Business ProfileforMax Health

*********************************** ********************************************************* ************ ******************* 12/21/2023 Better Business Bureau Subject: Complaint Regarding Failure of Max Health to Submit Necessary Referrals for Insurance Coverage Dear Sir/Madam,I am writing to lodge a formal complaint against Max Health, a healthcare provider, for their persistent failure to submit necessary referrals for medical procedures to my insurance provider, Aetna. This ongoing issue has resulted in significant financial and emotional distress, as I am now facing undue medical bills that should have been covered by insurance.The most recent and pressing instance involves a knee surgery I underwent on September 28th. Despite the procedure and associated anesthesia being covered under my insurance plan, my claim was denied due to Max Health's failure to provide the requisite referral documentation to Aetna. This is not an isolated incident; I have encountered multiple instances where Max Health has neglected to submit referrals, causing denial of coverage for other medical services as well.I have made several attempts to resolve this issue directly with Max Health, including numerous phone calls and emails to their corporate office, to no avail. Although I had multiple three-way calls with Aetna and Max Health, where Aetna clearly explained the procedure for submitting referrals, Max Health has continued to neglect this crucial step. In these calls, Max Health repeatedly insists that I do not require authorization, which is a misrepresentation of the issue at hand. What is required is a "referral," not an authorization, for the insurance to cover the costs.While I did manage to speak with the office manager at Max Health, who resolved some of the denied requests, the claims related to my knee surgery on September 28th remain denied due to the lack of a referral.This situation has placed an undue burden on me, both financially and emotionally. The negligence exhibited by Max Health in handling referrals has led to not only unwarranted financial implications but also a significant level of stress and frustration.I am seeking the BBBs assistance in addressing this matter with Max Health. It is imperative that they adhere to the proper procedures for submitting referrals to ensure their patients receive the insurance coverage they are entitled to. I hope that through your intervention, Max Health will rectify the current issues and improve their processes to prevent such occurrences in the future.Thank you for your attention to this matter. I look forward to your prompt response and assistance.Sincerely,***********************************