ComplaintsforCHAMPVA
Health Insurance
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Complaint Details
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Initial Complaint
09/11/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I filed reimbursement claims back in February 2024 for my wife who is covered under CHAMPVA. While I was gathering information to get the correct information from the providers to submit I had asked 4 different representatives if CHAMPVA would cover as primary for her psychiatrist since they no longer take BCBS. I was told yes every time also the ********** called to confirm this and they were told the same thing. In August the ********** was informed that coding on the *** was wrong so the claim would be denied which in turn caused the ********** to cancel my wifes appointment and tell me we would have to self pay. My wife has a sever TBI and has been with this psychiatrist from the beginning. When i called. CHAMPVA to see what all needed to be done I was then told that there may be a possibility that they wont cover as primary, something I was never given the possibility of any of the hundreds of times I called. So now my wife has been without care and faces possible loss of medication because CHAMPVA failed to give correct information ultimately guaranteeing a ********** money that they may not get. Not only that but have lied several times about sending letters when I never received 1. In fact I wouldnt have found any information out regarding her claims had I had not called. So 7 months in and all I ever get told is call back in ***** days for an update. I work for the ** and I know they have policies and yet not one is followed and no one held accountable. If I had known then what I know now I would say dont even bother with CHAMPVA its a waste of time.Initial Complaint
08/01/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Initial forms sent to CHAMPVA for approval for my spouse as she is my beneficiary. I never heard back from them. I tried to call many times but the CHAMPVA phone line would never pick up the call. After many weeks of trying they eventually answered, There was one line on the application that was not correct but CHAMP never called to offer assistance. And, when I did speak to CHAMP they were very unprofessional and rude to my spouse and myself. Moving forward to calls placed on 8/1/24. When you leave a call back number CHAMP called once and said they would have to call my spouse back but a 4pm the phone rang once from CHAMP but no one was on the line. We are trying to find out from CHAMP who is getting paid back the co-pays. A simple question that has not been resolved. We just want a call back.Thank you.Customer response
08/01/2024
In regard to complaint #********. This has been resolved. Thank you.
***********************************
********, ***** 04664Initial Complaint
03/15/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
*** submitted a claim for reimbursement from my secondary health insurance Champ Va two years ago. They approved it and tried sending me a check 2 times which never made it to me. Then they canceled the check and sent my claim back for reprocessing which I have no idea why since it was already approved. Now they are saying they cant open my file at all and I have to resubmit again. Reimbursement is for 2000$Initial Complaint
12/20/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I am writing this because because you can't contact such a person who takes complaints at CHAMPVA . CHAMPVA is great once you know how it works. But there are a couple of concerns:1) CHAMPVA uses social security numbers for Member ID - I just got done calling a *********** medical billing office who does billing for MD Imaging in *******, **. I had to give them my member ID which is my social security number.We don't live in a era that uses Continental ************************ billing departments. Usually billing is outsourced to ***********, ***********, or even ***** for some things.CHAMPVA needs to change the practice of using Social Security numbers immediately. It is an unsafe practice. Note: they finally managed to change it for the Veterans.2) They disconnect on you, especially if you press the "Patient" line. Several times I have given my ID and then you wait for a response, only to find out they are no longer on the line - the line is just blank.Initial Complaint
08/23/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I have qualified for ChampVA since October 2021. My daughters was seen by their primary care provider on multiple occasions. This past June when 2 of my daughters was seen, ChampVA denied the claim that their *** submitted and their reasons was "patients have other insurance" which is not true. I called and is on hold for several hours before the phone disconnect. I finally got someone to help me on 8/18/23 and she assured me that it was a typo and that they will send payment to the doctor once they resubmit. Today (8/23/23) the *** called me to let me know again that the claim was once again denied. I called back and waited on hold for more than 40 mins. When the representative answered the phone, it sounded like she was under water and it was hard to understand her. She had an attitude the whole time. She starts yelling at me while I am explaining to her the situation and calling me a liar. Once I asked her to please transfer me to someone else because she was not understanding me, she stated " I can't do that, you have to call back to get someone else". I then asked if she can transfer me to her manager and she hangs up in my face. She never gave me her name but she had a thick african/island accent. This call took place on 8/23/23 between 4pm and 4:50pm.Initial Complaint
07/14/2023
- Complaint Type:
- Product Issues
- Status:
- Unanswered
