Business Profile

Insurance Claims Processing

Allied Benefit Systems, LLC

Complaints

This profile includes complaints for Allied Benefit Systems, LLC's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

34 total complaints in the last 3 years.
18 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:01/23/2025
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I was prescribed ******** by my family doctor on 12/30/2024. To date I do not have my prescription. Allied-US-******* -Aetna said twice when I called they had not received any faxes from my doctor and then said they received a pre-auth but no treatment notes. I have spoken with my doctor several times and been told the pre-auth and treatment notes have been faxed to US ******* more than once. All this delay seems intentional. Perhaps if patients are frustrated and delayed they will just give up. I need my prescription!
Business Response
Date: 01/24/2025
*****,

Thank you for bringing this to our attention. Weve reviewed the situation and confirmed that your medication approval is now in place. A member of our Care Team has reached out via phone to share this update and assist with any next steps to ensure you receive your prescription.

We take these matters seriously and are committed to supporting you. If theres anything further you need, please dont hesitate to contact us. If youre satisfied with this resolution, wed appreciate it if you could update the status of your BBB complaint.

Most sincerely,

Allied **************** Team
Customer Answer
Date: 01/25/2025

Complaint: ********

I called Allied 1/24/2025 and was only then informed the 12/30/2024 prescription was approved 1/17. There was no communication of this to me.
It is a complete lack of customer service and or follow up or follow through.
Hopefully the next prescription will be a more efficiently processed.

Sincerely,

***** ********
Business Response
Date: 02/05/2025
Dear Mr. ********************** you for bringing this matter to our attention. We sincerely apologize for the frustration and inconvenience caused by the delay in communication regarding your prescription approval.

Allied strives to provide exceptional customer service. We are taking your feedback seriously and will review our communication protocols to prevent such issues in the future.

We appreciate your patience and understanding. If you have any further concerns or need assistance, please do not hesitate to contact our member services team, using the phone number found on the back of your ID card.

Sincerely,

Allied **************** Team
Customer Answer
Date: 02/06/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

***** ********
Initial Complaint
Date:01/20/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have 4 instances from June 2023-present where the insurance is refusing or threatening to refuse coverage altogether for health services when they were my primary insurance. I have received explanation of benefits indicating high possible charges and medical bills for services that should be covered ( amounts including $7,000, $11,000, $1,000 so far). I had to file a formal complaint with Priority Health who was the secondary insurance on one date of service in order to get charges reprocessed by Allied as they wouldnt assist me directly. This was to avoid paying over $7,000 out of pocket simply because they were not processing claims appropriately and working with Priority Health. Each time I have attempted to call allied for support I am given a variety of excuses (out of filing time, not responsible for fees, rude employees, requiring me to request medical records be sent to them in order to determine if I will pay $11,000 out of pocket). They seem to not want to cover things that are in fact their responsibility and I have reached a point of desperately needing support.
Customer Answer
Date: 02/17/2025
Thank you. I have attached financial verification of three different scenarios in which Allied has created complications with explanations below.

1) Explanation of Benefits (EOB) from Allied
Please note the section specific to Edgepark, which is a durable medical equipment company that supplied by insulin pump. I am a type one diabetic in which Allied had been authorizing my diabetic supplies each month prior. They are now claiming they require medical records to be sent to them to determine my eligibility for coverage. I have asked my diabetic providers to send medical records to ******************** on 3 separate occasions since January 6, 2025, and each time I contact Allied they tell me records have not been received despite my providers telling me they have received confirmation of receipt. They have 60 days to process by their medical review team and if these records are not received they state I may be eligible for the full amount.
2) **** from ************* Anesthesia
Allied has refused to cover epidural fees for my c section June 28, 2023, and the point of contact I have from the anesthesia company has told me they are refusing to cover claiming its my responsibility and not giving reason as to why. It is close to being sent to collections and I cannot afford this when it should be covered.
3) A screen shot from ***************, medical provider for my c section and delivery of my son. Allied was my insurance and Priority Health my husbands insurance in which we both carried on our son. My husband and I spent an incredibly long time contacting both insurances and they were both refusing to pay for my sons newborn charges. Come to find out, Allied was responsible for the first 72 hours of my sons life for medical expenses per Priority Health, but were refusing to cover the expenses. They allowed no option to file a complaint, stating it was past one year processing time for claims, and I was told I needed to contact the medical provider and ask for all fees to be written off, in which that would never be possible. I filed a complaint through my husbands insurance, Prority Health, and they coordinated getting all bills reprocessed by Allied and just recently paid for.

