Collective Health Avis 12

Everyone is really nice every time I talk to them, but there’s constant conflicting information and downright incorrect information. Some of them will go the extra mile and some of them will just push the responsibility back on a third party. My providers also mention it’s exceedingly difficult to get a hold of anyone.

Currently, they are billing my in-network providers as out-of-network and so I don’t have a correct estimate to pay for an upcoming appointment. Very disappointing.

Extremely long wait times. Inaccurate billing. Inaccurate clearinghouse information provided by Collective. EOBs are sent manually??? Representative don't call back, even though I was told to expect a follow-up call ( more than one occasion). Single Case agreements are impossible. I just call and call...

Collective Health is incompetent. Their customer service people are pleasant, but give incorrect information.

Constant delays and denials of benefits that are included in one's plan.

They make an art of saying it is always the customer's fault and you need a new code, that wasn't ever required in prior years, or they tell you a provider is Out-of-Network when the provider is, and always has been In-Network

They also require users to 'waive' all rights to a class action law suit in order to use their online portal.

Check out Reddit for good information from other fellow Collective Health sufferers.

This company is trash. Ever since Providence partnered with Collective Health all of my insurance claims have been denied for no rhyme or reason. They SHOULD be in-network, but they LOVE stating it is out of network and trying to charge me $210 per therapy visit that was covered completely before this awful company came along.

I've called them 3 times and they are always unhelpful and incredibly vague. They also contradict themselves as they kept telling me my claim was approved, when I could clearly see it was denied on their website. They obviously just care about charging patients the max out of pocket rate so they can make money. Truly a disgusting scam. 0/10

Processed in-network claims as out of network incorrectly in February. Said it was a one-time mistake being corrected. It took forever to correct, and then months later, it happened again here in April.

Hold times for customer service have been 1-2 hrs for members like me, and even more hours for providers, causing them to nearly cancel my husband's surgery in January due to being unable to verify the billing expectations in time. They are basically a scam.

Collective Health is the most difficult insurance company to get things approved through for medications. Unfortunately, they were awarded the contract to support Providence Health through the State for employees. I broke my back in 1991. It took 15 years before a doctor realized I knew my back had be broke. Then, I had a failed surgery which has caused chronic pain 24/7. Before Collective Health everything wa so easy and physicians actually could practice medicine and were never questioned when a prescription was written. Not anymore. Collective Health denied my prescription for a low dose of pain medication so I paid $363 out of pocket for 30 days worth of meds. Then, as a Type 2 diabetic for 15 years, ai take a short acting and long acting insulin injections. My doctor wrote the same prescription ai had used for 15 years and Collective Health denied it. My doctor tried another brand. They denied. At this point in haven’t had insulin for five days. However, Collective Health finally approved another generic insulin but it had to be ordered by my doctor using mail order and I won’t receive it for 4 more days. This is totally ridiculous that I should have to do without insulin for 9 days. I truly hope that Providence doesn’t give them an new contract next year. I am not the only one who has been a victim of Collective Health’s stinginess. Two of my physicians of mine says they are not practicing medicine any longer and all they do is check vitals and insurance companies like Collective Health are practicing medicine as it has been removed from their hands. This is unacceptable for not only patients, but for physicians who have dedicated their lives to help others. Collective Health acts as though doctors are not educated or experienced in prescribing medication for patients they see consistently. Collective Health never sees a patient. Sad.

I used to have great insurance, but since my insurer started using Collective Health as a TPA it has become garbage. My provider couldn’t even submit prior authorizations because their portal showed me as being uninsured. Just waiting to see how they screw up billing when it arrives for my prior authorizations that were approved last year. Total dumpster fire.

I didn't get the new insurance cards for my family before they had appointments in January but the new cards were required. It took 2 weeks to get them after requesting new cards. The app is broken and requires you to authenticate every time you change menus. They were suppose pull over last year's information and haven't. Nor have they processed anything that has been submitted. My kid has a bill but hadn't been to the doctor yet.... There's plenty more.

There was no communication from Providence that my number would change, much less coverage.
I was trying to refill a prescription I have been on for over a year and when I went to pick it up I found out it was not covered! I had to get my doctor to get pre-authorization....for something I was already on? That took over 3 weeks!

I have tried to find out what else now needs pre-authorization on the patient portal...cannot find any information about it...
Useless

My employer switched our health insurance to Collective Health at the beginning of the year and it has been an abject failure.

In the first few days, problems arose. Providers could not verify coverage, despite providing them the insurance card given to us by Collective Health. This happened with every provider who tried.

When I called to see what was going on, the message said, "Wait times are longer than expected. The expected hold time is 10 minutes." Ok, not a problem. But then I was on hold for over 50 minutes before I spoke to someone.

Once I got a person on the line, they said there doesn't appear to be a problem, despite providing them numerous of health care professional who could not verify our coverage.

After explaining the situation again, I was told to hold, "for just a minute" while the agent checked on something.

After 30 more minutes on hold I was tranferred to someone to whom I had to explain everything over. The agent said they would contact the providers that were having difficulty on my behalf, and that they would call me the next day to follow-up.

Having already lost confidence, I actually made the agent promise to do so.

The next day, crickets.

Despite this, I called back, asking a new agent for a copy of our policy. I was continuously directed to a "summary", not the actual policy.

I was again put on hold for at least 15 minutes only to speak to the "Escalation Team" who informed they could not provide me a copy of the policy because they didn't have it. What?!?!

Simply unbelievable.

STAY AWAY!!!!!

I previously had a direct BCBS insurance policy. My employer switched to Collective Health. You are _not_ allowed to contact your insurance company directly when using Collective Health. Unfortunately, Collective Health is not very good at dealing with insurance companies. I had an obvious billing mistake and Collective was unable to resolve it. I am unable to talk to the insurance company at all to do so myself. I will be losing thousands of dollars because of this.

I have been employed for 4 decades. And, for the most part, dealing with HC claims and providers has been very time consuming/frustrating.
UNTIL, Collective Health, came into the picture. For the last two years, they have been a terrific partner. CH is a TPA that is incredibly positive and client friendly. When I have had an issue, they have promptly addressed it. In most cases, the resolution was in my favor. When not, there was a legitimate reason, which CH clearly explained to me.