Public Mediation

Disappointed Customer( Billy Jenkins) vs. Healthscope Benefits Provider

Major screw- up and refuse to pay bill, Healthscopebenefit provider

M. J. vs. Healthscope Benefits
27 Corporate Hill Dr, Little Rock, Arkansas, 72205, United States
Amount Involved: Other terms
    • Status: In Negotiation
      This claim has posted for public comment and negotiation. It will remain posted until resolved to the claimant's satisfaction. Suggest a resolution to help these parties reach a settlement.
      (seeking public comment)
    • Claimant Seeks: 1 non-monetary items.
    • Claim #: 1875722
    • Amount Involved: N/A
    • Filed On: Sep 08, 2021
    • Posted On: Sep 19, 2021
    • Complaint(s):
      • "I just feel ripped off."
      • Other
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Statement of Claim
Claimant says:
"My husband( Billy Jenkins) was working for a company by the name of Southeastrans located in, Indianapolis, IN, my husband (Billy Jenkins) insurance started in October 2018, at that time, we had no issues what so ever, until the company (Southeastrans) changed providers without notifying anyone, HR will deny it, because they have indivduals whom are very rude, anyway, we thought our insurance was still in place with( Healthscope Benefits) and all billing was to go through another insurance company by the name of (EBMS), so on, March 30, 2019, my husband (Billy Jenkins) was in a bad car accident, another driver hit him in the parking lot, where Target department store is located.
I (Michelle Jenkins) wife, took my husband (Billy) Jenkins) to Porter Regional Hospital, were he was diagnosed with a mild concussion, insurance information was given, and the hospital was to bill our insurance company(EBMS) at (P.O. Box 21367, Billings, MT 59104-1367. This is the problem after two years plus no one paid the bills that was due, until this year 2021 (EBMS) decided to pay, but no one ever told us that, (Healthscope Benefits provider) contract would expire on, March 31,2019, We just found this out last week, when, I phoned Healthscope Benefits (9-31-2021) when speaking with Donna a customer representive, whom stated they received the hospital bill on (10-11-2019). I stated why didn't your company reach out to us? Donna the customer representives stated they sent us out a letter. I stated no disrespect, we recieved nothing, she also stated they wanted to know, if my husband injuries due to accident, if we would have recieved anything from them, all the information would have been completed on our behalf. Donna then stated they cannot pay this $8,668.20 dollar bill. 
I stated after the Emergency room vist on, March 30, 2019, my husband woke up with, physical functional losses, I had to close all blinds, because the lighting hurt his eyes, uncontrolable headaches, ( in which he still have today, and it will be with him for the rest of his life, I had to help him shower/bathed, using the bathroom, assisting him to doctor appointments, this mild concussion turned into something more serious, and Healthscope Benefits have the nerve to say, they wont pay the bill.
We paid over five-hundred dollars a month, in which my husband worked six days a week to get, we were living in hotels, due to this accident and now the hospital ( Porter Regional Hospital) placed a lien on my husband. This has been very stressful on us both and still fighting. 
I have prayed about it, I have called about it and now am reaching out for more help in getting this billing issue resolved, so we can move on, PLEASE!!!!"
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Additional Communication Between Claimant and Healthscope Benefits Hide
  • Sep 28, 2021, Claiming party added:
  • Good morning, I have really been doing some homework, when it comes to insurance companies, I have made a another attempt to reach out to Healthscope Benefits to find out that; when speaking with customer service representative Lavern @ 15:40pm on 27th, September 2021, she informed me, that my husband former employer; Southeastrans gave way of the group insurance they had with their company on 31st, December 2019, but gave the company permission to continue speaking with their employees until 31, December 202o, Lavern stated also, that Southeastrans medical transportation was not paying them(Healthscope) in littlerock, AR because the company had the other insured ( EBMS) in Billings, MT as the new provider, now Southeastrans Medical transportation was still receiving the premiums from the employers, and EBMS was the dole in which the company pays the medical claims, so why not pay the claim on 30, March 2019? Southeast put the new insured ( EBMS) as the new administrator, but made people think ( Healthscope was the main insurance and ant claims were to be paid by them, when (EMBS) was to take care of this situation.

    I phoned and spoken with Joann at EBMS and asked her was EBMS still Southeastrans main insurance company the company is using today? She stated yes, I asked her for the subrogation website, main phone number,and website, she stated that customer service representatives are the only people whom can speak to the subrogation meaning: allows your insurer to recouo costs for medical payments,including deductible, from the at fault driver insurance, a refund for you and the insurer. This is a big mess

What Claimant Wants Hide
Non-Cash
What By When How Much
1. pay the bill that's due Oct 25, 2021 N/A
Cash
1. Other – Pay for claim posting cost Oct 25, 2021 $14.99
Just make me happy!
Claimant invites HealthSCOPE Benefits to make a fair offer to resolve this complaint.
Cash total : $14.99
Non-cash: 1 items
  • 0
Do you agree with the claimant’s demands?  (If you are a party to this claim, click here.)
Awaiting response from Party
Richard Chapman commented
Richard Chapman (Comment):
"Was the other party responsible for the accident. Has anyone approached the other party to the accident about insurance coverage for the injuries. Most all automotive insurance carries Injury insurance. If you were not at fault in the accident the faulty party is responsible for the bill for the injuries. You need to contact a injury lawyer if you were not at fault."
 (25 days ago)
Reply

Respondent's Counteroffer


There has been no response to this claim from HealthSCOPE Benefits. This claim will remain posted until resolved
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  • Contributed Solution: by George Maxwell On 09-21-2021
    Southeastrans is self-funded and its HR department needs to help your through this insurance nightmare. More...
If you are a party to this claim, click here.
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