Over all, I have felt they have refused to pay for medically necessary services that they are responsible for and have not provided any support.

I thank you for time and consideration in this matter and helping me to navigate these complex issues.

Business Response
Date: 09/03/2025
We are working internally on this request.

Thank you!
******* *******
VP, ***************** & Operations
Direct: ************
******************************************
Initial Complaint
Date:01/02/2025
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Allied has been stalling on paying my medical bills from an emergency room visit that turned into a hospital stay and surgery on June 21/2024 and on an approved surgery on October 21/2024 at ******************************* in ************.
Customer Answer
Date: 01/04/2025
I have more bills and emails if needed
Business Response
Date: 01/25/2025
Hi ****,

Thank you for bringing this matter to our attention. We apologize for any frustration or inconvenience youve experienced regarding the processing of your medical claims.

We want to assure you that we have thoroughly reviewed your concerns. The claims from your June and October 2024 procedures have been addressed, with payments issued. You were previously notified via email on December 17, 2024, about these payments, but a member of our team will follow up this coming week to ensure you have all the necessary details, provide further clarity and support, confirm the resolution and ensure you are satisfied.

We appreciate your patience as we worked to resolve this matter and remain committed to assisting you with any additional questions or concerns.

Sincerely,
Allied **************** Team
Initial Complaint
Date:12/20/2024
Type:Customer Service Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
***** ****** <**********************************************************************>
Attachments
12:18 PM (54 minutes ago)
to **********************************************************************************************

***** ******

Assistant Vice President/Underwriter

**************************************

***************, *******; 62864

*************

Fax **************
Business Response
Date: 12/19/2024
Good afternoon Ms. ****************** have created case # ******* for Ms. ******** concerns. However, with the complaint information we received, I am unable to locate a policy associated with Ms. ******** daughter ********. Please contact the complainant and verify if their concerns are associated with ********** or another carrier? In order to proceed, please have the complainant to provide the Nationwide/Allied policy number and the Nationwide/Allied policyholder's address on file.

I will retain your file until the requested information is received or for 2 days, whichever occurs first. If you have any questions, please call ************** and refer to the case number above.

Nationwide is On Your Side.
Thank you!

******* ******
Customer Answer
Date: 12/19/2024
Im not sure where nationwide came from it has always been allied insurance I have attached the card
Business Response
Date: 12/20/2024
Better Business Bureau Of Columbus ****
**************
******************-2540

December 20, 2024

Nationwide OCR Ref # *******

Dear Better Business Bureau Of Columbus ****:

We believe complaint ID # ******** for complainant ***** ****** was sent to Nationwide in error. This complaint is related to a health insurance claim with a different carrier. The other carrier is perhaps Allied Benefit Systems or Allied National, not Allied Insurance an affiliate of Nationwide Insurance.

Sincerely,

******* ******
Nationwide Insurance
Customer Relations Coordinator
**************
Customer Answer
Date: 12/20/2024
****************

*******************************************************************************************************
Customer Answer
Date: 12/20/2024
****************

*******************************************************************************************************
Customer Answer
Date: 12/20/2024
I have been fighting with them on my daughters behalf since late September early October. My daughter is over 18 and she has given permission for me to talk to her insurance. She has allied through her employer. I kept her on my family plan as secondary. Allied refused to pay because even though every person I have talked to admits allied should be primary they say they are secondary. Which is also what my insurance says. Allied wont return a call or reach out to the secondary insurance to coordinate benefits. ******** is being threatened my service providers that they are going yo turn her account over to collections if no payment is made. Allied has continued to accept her premium with no payments being paid out.
Business Response
Date: 01/07/2025
Hi *****,

We appreciate the opportunity to address your concerns and want to assure you that this matter has been escalated to our client service representatives for resolution. We are actively working to investigate and rectify the issue youve described.

Due to privacy regulations, we cannot share specific details through this platform, but please know that we are committed to ensuring your daughters account is handled appropriately. Our team will reach out to you both directly with updates and next steps.

Thank you for your patience as we work to resolve this matter. If you have any additional questions, we encourage you to contact our member services team directly for further assistance.

