Aflac’s earns a 2.0-star rating from 170 reviews, showing that the majority of policyholders are somewhat dissatisfied with insurance coverage.
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accident policy claims not being paid
I file a claim with AFLAC, send in proof of the visit from the doctor's office (statement/Superbill) instead of the HCFA 1500 form because our insurance wasn't billed and they deny the claim. We have had lots of accident claims and are not "black balled" because of it. They will not pay claims without a HCFA no matter what I send them. I was told by Mary Perez on 12/18/17 that they need proof that the visit took place. I said I gave them the doctor's supper bill that shows date of service, date of injury, diagnosis codes, procedure codes, charges, payments, write-offs, doctor's name, clinic name, address, phone number, doctor's NPI, clinic's tax id number, our name and address. Mary said she needs the HCFA because they have to prove the visit took place so I asked her if she is accusing me and the doctor's office of committing fraud against AFLAC since she is not taking the office's paperwork. She was silent and then said no but she needs proof. I told her it doesn't make sense for us to bill insurance when the provider is out of network. It would be $25 copay, plus at least $500 deductible, plus 20% coinsurance so two visits that cost $260 if billed versus $90 if paid at the time of service. She said why can't we go to a different doctor? I said would you go to a different doctor if you found one you like and trust? She said no, but you have supplied HCFA's in the past. I said yes when we lived in Bend, OR and the doctors there were in network with the insurance I had then but we don't live there now and the insurance we have doesn't cover this particular doctor. I also asked for where in my policy does it state that if I utilize the service I am paying for that I will have have a hcfa only for proof of visit. She said it isn't in my policy. I said it has to be somewhere or the adjuster is just going rogue. She said it probably is somewhere so I requested it and she said she wouldn't supply it. She said the only way I will have my claims paid for is if I submit a HCFA form. She doesn't care about the cost to me and my family just as long as AFLAC doesn't have to pay the claim.
This has been going on for some time now. I have even sent in chart notes for previous claims, as that was what was requested, and I was told to get "the complete chart note from the doctor." To which I replied, Do you think the doctor just made a special partial note for AFLAC? These are his notes with his signature, dates, address, etc.
The claim for my wife was submitted around 12/8/17. My last claim was submitted for May/June 2017.
We are now "black balled" ... incorrectly stated "not black balled"
aflac representative
Hello,
I have 4 policies with Aflac through my employer Moda Health. I had wished to cancel ONE policy and modify one policy (keeping 3 and cancelling one). I emailed my representative and got a very vague response. I have just now had time to call Aflac Customer Service to find out open enrollment for my group has passed. It was November 6 - December 1 which is during the time frame I had reached out to Bonnie Mc Creery my Aflac representative. Had I got an actual answer to my question I would have been able to make the desired changes. As it is, I am now not able to do that and I am extremely displeased with this.
short term disability claim denied
I turned in my 2 weeks notice of resignation to my employer, who would not allow me to work the 2 weeks out. I was to start my new job at the end of the 2 weeks, during the 2 weeks I had to see a doctor who put me out of work beginning the first day of the new job. Surgery on 11/2...every hoop they asked me to jump through I did. Records sent multiple times from surgeon and PCP. Claim Denied in the end d/t unemployed! This is utterly ridiculous! Between the ex-employer and Aflac, having surgery and being out of work, I'm at my witts end! I have stopped the next payment due to come out tomorrow. Aflac is fraudulent...Doctor said I couldn't work and ex-employer wouldn't allow me to. So much money down the drain.
