DELTA AIRLINES

During our review, we reached out to our Enrollment department to address [redacted]’* concerns. However, [redacted]’s information was not found in our system which required [redacted] to be contacted.An outbound call was placed to [redacted] by our Enrollment department so we could address [redacted]...

[redacted] concerns. However, there was no answer from [redacted], so a detailed voicemail was left including the nature of the call and a direct call back number ###-###-####. This way [redacted] may call our Enrollment department directly so her concerns may be addressed.I apologize for any difficulties or confusion this may have caused [redacted]. We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]Regards,Julian C[redacted]Executive Resolution Team

Hello,
Thank you for your inquiry, regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.
Upon receipt of the complaint we immediately reached out to our Claims department to have...

the member’s concerns reviewed. We were advised that the claims are processed correctly per the benefits.
Prenatal benefits are for routine care prenatal care which is billed as a global fee by the physician. These tests are not part of routine care based on policy and therefore covered under the medical benefit not the prenatal benefit.
The Maternity benefit includes:
• All prenatal and postpartum visits, including the 6-week postpartum check-up
• Routine urinalysis
• Delivery
Per policy all prenatal tests billed separately from the global fee are to be covered the same as any other medical test to diagnosis or treat a disease. Please refer to your plan booklet, which states:
“PRENATAL TESTS: Pay expenses for covered prenatal tests on the same basis as tests to diagnose or treat disease.”
I understand your concerns and recognize this is not the outcome you desired. I want to assure you we reviewed all the documents and available information before issuing this response. Our actions are solely guided by the plan guidelines in order to administer fairly and equitably to all participants.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [email protected].
Thank you,
Ashley S.
Complaint and Appeal Consultant
Executive Resolution Team

Dear Ms. [redacted]   Please see our response to complaint #[redacted] for [redacted] that was received by us on June 22, 2016. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.   Upon receipt of the...

complaint we immediately reached out to the Claims department to have the member’s concerns reviewed. We are currently in the process of reviewing and correcting any claims on file for the member. We have contacted the member directly to let him know we are working to rectify the situation and will contact him directly once the claims review has been completed.   We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. Cohen’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]
* Sincerely,   Ashley W. Complaint and Appeals Consultant Executive Resolution Team