Sincerely,
Allied **************** Team
Customer Answer
Date: 01/08/2025

Complaint: 22701714

I am rejecting this response because:
****** client service *** called me on 12/20/24 from ************ and was very rude. She kept telling me she told me why they were not primary well I still dont know why. I asked if allied could call my insurance to get this worked out and was told no allied was not changing their stance. Ok, but someone needs to help me figure it out instead of just not paying. When I told ****** I was assured she would call me on Monday but yet here it was a Friday and she just called. Her response was I did not have an update. Good company policy would have been to call me and let me know it was still being worked on. I have correspondence since 9/30/24 with nothing being fixed yet. This company has drug their feet and not paid any claims but still took my premiums. Wont respond to phone calls or emails. I do not accept anything they have said and they need to get some good customer skill training. I have sent an email to them complimenting some of their call agents. I would love for someone in upper management to listen to all my calls and me being told the exact opposite of Brendas response but apparently she is the final answer and I will not talk to her again with her attitude and poor customer service. I am still waiting on over ***** of bills to be reviewed and paid.
Sincerely,

***** ******
Business Response
Date: 01/21/2025
Dear *****,

Thank you for bringing your concerns to our attention and for your patience while we worked to resolve this matter. As of now, all affected claims have been sent back for reprocessing. We are committed to ensuring these claims are handled appropriately, and we hope this addresses your concerns.

Additionally, our ************** Representative Manager reached out to you last week to share this update personally. We sincerely hope that this resolution demonstrates our dedication to addressing your concerns and supporting our members.

If you have any further questions or need assistance, please do not hesitate to reach out to us. If you feel your concerns have been resolved, we would greatly appreciate it if you could update the status of your complaint with the BBB.

Thank you again for your patience and for allowing us the opportunity to make things right.

Sincerely,
Allied **************** Team
Initial Complaint
Date:10/24/2024
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have made numerous calls to receive my owed reimbursement money. I keep getting the run around and told many different solutions by many different reps. ** has been over a year to receive my owed money via check. I want to complain of the service I have received from Allied Benefit Systems.
Business Response
Date: 10/31/2024
Dear ****,

Thank you for bringing your concerns to our attention. We understand how important this matter is to you and are committed to ensuring it is resolved as swiftly as possible. We apologize for any confusion or frustration you may have experienced in the process.

Our internal teams are actively collaborating on your case. Please rest assured that we will continue to provide updates to you as they become available.

Thank you for your patience as we work toward a resolution, and please know that we remain dedicated to assisting you.

Sincerely,
Allied Benefit Systems
Customer Answer
Date: 11/04/2024

Complaint: 22470426

I am rejecting this response because: I have a reference #: CC6915230. I have attempted multiple times to resolve and I keep getting told per the supervisors there is "NO UPDATES"

Sincerely,

**** ******
Business Response
Date: 11/15/2024
We understand the urgency of this matter and sincerely apologize for the experience youve had. Your concern has been escalated to the appropriate team, who will work directly with you to ensure a resolution. If you have any further questions or need additional assistance, please let us know.
Initial Complaint
Date:10/04/2024
Type:Order Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Allied is refusing to pay for a legally prescribed medication from my same doctor for the same prescription for the same quantity for the last 2 months now after successfully providing the medication for years.
Business Response
Date: 10/09/2024
Dear Jason,

Thank you for bringing this issue to our attention. We apologize for the confusion and delay you’ve experienced. Please know that this situation is highly unusual, and we are aligning with multiple departments to ensure a swift resolution.

Currently, our team is working closely with CVS Pharmacy to address the issue. Additionally, a member of our Enhanced Case Management Team will be reaching out to you directly to provide further assistance.

In the meantime, if you have any questions or need immediate support, please feel free to contact us using the number on the back of your ID card and ask to be transferred to our Enhanced Case Management Team. We are here to help and appreciate your patience as we work to resolve this matter.