Anissa Rowlett Claim # [protected]
Surgery and not being allowed to work should be sufficient!
claims and payment
I filed an accident claim on Oct 23 with Aflac. I work for myself and I have a residential cleaning company. I was moving furniture to sweep the rugs and I developed a sharp Right quadrant pain, as I continued repetitive movement with my job the pain continued. I notified my doctor he ordered a CT scan which showed an umbilical Hernia. My doctors ordered more tests to be sure there was nothing else. When the tests returned It also showed my Gallbladder was not functioning properly. I was then sent to a surgeon. On October 19, 2017, I had Gallbladder removal and hernia surgery. My claim for the Hernia was denied. I am over disappointed with Aflac, their customer service, claims Dept and Supervisors. I have spent numerous hours on the phone and not 1 resolution. I gave them the authority to call and and my doctor if this was a pre -existing condion and if my job caused the hernia. I offered to send copies of prior Ct scans showing this is a current injury from my job. In my accident handbook Hernia is listed. I was working, moving furniture and the sharp pain developed so I contacted my doctor. You do not need to be a brain surgeon to see moving furniture can cause a hernia. It was not there in prior CT scans. This was new, it was never there and i was moving furniture to sweep. I am so tired of repeating the same words to each and every Aflac person. Some can be very rude and quick to their own assumptions. I pay my premiums on time and hernia is in the book. Once again I was on the job. I was told today after I forced the supervisor to contact the Drs office that she does not know how long this will take. Are you serious? You like your premiums on time and you claim to offer help, one day pay, claim resolutions... Maybe you need to stand by your word and understand a Hernia that was not there prior and that when a person seeks medical attention while on the job and a hernia is found it's an accident.A Job related accident. An injury from an accident that occured while on the job. The reference # is LO4WRTL Policy # is POC23839. I feel I am entitled to this claim. I am tired of aflac employees explaing to me their opinions. I am still limited because of my job. Right there key word. Job.. My lifting restricions will be gradually increased because I had a hernia. Job related hernia. Maybe your employees should become better educated & with more empathy.. Instead of being dictators who make false promises to help settle a claim
policy
I got aflac thru my employer... Well i quit there in april. I just recently returned to that employer in october... Aflac took my first 2 checks to go back on what i didnt pay.. I wasnt working there so the ins should of been canceled but it wasnt. I didnt even get anything in the mail about not making payments either. I didnt have the ins from april when i quit til i came back... Why do i need to pay for sonething that should of got canceled..
the services and the agent.
The Services was Bad. I was thinking about the Aflac Insurance at my Office No would never put our Employee's through what my husband had to go through. Bad Services. My Husband went through so much to do his claim and he was talked to bad. Wasn't friendly at all and the agent, was no good. They tried so hard to stop the claim and still he didn't get all his money. He was out of work 2 month's and that's how long it took.
claim cancellation
First of all let me say I have been an AFLAC customer for over 20 years. During this time there have been a few claims that they have denied for one reason or another and I have been fine with that. The last two weeks, however, I have submitted 2 accident claims, two weeks apart. Upon submitting the claim and documentation for the smart claim I have received emails indicating that AFLAC has received these items. Several hours later I log into the AFLAC website and the claim has mysteriously disappeared. All I receive is a form email from AFLAC when I question it, put one never ending hold when I call to check, and my agent is beyond worthless.
claim still not paid
My husband had a lobectomy in march 2017, I submitted a claim in april, provided over ten years worth of medical records that are completely unrelated, the send letter saying they closed claim pending receipt of records they already received; resent records and they reopened claim in august, and it is now the end of october (7 months since surgery) and still the claim has not been paid. Its not a huge claim but my husband hasn't been working for almost a year because of valley fever so any lit bit would help.
Aflac is not a health insurance policy; it is an occurrence/event policy. They pay out for an occurrence/event yet they somehow decided they need to review a claim like a medical insurance company asking for unrelated medical records. How ridiculous is this.
