ComplaintsforMax Health

• Initial Complaint

  12/21/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  *********************************** ********************************************************* ************ ******************* 12/21/2023 Better Business Bureau Subject: Complaint Regarding Failure of Max Health to Submit Necessary Referrals for Insurance Coverage Dear Sir/Madam,I am writing to lodge a formal complaint against Max Health, a healthcare provider, for their persistent failure to submit necessary referrals for medical procedures to my insurance provider, Aetna. This ongoing issue has resulted in significant financial and emotional distress, as I am now facing undue medical bills that should have been covered by insurance.The most recent and pressing instance involves a knee surgery I underwent on September 28th. Despite the procedure and associated anesthesia being covered under my insurance plan, my claim was denied due to Max Health's failure to provide the requisite referral documentation to Aetna. This is not an isolated incident; I have encountered multiple instances where Max Health has neglected to submit referrals, causing denial of coverage for other medical services as well.I have made several attempts to resolve this issue directly with Max Health, including numerous phone calls and emails to their corporate office, to no avail. Although I had multiple three-way calls with Aetna and Max Health, where Aetna clearly explained the procedure for submitting referrals, Max Health has continued to neglect this crucial step. In these calls, Max Health repeatedly insists that I do not require authorization, which is a misrepresentation of the issue at hand. What is required is a "referral," not an authorization, for the insurance to cover the costs.While I did manage to speak with the office manager at Max Health, who resolved some of the denied requests, the claims related to my knee surgery on September 28th remain denied due to the lack of a referral.This situation has placed an undue burden on me, both financially and emotionally. The negligence exhibited by Max Health in handling referrals has led to not only unwarranted financial implications but also a significant level of stress and frustration.I am seeking the BBBs assistance in addressing this matter with Max Health. It is imperative that they adhere to the proper procedures for submitting referrals to ensure their patients receive the insurance coverage they are entitled to. I hope that through your intervention, Max Health will rectify the current issues and improve their processes to prevent such occurrences in the future.Thank you for your attention to this matter. I look forward to your prompt response and assistance.Sincerely,***********************************

• Initial Complaint

  12/08/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  This company has called me daily for about a year asking for *****. I've asked them to stop nicely. I've asked them to stop rudely. I've blocked their calls. They keep calling and leaving messages daily! I feel harassed at this point.

• Initial Complaint

  09/09/2022

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  MaxHealth Complaint I am having extreme difficulty with ******************* staff at Max Health. My primary care physician provides referrals to specialists I need to see. Several of my specialist have had to cancel my appt 3xs because no referral has been received; at present my Neuro specialist has had to cancel and reschedule my appointments twice due to not receiving PCP referral, and another of my appointments in two days is on the verge of being canceled again because this referral paperwork still has not been received. The few referrals done recently, have either been sent to the wrong physicians in the wrong town or sent days/weeks after date of appt. This negligence is preventing my care and my health issues are retrogressing. . The company is called MaxHealth in ***** *******. They purchased my PCPs private practice in the past 18 months and I (and others) have had constant problems getting these referrals processed and sent for my medical care. This is an urgent situation having negative affects on my health. I and my doctors have made repeated requests to MaxHealth via phone, in writing, and electronic for this information well in advance of schedule appointments. This clerical staff is negligent and simply does not do their job, directly affecting my health mentally and physically. My primary care doctor makes the referrals but the clerical staff is not processing the referrals which prevents me from having the appointments I need to be having. I am a senior citizen and I am experiencing a serious decline in my health because of this negligent and abusive pattern of behavior. It is unacceptable and company does not respond. This company is playing with my health. This is not a reflection on my personal physician; he is doing his job. This is a direct problem with the clerical staff in the ******************* of MaxHealth in ***** **.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