Sincerely,
Allied Customer Service Team
Initial Complaint
Date:08/01/2024
Type:Order Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Allied Benefits is handling my Cobra. I was mailing checks each month by the 10th of the month for the 1st of the following month. They lost 3 of my checks so I asked them what I could do to prevent this. They said to sign in on their system to have the payment drafted each month. The payment drafts on the 30th for due date of the 1st which causes a delay of 4-5 days for processing. I can't get prescriptions filled, etc. I have to call each month because of the gap in coverage. They won't allow the date to be changed from the 30th (due to government policy). There are no other options. This is unacceptable and very unprofessional. They need to fix their system in house to prevent losing clients checks and they need to improve their online payment system so there is not a gap in coverage.
Business Response
Date: 08/02/2024
Thank you for bringing this to our attention. We take your concerns seriously and are currently reviewing the situation with our internal team. Someone will be reaching out to you shortly to discuss this further and work towards a resolution.
Initial Complaint
Date:07/23/2024
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I want to know how a health insurance option be can be offered to someone who isn't ******** age, or receiving ******** stating it reimburses ******** and all other costs are the patient's responsibility. This costs ***** a month. It pays nothing if you are diagnosed with anything that requires a hospital stay or surgery. Unfortunately this was sold to my son as a health insurance option who was just diagnosed with end stage renal failure.
Business Response
Date: 08/02/2024
Dear *******,
We appreciate you reaching out regarding concerns related to your son's healthcare plan. Unfortunately, we are unable to disclose details of this complaint or complete a proper investigation without direct authorization from your son, who is the plan subscriber. If your son has already provided a HIPAA Authorization Form, please let us know his name and employer name so we can locate it. If he has not, please have him call our customer service team at the phone number listed on the plan subscriber's ID card to put one place.
Thank you for your understanding,
Allied Support Services
Customer Answer
Date: 08/03/2024

Complaint: 22028218

I am rejecting this response because: It did not answer the question as to how a policy can be sold stating it reimburses ******** first, and then patient is responsible for additional costs when the the patient is not Meducare age. I'm asking as a consumer. I would not have even been aware this type of insurance is even an option for people, if it had not happened to my son. This worries me that other young adults are paying monthly for coverage that will not cover any major medical expenses if they were to arise.

Sincerely,

***************************
Initial Complaint
Date:06/25/2024
Type:Order Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Allied Benefit Systems website says certain doctors and dentists accept our coverage. Even their member portal shows these providers as in network. When I call to make appointments with said providers, they have never heard of this provider, and don't accept the insurance. I have had several appointments cancelled by the provider, saying they are not in network, even though the Allied's member portal shows them as being in network. When I call Allied's member services number, it's an automated system saying that they do not have provider information, and then it hangs up on you. There is no way to talk to an actual person about the problems I'm experiencing. We're paying over $600 per month for family coverage, plus deductibles, and receiving nothing. This feels like a very fraudulent business.
Business Response
Date: 07/01/2024
Dear ******,
We received your complaint, which is currently under review. An Allied representative may contact you directly if more information is needed.
Thank you,
Allied Support Services
Initial Complaint
Date:06/13/2024
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
My daughter had an Ultrasound done at a hospital on 7/14/23. On 12/13/23 I received a bill from the hospital in the amount of $614.00. This was due to Allied Benefit Systems, my daughter's insurance company at the time had changed their claims mailing address and failed to let their customers know via letter with new cards. ******************** just sent new cards, I assume they expected their customers to figure the address change out for themselves. This resulted in the claim being rejected as it was sent to the wrong address by the hospital, prompting the hospital to send me the bill for the full amount. It was at this time that I discovered that Allied had made this claims mailing address change. So I provided it to the billing department at the hospital so they could resubmit the claim. They did as per statement dated 12/31/23. I then received another statement from the hospital with a breakdown that you will see the initial charge of $614.00, payment adjustment of $191.47 and remaing balance of $422.53, this amount is toward the bottom of the page where it says "Insurance Balance". Leading me to believe that that amount was to be paid out of the *** account that the plan had. An *** from Allied reflects that same information, says patient 0.00. Upon speaking with a customer service rep from ******************** who first told me that he could not locate this ***, he looked it over and said that I would owe the $422.53 as part of the *** deductible. On a second *** from Allied, there is a claim for the *************** having read the ultrasound in the amount of $35.48. The information on this *** was supplied using the very same verbiage as the *** where they claim I owe the $422.53, as well as I never have received a bill from radiology for the amount of $35.48, I should have received a bill from radiology if that "deductible" wasn't met. Allied has been nothing but erroneous from the beginning. This paperwork has been misleading, Allied should pay when it is their mishap
Business Response
Date: 06/14/2024
Dear *******,
We received your complaint, which is currently under review. After review, an Allied representative may contact you directly for more information.
Thank you,
Allied Support Services
Customer Answer
Date: 06/17/2024

Complaint: 21843403

I am rejecting this response because: Allied needs to reply through the BBB with their second response after reviewing the complaint. They also need to ask any questions they may have for me using the BBB portal.

Sincerely,

***************************

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