We have nothing to hide, have provided everything they asked for, so why is it so difficult for them to pay this claim. I email them weekly but they keep saying they need more time. Apparently 7 months is not long enough! Before this I would have said aflac is a great service to have but obviously I am completely second guessing this now.
cancer policy ps281918 - nancy watts and b3398336 victoria phipps
I have been calling on this same issue since June 6, 2017. I have a cancer policy that was family coverage with my daughter. She turned 26 in August and was no longer eligible to be covered under my policy. I wanted to purchase a policy for her. After 6 phone calls and completing several different forms I got someone to send me the property form and I was finally able to get someone to provide me and set up the policy for my daughter's account. A check was sent for $169.26 that cleared y account on 8/28 which was to cover a 3 month period for my daughter's policy. My policy drafts on the 15th so when the draft did not come out on 9/15, I called again. Turns out the amount sent was applied to my policy. I was told the amount would be reversed off and applied to my daughters policy. This did not happen. I placed another phone call and did another recording to authorized you to draft my account (I have had to do the same recording several times for other issues). Again the draft did not come thru. I got a notice saying my premium had not been received. I called again on 10/19. My daughter was with me and I was told the reversal had happened and that the premium was properly applied to my policy. I again had to give my bank account information and was told my account would be drafted for my premium for the September and October amounts due on Monday, 9/23. Yesterday, I receive a check in the mail made payable to my daughter for $84.24 as a refund for my daughters policy. Keep in mind, I paid $169.26 for a 3 month premium for her policy. I call tonight as my premium is yet to be drafted. The person I talked to, was very condescending and talked to me like I was stupid. I admit I totally lost my cool as I have been trying in June 6th. All I want to do is to have my policy drafted as it should and make sure my daughters policy is paid current an in effect. I seem to not be able to get this done. My time is valuable and to have to keep calling to get this taken care of is poor business on your part. I have been pleased with the service I have gotten with AFLAC in the past; however, it appears as if you are not interested in my business. I just need to know what I need to do to get this issue resolved without having to call another 12 times.
claims processing
I have been going round and round with AFLAC on policy P0F3D0V9. Over and over I continue to run across inconsistency and incompetent claims representatives. Aflac continues to drop the ball in my claims processing with no empathy or remorse. I have been giving incorrect information on multiple occasions and found errors in the processing of claim.
Hello,
I hate that this email have to be sent to you Ms. White. I realize that as President of AFLAC you have more imperative business matters to handle. However, I believe my experience with claims customer service and processing is of much concern.
My father Gale Grant policy holder P0F3D0V9 and PU3166775 date of birth 6/29/51 passed away with unpaid claims January 13, 2015. In May 2017, I discovered unpaid claims and began working on the process to get claims paid. Since June 2017, I have experienced nothing but turmoil and inconsistency with AFLAC claims department. Without going over each mistake and unfortunate incident, I will discuss most recent. On August 18, 2017, I faxed a claim request for Hospital Indemnity policy P0F3D0V9. I provided the dates of service that my father was in the hospital which were 11/12/2014 to 11/21/204. I also provided the dates my father was transferred to Autumn Wood Nursing and Rehabilitation Center; which were 11/21 to 12/22/2014. Under my father's policy his paid $100 per day for hospital stay and rehabilitation stay. All supporting documents were provided. However, on multiple occasions documents were not found or were sitting in queue and not reviewed. Since August 18, 2018, the processing of claims has been back and forth and numerous error made by AFLAC claims processing. My first denial was that AFLAC needed itemized bill because they could not determine if insured's stay was in hospital or rehabilitative. Despite that I provided the Discharge Summary papers from the hospital. After providing itemized billing for 5th time, claims denied due to dates of service. I was advised that Rehabilitation Service could not be paid because the dates were before hospital stay. I contacted AFLAC and advised per document sent the hospital stay were prior to Rehabilitation stay. I was advised claim would be esculated. After again providing the details of Gale Grant's hospital stay and esculating call for the third time benefits for hospital stay were approved and paid out on 9/26/2017. However, the check was sent to the ncorrect address. The benefits were sent to my deceased father address which was to updated on the policy 1/2015 and 5/2017. This was the second time the a check was sent to the incorrect address after the correct address had been giving.
