Complaints

This profile includes complaints for Administrative Concepts, Incorporated's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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• 

  Administrative Concepts, Incorporated

  400 Campus Dr Ste 300 Suite 300 Trappe, PA 19426-4948

  
• 

  Administrative Concepts, Incorporated

  PO Box 4000 Trappe, PA 19426-9000

  

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:01/27/2024

  Type:Billing 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.

  *************************** member# ********* My son play ECNL soccer and they have a policy with ACI. He broke his leg during a game on 10/14, had surgery on 10/15, and was discharged on 10/16. I have a high deductible thru my employer so it was the primary. I received a bill from the surgeon for $1464 and ********************** for $4800 which have yet to be paid. I sent in UB04 from hospital and summary from the surgeon that includes ICD and CPT codes, and etc but whomever reviewing the claims don't see to be very good at it.11-11-23 EOB statement on page 3 for ***************************** shows the amount bill being at $3300 and my portion being $1464. It also shows the ********************** charges on page 3 as well. I am no claims specialist but it doesn't take genius to connect the dots. Please send payment to providers.

  

  Business Response

  Date: 02/15/2024

    We have reviewed the claim and here are the actions taken on the documents submitted, as well as what is still needed to complete others. The insured will be receiving letters and copies of EOB's in the mail.

  Claim # *******-02
  Charge- $3303.00
  Date of service- 10/15/23
  Provider- Scoliosis Inst.
  Paid- $0
  Pt. resp.- $1464.87
  Called provider for Tax ID# today.  PH#************.Spoke to ******** who will have office call me back.
  Claim pending provider Tax ID#
  
  Claim # *******-03
  Charge- $33.00
  Date of service- 10/15/23
  Provider- Radiology Asc. .
  Paid- $0
  Pt. resp.- $15.13.  This amount was applied to members deductible today.
  
  Claim # *******-05
  Charge- $73,172.16
  Date of service- 10/14/23 10/16/23
  Provider- ****************************
  Paid- $0
  Pt. resp.- $5,694.30.
  EOB only received. Pended itemized bill.
  
  Claim # *******-07
  Charge- $25,547.23
  Date of service- 10/14/23
  Provider- *******************
  Paid- $0
  Pt. resp.- unknown
  Balance due bill received only. Pended itemized bill, EOB. Balance due bill states member **** $4800.38.
  
  Claim # *******-08
  Charge- $124,065.05
  Date of service- 10/14/23 10/16/23
  Provider- *******************
  Paid- $0
  Pt. resp.- unknown
  UB04 received.  Pending EOB.  Balance due bill received states the member owes $4800.38.

  Thank you.

  Customer Answer

  Date: 02/15/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 21210076
  
  I am rejecting this response because:
  
  I received an email on 2/6 from *************************** stating that my submission on 1/25 contained ALL the information needed for claim completion but was still under review and I should receive a letter/EOB once complete.
  Regards,
  
  ***************************
  
  
  
  
  
  
  
  
  

  

  Business Response

  Date: 03/25/2024

  We have been in touch with the hospital regarding billing discrepancies and balance due showing $4,800.38. They did not know why we received different billing, but verified the total charge was $124,065.05 which resulted in opur paying an additional $715.14 to ***************.

   

  Here is a breakdown of recently considered charges. There are no additional bills pending:

  Claim # *******-02
  Charge- $3303.00
  Date of service- 10/15/23
  Provider- Southwest Scoliosis Inst.
  Paid- $1171.90 by ACI 3/22/24
  Pt. resp.- $1464.87 per primary EOB.  Remaining PB is $292.97 after ACI payment.
  Tax ID# and remit address obtained 3/22/24 per ****** at Drs office.
  
  Claim # *******-07
  Charge- $124,065.05
  Date of service- 10/14/23-10/16/23
  Provider- *******************
  Paid- $715.14
  Pt. resp.- 5694.30
  
  Claim # *******-08
  Charge- $124,065.05
  Date of service- 10/14/23 10/16/23
  Provider- *******************
  Paid- $3816.46
  Pt. resp.- $5694.30

   

• Initial Complaint

  Date:12/14/2023

  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.

