The Black Hawk Claim review: Insurance

I called [protected] to enroll in a healthcare plan as my employer does not offer. I found the number from a google search. On 12/14/2020 I spoke with Kenneth Jose who informed me it was aetna insurance plan unfortunately due to it being on the phone I do not have that in writing just in my notes I wrote in on my phone when speaking with him. I received the card in the mail but certificate of insurance via email. The card was paper like with no back and multiple names with no aetna ID anywhere. I asked via email what to tell my doctors in which they stated to tell them its a multiplan. Since I started going to doctors, I have been stuck with bills as the claims department is unreachable. Doctors and myself cannot get a hold of the Black Hawk Claims department since. I received a letter in the mail in October 2021, not dated, that the insurance was being terminated but has an unknown exact date when. I cancelled on 10/31/2021 with them due to the reoccuring issues and lack of contact. This seems time sensitive as I wont be able to reach them much longer inquiring about these bills.

I had surgery for my back fusion scheduled on 5/10/2021 which I told you about how they gave me some hope with being able to find avenues with grants due to the Dr. Sathish Subbaiah being out of network. I knew the odds were slim being out of network but Alyssa (representative from the insurance) made it seem like we could make it happen so it was then scheduled until she called me a few days prior to pre op cancelling it.

I got injections on my back and neck on 5/19/2021. Those were deemed not covered but I was not aware of that until I scheduled another two injections in October and got a call from Stony Brook saying they were not going to be covered by my insurance. I question the 0$ deductible and at least paying a portion of this but got no answers especially if they haven't even paid my other medical bills so I did not proceed with the scheduled injections. I didn't even go to any other doctors I needed after finding out they haven't been processing any claims or covering any of my past claims so I haven't even utilized this insurance since September 21st.

I do not make a lot of money, maybe 27k a year, as I am part time due to my ailments. I paid 325.95 a month plus prescription which I get no benefits out of unfortunately. I tried googling the insurance and the claims to find alternate numbers and found negative reviews about the insurance and most highly the claims department through the BBB. I attached the email I received back after just requesting them to reach out to the claims department to contact me directly as at that point I just wanted to talk to a claims rep. I called the claims department almost daily at one point. I call and am usually around the 36th caller, I'm on hold for at least 1/2 an hour and it disconnects every time. There's an option to leave a message which I tried but get disconnected there as well. I asked the insurance rep for an alternate number and they only have one which is the number I have been using. [protected]) Then reading the claims report they sent me last week from Black Hawk for a February claim has a different number [protected]). I called and its the same recording and same scenario. I have recently reached out to Empire Justice for a para legal to help me in regards to this case. Zoraida Espinal, [protected].

NAPP- 11111 Richmond Avenue Suite 250

Houston TX [protected])

The Black Hawk Claim they actually sent me for one provider I saw in February, about two weeks ago states this:

Black Hawk Claims Alt- 11111 Richmond Avenue #215

Houston TX [protected])

The address on my card for Black Hawk also stated this:

Black Hawk Claims- PO BOX 79

Arnold MD [protected])

SALVASEN HEALTH 10713 W. Sam Houston Pkwy, Suite 100 Houston, TX 77064

One my certificate of coverage

NAPP or World Wide United Healthcare

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