On September 26, 2017, I also learned that my claim for Rehabilitation Stay was denied because claims said there was a gap when father went from hospital and rehabilitation facility. I advised that per the documents submitted my father was discharged from the Karmanos Cancer center via emergency vehicle to Autumn Wood Nursing and Rehabilitation Center per his doctor for physical therapy. A copy of letter was also provided. The claim was esculated and upon following up on 10/4/2017, I learned the claim was denied now because, I representative called Autumn Wood Nursing and Rehabiliation Center.
Therefore, I reached out to Autumn Wood Nursing and REhabilition and learned that it is a licensed rehabilitation facility per Nancy. I contacted AFLAC and spoke to representative Kimberly. on 10/4/2017. I advised Kimberly of what I learned and she to researched and discovered that Autumn Wood is indeed a Licensed REhabilitation Center. In addition per itemized bill he was there for physical and occupational therapy. She advised she was esculating claim and benefits should be paid out based on her discovery. On 10/6/2017, I followed up with 10/4/2017 call because of my lack of faith in AFLAC due to the multiple inconsistency and dropped balls. I spoke with representative Antonio. Antonio researched claim and reviewed notes and also reached out to Autumn Wood Nursing and Rehabilitation of Livonia and learned indeed it is a Licensed Rehabilitation Facility. I was placed on hold while he worked with a claims manager. Antonio advised that per claims the benefits are payable and would be paid. He could not give the exact amount of claims because numbers have not been finalized. He advised I could follow up on the following Monday or Tuesday.
On Tuesday, October 10, 2017, I spoke to Ashley. She advised me of two disturbing things. First was the claims check that was mailed to the incorrect address was not fed ex as agreed per AFLAC on 10/4/2017. She also advised that she did not see where a claim for Rehabilitation benefits were esculated and told would be paid. She told me that AFLAC does not record calls or notes from previous call in a chronological order and have search for notes. She provided no empathy for my concern but argued protocol. I tried to advise her what was already previously discussed. After waiting on hold for an hour she advised that she needed to call Autumn Woods to verifiy Licensed Rehabilitation Center. Per conference call with Ashley, Nancy, and myself it was again verified for a 3rd time that Autumn Wood is a Licensed Rehabilitation and does business with AFLAC all the time. At this point I requested a supervisor.
After speaking with Tamera at [protected], she understood my concern and began trying to solve. She then hit me with that claim is now being denied because Autumnwood of Livonia is a skilled nursing home. I advised her that it is both a Nursing Home and Licensed Rehabilitation Center per previous calls to Autumnwood and literature presented. I also advised her that this is 4 different reason I received why being denied and how can I trust such reason when there have been several error and mistakes. On 10/6/2017, claim was reviewed by claims management and relayed to customer service representative Antonio that claim would be paid.
It now appears that AFLAC is going back on their word and finding any reason to deny claims. Autumnwood of Livonia have agreed to submit a letter confirming they are a Licensed Rehabilitation but they are also stunned by the recent contact from AFLAC.
At this point, I am very upset and very dissatisfied with AFLAC. I am on the verge of canceling my 3 policies and advising my benefits department of my experience. I have had to take multiple hours away from work to try and resolve as well as correct AFLAC claims processing errors. I appears that the claims process is not seamless and its not consistent. The efficient level is low. This has also been a traumatic experience because in getting claims process I have had to relive my father's illness and passing. I have been stressed and upset at the amount of time and energy I had to give this matter. I have lost money because I could not turned in the claims amount to Probate Court due AFLAC failure to process claim efficiently.
I am asking that someone review all my requests and calls. I ask that some review the notes and previous claims and note the error and misinformation given. I asked that my claim for Rehabilitation stay and services be processed as payable benefits based on investigation and previous promises made to me. I feel an exception be made because of the lack efficiency, errors, and improper handling of claim. I ask that AFLAC act on Good Faith. If we can not reach an agreement, I request appeals procedure and your legal department's contact information.
If there is additional information needed please contact me Melinda Cook at [protected] or mstaylor118@gmail.com.