  This company is also listed as *********** ****, ***** ******, ********** and bank transactions come up as ****** *******. This company is also the same as ******************** all the same phone numbers etc. This company name has taken $1494.50 out of my account without my permission, someone stole my debit card info & used it for all of these insurance coverages, This company admits to another name on account info, how ever they will not give a name, I have tried many many phone calls with these companies to get my money back & they will not admit fault. They say there is proof it was me who started accounts (just like ******************** yet they will not send me any proof. I have turned disputes into bank, but after so long of the company not responding the bank can do nothing. All together from Jan 2023 to Sept. 2023 these companies have stolen $2831.15 from me.

  

  Business Response

  Date: 12/18/2023

  ACI is a Third Party Administrator contracted to process claims for various insurance companies. ACI does not sell insurance, does not have access to sales records, nor performs any functions related to the sale, establishing premium rates, collection of premium, refund of premium, fulfillment of policy documents or any responsibility in providing written policy information upon completion of the sale. As a result, ACI does not have the ability to address sales related issues.

  I would suggest this complaint be directed to the organization that he purchased the policy from.

  Customer Answer

  Date: 01/10/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because:
    You are still involved with allowing fraudulent activity 
  
  Regards,
  
  *************************
  

• Initial Complaint

  Date:07/20/2023

  Type:Product 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 received two letters today in the mail post marked 7/7/23. The letters stated they were official notifications regarding unclaimed property in the form of checks that are outstanding. They stated that if the checks are not cashed by 8/15/23 they would turn the unclaimed property over to the state entity that governs the property. Check # ****** dated 8/29/15 is for $2,546.25 with claim # *******-**. Check #****** was for $0.65 with claim #*******-**. I've contacted * ***** Credit Union and the Secretary of State of Illinois to see if the checks were legitimate. They said the letters looked official but they could not confirm if the checks were legitimate. I was recommended to contact the Better Business Bureau for help.

  

  Business Response

  Date: 08/01/2023

  I sent the following e-mail to the insured and will follow up with a phone call later today:   I believe this is a satisfactory response to his inquiry.

  ******************** - We received this inquiry you sent to the BBB.

  I received two letters today in the mail post marked 7/7/23. The letters stated they were official notifications regarding unclaimed property in the form of checks that are outstanding. They stated that if the checks are not cashed by 8/15/23 they would turn the unclaimed property over to the state entity that governs the property. Check # ****** dated 8/29/15 is for $2,546.25 with claim # *******-**. Check #****** was for $0.65 with claim #*******-**. I've contacted ************ ************ and the Secretary of State of ******** to see if the checks were legitimate. They said the letters looked official but they could not confirm if the checks were legitimate. I was recommended to contact the Better Business Bureau for help.
  
  Let me assure you these were in fact checks issued to you and I have attached copies for reference.  As our letters pointed out, if you wish the checks reissued to you, you should check the box you would like replacement checks, unless you did receive and cash them previously.
  
  Since the deadline is approaching, it would be best if you checked the appropriate box and mail the letters, but also respond by e-mail to all on this e-mail of your decision in the event the letter does not reach us by 8/15 and we will take the appropriate action.
  
  Thank you, and let me know if you have any questions.
  
  Regards,.
  
  ******************************, AIC,ALHC, FLMI, PAHM
  Director, Claims Department
  ACI Administrative Concepts, Inc.
  PO Box **** 
  Collegeville, PA *****
  Office: **********************
  **************
  

• Initial Complaint

  Date:06/12/2023

  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.

  My travel insurance agency, *******, approved a claim on May 12 and forwarded it to ACI for payment. ACI said it sent a check but as of June 12 I have received nothing, and ACI does not respond to emails or telephone inquiries. ACI has failed to meet its obligation to simply pay an approved claim. In my one telephone call they said the check was enroute, which was a blatant lie. Zero customer service and outright deceptive business practices.

  

  Business Response

  Date: 06/21/2023

    *********************** was enrolled in *******s Leisure Travel policy for a trip scheduled to begin on 05/09/2023. On 05/12/2023, ACI received notice of **. ****** cancellation. On 06/07/2023, ACI issued payment of benefits.
  
