MultiPlan - MultiPlan PHCS - "covered services"

Apr 11, 2022

RubyCabs-of Lakewood, US

On 3/30/22 I was admitted via emergency with Los Alamitos Med Ctr in Los Alalmitos, California. The admission office needed to verify my benefit coverage and was told that "I do not have emergency or inpatient coverage". Called member services and told me that I have 70-30 coverage and LAMC need to bill them to claims services. This went on for 2 days. LAMC requested for an LOA since they are not contract providers although PHCS has them in their provider directory. PHCS declined LAMC for LOA. On 4/1/22 I was ready for discharge and ended up paying my bill out of pocket. When I called PCHS to cancel my plan, I was offered a "reimbursement" by member services. However claims dept. said I do not have coverage and member services may have "misinformed" me about the 70-30 coverage or reimbursement. This could be a potential small claims court case...

On my enrollment, I was personally informed by the "senior benefits operator" that I have hospital coverage with no deductible. Signed up in feb 11, 2022 - made 2 monthly payments before this unfortunate emergency event happened.

It am disgusted by the level of fraud and misrepresentation this company is committing. Beware of the sweet deals or "cheap coverage" they sell. You are better off applying with reputable direct insurance companies.