Sincerely,
Melinda Cook
[protected]
The complaint for policy P0F3D0V9 continues to be unresolved and inconsistent service.
claims processing
I have experienced the absolute worse claims handling and service on the following policies; P0F3D0VD and PU316775. Claims handling has been unethical and unsatisfactory . There has been no consistency in claims processing. I had to all the work myself. No one has called me back or followed through with commitment. I almost feel an attorney is need
trying to get coverage
I did try to get coverage through my husband's employer. I was given a name of a representative, I spoke with him many times, he was terrible, he did not call my husband's boss for confirmation, I had to have the boss call him. This person kept telling me he was going to go to my husband's place of employment and meet with him and discuss his products with other employees, he never did that either. I started calling him in July, 2017 when I first found out they carried this insurance, because I have heard so many good things and I thought it was a good idea “just in case”. Well, after many phone calls by me, I finally was able to get my husband signed up October 15, 2017, THREE MONTHS LATER. To say the least, these people were VERY unprofessional and I would NEVER refer anyone to your business. I also hope I never need to file a claim for any reason, because I can't imagine that experience will be any better. I am very disappointed in the whole experience and when I have time to look around for another company that offers something similar, I am done with Aflac totally! I see they have many more complaints against them and they do not like to follow through on their promises.
agent complaint against market director, rsc and dsc
For no apparent reason all my account work was transferred from me, no notice, zero communication, just all my hard work gone to someone else, tried reaching out for answers from them, Aflac Trust, silence.
If this is how agents in good standing get treated I'd hate to see what can happen if an agent actually messed up.
Lawsuit pending dependent on answers
request a refund
In May 2017, I called Aflac and opened an Aflac accident policy. Then, I realized I didn't need the policy because my employer provided accidental insurance. So I called the next day to cancel the policy, and asked them to send me a cancellation notice. The customer service rep stated a noticed isn't needed due to the policy hasn't been created yet. In June, I checked my account and noticed that $43.00 had come out of my checking account. I called Aflac immediately and explained to them that I need those funds returned due to that I never had a policy issued. The customer service rep stated to me that it takes 10-14 days just for them to have it clear on their end for the refund to be issued. This is ridiculous! but I said fine okay. Come, July 15 I still have not received my refund which by the way they stated is coming in, in check form. I called the customer service line again and another rep told me now it takes another 10-14 days for them to issue the check!. Are you kidding me!.. A whole month just to receive my refund! Today is now August 15th 2017 and I still have not received my refund yet! I called again this morning and they refuse to allow you to speak to a supervisor. No one is helping me with this matter and I feel like I might have no choice but to get a lawyer. This is unbelievable. Their customer service SUCKS! and this issue has been going on for way to long for it not to be resolved. I want my money back AFLAC!
joshua west aflac agent
I had a meeting with an Aflac agent by the name of Joshua West Aflac insurance company agent I was interested in getting a life insurance policy meeting went extremely well until the end we were walking to our cars he opened his car door and it smelled like weed I asked him about that he said that it's legal to smoke weed here in Las Vegas NV but only if you have a medical card he said his Co workers and management team know all about it which he is right a couple of my friends had the same experience with him and complained to every media website including Aflac Facebook page with no results they just blocked me and my friends there's a lot of complaints everywhere about how horrible Aflac is concerning payouts they take your money make empty promises and they are smoking weed along with him it's sad and disturbing that a company doesn't care to resolve issues his name is Joshua West he's an Aflac agent here in Las Vegas NV
I know nothing will get done it's sad and disturbing needless to say I will not be doing business with Aflac and I will make sure that everyone I know bad mouths Aflac too Joshua West too he's going to be costing the company a lot of money I hope he's worth hanging on to what's sad I saw a picture of two kids in his car he needs drug testing and sent to rehab but that'll never happen cause Aflac smokes weed along with him
my agent james tuber is very unprofessional and unhelpful
In trying to cancel or get information on how to cancel my insurance, James Tuber and Roger Sass Jr, were both very unhelpful and actually told me there was nothing they could do for me but in one phone call to Aflac a simple representative was able to get the job done. They basically lied to me and both James Tuber and Roger Sass Jr are good for absolutely nothing!
