The following (long) letter is on its way to the credit bureaus and should explain most of it.
(Personal Info Removed)
21 February
Gentlemen:
We are writing to inform you that we are vehemently disputing any and all entries found in our files that were reported by Alabama ER Admin Services and/or CMRE Financial Services. We request that any derogatory information that has been reported to your agency by these two entities be immediately amended to show that (personal info removed) were never at fault regarding this matter. We would appreciate being informed, in writing to the address listed above, when this has been accomplished.
GE Group Administrators, a health insurance company, has behaved in virtually a criminal manner in their response to this claim and has stonewalled, lied, and otherwise impeded the proper payment of this relatively tiny claim for over 16 months.
However, it has been the unwillingness of both companies, Alabama ER Admin Services and GE Group Administrators, to communicate properly between themselves that has resulted in attempting to wrongfully punish me for their poor business practices, as we shall attempt to explain.
On 10 November (personal info removed) suffered a broken leg and was treated at the emergency room of Baptist East Hospital in Montgomery, AL. At that time, she was fully covered by GE Group Administrators, under a policy that was paid for (personal info removed, via payroll deduction.
As a result of this incident, medical bills for emergency treatment, corrective surgery, and rehabilitation were submitted to GE Group Administrators by various entities. Some of these bills were paid in a timely manner, although several were not.
In each case, we received notification from the effected party and we were eventually able to make inquiries to GE Group Administrators and have the situation resolved to everyones satisfaction. The one exception to this was a claim from Alabama ER Admin Services for services rendered, which amounted to $144.00.
For a period that eventually stretched to over a year, we repeated a futile pattern. We would receive a notification from Alabama ER Admin Services, via U.S. Mail, that we owed them $144.00. Each time, we would call GE Group Administrators and were told that they had not received a claim. We were instructed to have Alabama ER Admin Services re-submit the claim. We would relay the instruction and go on about our business, thinking that these two professional entities would resolve the problem. After approximately nine months had passed and this cycle continued to repeat itself, we began to ask more questions about the claims submittal process from each of the parties.
Although we are still fuzzy on all of the intricacies, we were told that there is an electronic process that they are both subscribers to. Having lost faith in this electronic process, we tried to arrange for Alabama ER Admin Services to send their claim to GE Group Administrators via fax. This did not change the cycle of futility. We would receive another past due notice from Alabama ER Admin Services, call them to ask if they had re-submitted their claim, and receive an affirmative answer. We would then call GE Group Administrators, who would say that they had not received any such claim. We would, again, get a fax number (which changed from time to time) and relay it to Alabama ER Admin Services. Each time, we felt sure that this time everything would be cleared up.
During the months that this cycle was playing itself out, we tried repeatedly to simply have the representatives of the two companies talk to each other to clear up the mess, but they both refused. A representative of Alabama ER Admin Services firmly told us that they do not speak with the insurance companies and she pointed out that the bill is the patients responsibility. Perhaps that it is true, legally speaking; but if a company simply wants to be paid the money it is due, and could do so by making a phone call, it seems that it should make the phone call (toll free).
For its part, the representatives of GE Group Administrators said that they were more than willing to talk to Alabama ER Admin Services, as long as GE wasnt making the phone call. This struck us as extremely childish on both of their parts and we told them so, but to no avail.
In November after a full year of this fiasco, we wrote a particularly frustrated e-mail to the GE Group Administrators website, which finally elicited a response from someone in seniority who promised to look into the manner. Although they never gave us any feedback of their accord, our inquiries revealed that, as of mid-December, the claim was finally registered and was being investigated.
At long last, we called (still no feedback, despite our ardent pursuit of the matter) and were told that a check had been mailed out for the full amount on 27 December.
We were quite relieved until we received another notice from Alabama ER Admin Services that we were severely delinquent. After we verified the payment by GE Group Administrators again, we called Alabama ER Admin Services with the payment information. They said that they hadnt received it and that the payee reported by GE Group Administrator was the wrong doctor.
We reminded Alabama ER Admin Services that they, not us, had submitted the claim and that we didnt know the names of any doctors there. It seemed to me like another issue easily resolved by a phone call between the two companies, but Alabama ER Admin Services refused to take any responsibility or action, other than referring my account to a collection agency.