I received my Champ VA coverage in June 2018 after my husband was 100 percent disable by the military. I received a package from the Champ VA program along with my card and it stated that I could refile any medical bills dating back to December **** for reimbursement that I had paid on. I filed the claim and submitted the bills. The package came back to me with a letter stating that I had not given the correct information needed and that I needed to send the EOBs with the package, so I called all the hospital's and physician's offices needed and got the EOBs and resubmitted the package for a 2nd time. The package was returned again stating that I needed to resubmit with CMS-**** forms and UB04 forms, so I called the hospital again and explained the issued and they sent the the forms I needed, and I resubmitted again. In between all the resubmission I made multiple phone calls to the Champ VA program, as they apparently lost one packet of information and I had to resubmit that twice, and now I have received the packet back again today, 7/14/2023 and they are asking for more information. I am at a loss for words as to what to do. This process is now into its 5th year with no resolve. I'm asking for someone to please please help me. I find that all of my efforts and phone calls fall on deaf ears. I have worked in healthcare for almost 30 years, and this is just unacceptable patient care.Customer response
08/16/2023
It doesn't say how you tried to contact ChampVa. Do you have the correct number?Initial Complaint
06/13/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
There are no health care providers that except champva for my son. I have ask for information on providers and have been told there is no such information. This insurance is a scam to veterans and their families. I now have to find a way to get medical coverage for my son out of pocket even tho I am a disabled veteran that was assured my son would be covered thru my service to my country.Initial Complaint
04/14/2023
- Complaint Type:
- Product Issues
- Status:
- Unanswered
I applied for CHAMP VA Benefits in December 2022 with all forms needed. I was informed that they are behind in processing applications and will take six (6) weeks. That was four (4) Months ago with no resolution. I am now being told that my ex-wife, that divorced me three {3} years ago, had not been removed. I have sent three {3} separate times to the fax number given to me by CHAMP VA. I was told that they never received my divorce decree and to re-fax the decree, and it would take more time to complete the application process.Initial Complaint
06/15/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
My son (age 5) currently has ******************** due to his father being a medically retired 100% disabled veteran. My son has been diagnosed with numerous medical conditions - he has been referred for occupation therapy, physical therapy and speech therapy. ******************** covered both occupation therapy and physical therapy with no issues, they even covered Speech Therapy from the time he started which was 2/17/2020 up until 10/16/2022 (that is 57 approved and paid claims for speech therapy that they covered). All of a sudden beginning middle October (when they stated they switched billing systems) they are no longer covering his speech therapy. The EOB's originally stated missing info - this was submitted by the therapist, numerous calls with the provider of services, ******************** and myself took place in which we were told for months that it was an error on their side and they would resolve it. We were assured it was a covered service (numerous supervisors also stated this - we kept very detailed notes) as it had been for over the last 2.5 years! Now on our call with them early June I spoke to another supervisor who now states that the service is not covered, she also slipped up and stated that their coverages changed in October and they aren't required to notify the subscribers because they are not an actual insurance company but rather a supplemental service which is ran by the Government. So I guess I shouldn't be shocked at this - however I did go through all 56 approved claims with her, all which had the same billing codes as the newly denied ones. Best part is 4 claims were actually approved this year and paid! (Must have been an oversight some how since this service supposedly isn't covered anymore). I requested a call from her supervisor in which she ASSURED me would happen, after I asked what do I do if I don't receive that call, guess what? NO CALL was placed to me. Needless to say I am getting in touch with my Congressman. ******************** and it's employees should be ashamed!Initial Complaint
06/02/2022
- Complaint Type:
- Order Issues
- Status:
- Unanswered
ChampVA will not fix an error in their claim processing system. Claims are being denied because of this issue. Radiologist are separate from hospitals; therefore, **** only for the professional readings; whereas, hospitals **** for the technical part. Radiologists use HCFA **** claim forms and file with modifier 26 for professional only. Hospitals **** on a UB04 form which is institutional claim form and modifier TC is not required since it is an INSTITUTIONAL claim. ChampVA will pay whoever gets their claim in first (normally the hospital) and denies the radiologists' claims as duplicate service. ChampVA refuses to acknowledge the problem and states that if we do not agree then we need to appeal the claims. My request is for BBB to address the issue with ******************** at ChampVA and have computer system fixed to acknowledge the difference between the technical (institutional) claim and the professional reading and pay for both services.
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Customer Complaints Summary
10 total complaints in the last 3 years.
4 complaints closed in the last 12 months.