denial of temporary disability claim
Aflac did not honor their agreement. I had open heart surgery and they did not feel this was a good enough reason to miss work. I signed on with AFLAC with a policy that covered temporary disability totaling $2000.00 per month for 3 months if I was to miss work due to sickness or injury. I unfortunately had to have open heart surgery and missed 6 weeks of work. They have denied payment for false reasons. I am assuming that they feel I will quietly go away as I am sure most people do. I WILL NOT! This is the kind of practice that gives people such negative impressions of insurance companies. The total payout Aflac would have had to pay is $3000.00 and I am amazed at their callousness to try and deny us such a small amount. These business practices have got to stop. I can assure you if Aflac does not rectify this I will make certain that everybody is aware of their shady business practices and it will cost them millions in lost sales. Thank-you Sincerely Colin Brown
My Desired Resolution:
HONOR their agreement. They are inventing reasons not to pay, reasons that I can PROVE are not true but they assume I will take this decision. Quadruple bypass open heart surgery IS a legitimate reason to miss work. If they elect not to honor the $3000.00 they owe me I will do everything in my power to ensure they lose millions. A picture of my "chest zipper" on the news with the declaration that heartless Aflac would rather see my wife and I on the streets than pay the paltry sum of $3000.00 .
Please contact me at your earliest convenience.
Thanks
Colin Brown
[protected]
chronic solicitation from robert beegel, aflac
Our facility has a long term disability carrier and I have expressed that to the representative who continues to come to our emergency hospital. We do not want any further solicitation from mr. Robert beegel or any other aflac representative. Please remove 75 sunrise hwy, west islip ny 11795 from your sales persons visit list. This in now being considered harassment and we have logged a complaint with consumer affairs and our local police department. Please honor this request without delay.
Thank you
Veterinary medical center of long island
75 sunrise hwy
West islip, ny 11795
my disability ck
I have been a loyal customer with Aflac since 2004 with three policies that I pay for each pay period. I recently fell ill and had file disabilty claim with Aflac for the very first time ever. I received one disability ck. I put in for continuance of disability everything summoned properly as I did the first time and here we go with the run around . With all the excuses from this is not ledgable to the employer didn't put a date of return. The employer wouldn't know the date of return if the doctor has me out indefinity right now until my health is better and I am until to return. I am so over this place . Now the excuse is we must verify by speaking with the employer that your not at work. Hello it's already been verified when they sent aflac the emploget a statement form. Does anyone know who to contact? I've tried to work it out with this company but at this point I will have to seek legal representation. As well as file a complaint with the Attorney General's office and banking and insurancing. this is definitly an act of fraud.
newest tv commercial
The dr. , laughing, at a patient, about to undergo surgery, who will have sell his father's corvette (I believe) because he cannot afford health care is not, I repeat, not, funny at all, and you all know why, as health care is already not affordable, whoever in advertising/marketing dept. Thought of the idea, and approved the commercial for release, needs to be fired for insensitivety, totally tasteless.
