pharmacy on Monday and on Tuesday morning I called because I wanted to pick it up at 1:00 on Tuesday. I was unable to get through due to an unusually high volume of calls so I left a voicemail. When I went to pick up my prescription it wasn't ready and I had to wait twenty minutes. On Thursday the pharmacy called because they had just picked up the voicemail. When I called customer service she supposedly was going to transfer the call to the pharmacy but it got transferred to a fax machine. My local pharmacy can fill prescriptions for 60 or 90 days and they are more efficient and have way better customer service.

★☆☆☆☆

sarah rasinska

3 years ago

★☆☆☆☆

Amber Grove

3 years ago