This referral wasnt made known to us until, after receiving another delinquency notification in February we called Alabama ER Admin Services and were summarily transferred to the collections agency, CMRE Financial Services. After a snippy conversation with Deana, a supervisor at this agency, we were ordered to request that GE Group Administrators mail an Explanation of Benefits (EOB) directly to the agency. We did so within the hour and Deana informed us that our account had been put on hold pending receipt of the EOB.
We received our copy of the EOB on 15 February. It really was nothing more than a computer printout and did not even contain contact information or any indication of whom it was from. After waiting a suitable amount of time, we called CRME Financial Services on 20 February. They said that they had received nothing. A call to Jonathon at GE Group Administrators that day indicated that the EOB had been sent, as requested, and that a check trace, although not requested, had been initiated.
The following day, we called to confirm this before confronting CRME Financial Services. This time, Lena at GE Group Administrators informed us that an EOB had NOT been sent to the collection agency, nor could it be sent legally, because it contains private medical information. Pat, her supervisor confirmed this, but had no explanation as to why we hadnt been informed. She did offer to mail and fax it at that time, dropping the apparent legal objection. They had not retained the address that I had requested they mail a copy to, so we had to contact CRME Financial Services to acquire that information again.
However, Deana indicated that I could just fax her our copy, which we did. When we called to verify that she received it, she indicated that she would then query Alabama ER Admin Services as to the status of the payment.
So, this is where we are today a standoff. GE Group Administrators claims that they put a check in the mail over 6 weeks ago. Alabama ER Admin Services claims that they never got it. My account has been turned over a collection agency, and I have no idea what has been reported to your agency regarding the matter. I have been informed that a check trace will take approximately 45 days to complete.
The fault, in our lay opinion, lies primarily with GE Group Administrators for their apparent refusal to acknowledge this claim for well over a year, incompetence, deception, lies, and poor customer service. We are trying very hard not to believe that they are either (1) refusing to pay a legitimate claim because they assume that we would rather simply pay the sum ourselves to salvage our credit or (2) attempting to commit some sort of fraud.
We believe that Alabama ER Admin Services has also behaved in a manner that has left something to be desired. They have repeatedly insisted on working only with us, instead of taking matters directly to insurance company, who is obligated to pay the bill. Again, I understand their contention that the bill is ultimately the patients responsibility; but this claim was not denied for any reason.
We note that GE Group Administrators contends that they did not receive a claim from Alabama ER Admin Services until late November and that they paid it in full within 6 weeks of receiving it. On the other hand, we do not know what happened on the numerous other occasions that Alabama ER Admin Services contends that they submitted a claim.
We are not and were not privy to whether they were submitted correctly or incorrectly, or whether they were submitted to the appropriate channels. For our part, we can state that we faithfully relayed to them the fax numbers and other instructions that we were given by GE Group Administrators.
We believe that we have acted in good faith at every step along the way. We acted as a middleman on at least a dozen occasions, despite our limited understanding of the internal workings of claims processing, and worked diligently to see that all parties carried out their obligations. They are the professionals in this industry and they could have and should have resolved this a year earlier.
We therefore reiterate our request that any and all derogatory information regarding us by Alabama ER Admin Services and/or CMRE Financial Services Agency be immediately removed from our credit information. We are quite confident that an inquiry by you into our account of these events will bear us out, and we encourage you to conduct one if you disbelieve us.
As a final note, a copy of this letter is being sent to Alabama ER Admin Services, CMRE Financial Services, and GE Group Administrators. Additionally, this letter will be posted as complaints at the Better Business Bureau website and at The complaint website. If any of these companies cares to rebut the facts as we have presented them, we keenly await a response.
GE Group Administrators
PO Box 15035
Arlington, TX 76015
(800) 457-1406
(800) 397-6241
(817) 557-6600
Alabama ER Admin Services
PO Box 35246, Drawer 107
Birmingham, Al 35246-0107
or
PO Box 4419
Woodland Hills, CA 91365-4419
(877) 864-7002
CRME Financial Services
3350 E. Birch St, Suite 200
Brea, CA 92821
(800) 783-9118
Sincerely
(personal info removed)
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