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Overview of Aflac complaint handling
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Aflac Contacts
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Aflac phone numbers+1 (800) 992-3522+1 (800) 992-3522Click up if you have successfully reached Aflac by calling +1 (800) 992-3522 phone number 0 0 users reported that they have successfully reached Aflac by calling +1 (800) 992-3522 phone number Click down if you have unsuccessfully reached Aflac by calling +1 (800) 992-3522 phone number 0 0 users reported that they have UNsuccessfully reached Aflac by calling +1 (800) 992-3522 phone numberClaims+1 (800) 366-3436+1 (800) 366-3436Click up if you have successfully reached Aflac by calling +1 (800) 366-3436 phone number 0 0 users reported that they have successfully reached Aflac by calling +1 (800) 366-3436 phone number Click down if you have unsuccessfully reached Aflac by calling +1 (800) 366-3436 phone number 0 0 users reported that they have UNsuccessfully reached Aflac by calling +1 (800) 366-3436 phone numberAflac NY Customer Service+1 (855) 207-2078+1 (855) 207-2078Click up if you have successfully reached Aflac by calling +1 (855) 207-2078 phone number 0 0 users reported that they have successfully reached Aflac by calling +1 (855) 207-2078 phone number Click down if you have unsuccessfully reached Aflac by calling +1 (855) 207-2078 phone number 0 0 users reported that they have UNsuccessfully reached Aflac by calling +1 (855) 207-2078 phone numberMedicare Supplement Policyholders+1 (800) 578-3107+1 (800) 578-3107Click up if you have successfully reached Aflac by calling +1 (800) 578-3107 phone number 0 0 users reported that they have successfully reached Aflac by calling +1 (800) 578-3107 phone number Click down if you have unsuccessfully reached Aflac by calling +1 (800) 578-3107 phone number 0 0 users reported that they have UNsuccessfully reached Aflac by calling +1 (800) 578-3107 phone numberReporting Fraud+1 (800) 227-4756+1 (800) 227-4756Click up if you have successfully reached Aflac by calling +1 (800) 227-4756 phone number 0 0 users reported that they have successfully reached Aflac by calling +1 (800) 227-4756 phone number Click down if you have unsuccessfully reached Aflac by calling +1 (800) 227-4756 phone number 0 0 users reported that they have UNsuccessfully reached Aflac by calling +1 (800) 227-4756 phone numberShareholder Services+1 (706) 596-3279+1 (706) 596-3279Click up if you have successfully reached Aflac by calling +1 (706) 596-3279 phone number 0 0 users reported that they have successfully reached Aflac by calling +1 (706) 596-3279 phone number Click down if you have unsuccessfully reached Aflac by calling +1 (706) 596-3279 phone number 0 0 users reported that they have UNsuccessfully reached Aflac by calling +1 (706) 596-3279 phone numberShareholder Services
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Aflac emailsaflacphyllis@aflac.com100%Confidence score: 100%Supportsiu@aflac.com100%Confidence score: 100%Supportaflacservice@aflac.com100%Confidence score: 100%
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Aflac address1932 Wynnton Rd, Columbus, Georgia, 31999, United States
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Checked and verified by Andrew This contact information is personally checked and verified by the ComplaintsBoard representative. Learn moreJun 13, 2024 - View all Aflac contacts
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I could be wrong but I don't think they are saying you have to bill your insurance. They need the HCFA form filled out and sent to THEM. The HCFA form is just a billing form (though these days most insurance companies do it electronically). From the sounds of it, they just want the HCFA form for THEIR billing documentation. It is just a general billing form. It goes to whoever is responsible for the bill (in this case Aflac). I remember back before claims were sent electronically we would even send HCFA forms to Labor and Industries for L & I claims. Instead of thinking of the HCFA form as an insurance billing for and instead just think of it as a "Invoice." In order to bill Aflac, they want you to send them an "invoice" using the HCFA 1500 form. Hopefully this helps...
The HCFA is the form to be sent to insurance companies. If it is filled out and I send it to AFLAC that is stating that my insurance was billed. If insurance isn’t billed than I am committing insurance fraud. That is why doctors offices have super bills which is the equivalent to a HCFA but doesn’t get sent to the insurance company because I paid at the time of service. Mary told me specifically that I have to bill insurance and send them the HCFA to prove that I went to the doctor. Apparently they don’t trust me or any of the physicians I go see. Again, if I send a HCFA without billing insurance then I am committing fraud which she even confirmed. She said she understands it doesn’t make sense to bill insurance in this case but they won’t pay if I don’t. My wife’s last two visits cost $90 versus $260 if I billed insurance. (Even with AFLAC paying for both visits - $155, I still would have been out $105. It would be stupid to bill insurance in that case. AFLAC just refuses to pay. I am paying for coverage and following their policies but they refuse to pay even if it is at the detriment of my family. Thank you for your input and any other suggestions is appreciated.