  Regarding **. ****** concern with timing of payment, our goal is to complete claims within 1-3 weeks of receipt. We regret that this claim was on the longer end of that cycle. However, to clarify, **. ****** claim was not approved on 05/12/2023. ******* does not have authority to approve claims. On 05/12/2023, ******* initiated the claim and forwarded it to ACI. We then enroll him in our claim system, have the file reviewed by a claim examiner, and approved by a manager. On 06/07/2023, ACI approved the claim. At that time, a payment was mailed to *************. According to the financial institution, the check was cashed on 6/16 for the full amount being claimed.

  We believe this to be closed with a satisfactory outcome.

  Customer Answer

  Date: 06/26/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  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. 
  
  Regards,
  
  ***********************
  

• Initial Complaint

  Date:04/05/2023

  Type:Customer Service 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 originally took out a dental insurance policy in 2020/21 with ********, through ********* Students Dental and Vision Enrollment, offered through ********* University where I was a graduate student. When I neared graduation in 2023, I sought to end my policy as I would received dental benefits through my employer. I have found it impossible to cancel my plan for various reasons. Firstly, the plan states within my portal that "Please note that these policies will renew automatically each month until you call and cancel." There is no option to cancel online. Secondly, the administrative services for my plan was run by "Administrative Concepts, Incorporated" whose customer service department never answers phone calls. I have been on hold for hours, despite calling numerous days. When on hold, a pre-recorded message says that I may leave a message and would receive a callback "within 1 business day." However, I have now gone two weeks since my original message and have not received a callback. I have since left numerous messages to no avail. Thirdly, I have obtained an email address (***************************************************) where I have sent a formal letter of termination on March 31, 2023. I have not received a reply to this email, nor have I received a written letter. This is unacceptable, as I am being charged monthly and have no way to terminate the policy.

  

  Business Response

  Date: 04/12/2023

  This has been resolved. The member called Customer service 4/5/23 requesting cancellation. The coverage was termed and the premium paid 3/30/23 is in the process of being refunded.

• Initial Complaint

  Date:03/22/2023

  Type:Customer Service 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 was injured January 25,2023 partial ceiling fell injuring shoulder and back I am out of work due to negligence I have a lawyer involved I have a accident policy I am not able to pay bills because my lawyer are collecting bills to submit for a settlement I was told I could submit a claim but have to submit a paid bill I don't understand how that could be done when it's an open case I went to the emergency room twice had xray the first time an ultrasound the second time I am scheduled to have a MRI Thursday I am undergoing treatment with a Chiropractor and I am confused as to why this policy is confusing or there is no provision in a case like mines which is an ongoing legal matter

  

  Business Response

  Date: 03/29/2023

  As you might imagine with a name like *****, we are unable to locate a policy just using his name and PO Box.  I have sent him an e-mail asking for more details to help identify his claim and respond appropriately.

   

  *****

  Customer Answer

  Date: 04/03/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered] I tried calling this person t speak with him in detail a put my claim or potential claim the answer was not sufficient I believe he has me mixed up with someone else .I have a claim for stating reimbursement can be issued to me lf the bill are paid he mentioned it would go to the hospital I am paying for this insurance and this company  is misleading customers.
  
   Complaint: ********
  
  I am rejecting this response because:
  
  Regards,
  
  *********************
  

  

  Business Response

  Date: 04/05/2023

  I had several e-mails with this gentleman. I informed him that if he signed an assignment of benefits when he received care, we would have to pay the provider. The bills do not have to be paid to be submitted for our review.

  I also informed him that the policy had an exclusion for any injuries covered by Workers Compensation as it was unclear if this was a work injury. I offered him my number and also that his attorney could contact me, but heard nothing further.

  Customer Answer

  Date: 04/11/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because: Please provide phone number so I could call I have searched for a phone number and do not see it
  
  Regards,
  
  *********************
  

  

  Business Response

  Date: 04/24/2023

  As mentioned, I did offer to speak with this individual and offered to speak with him or his attorney. My phone number is *********************. 

  He does not need to pay the bills to submit them, but if he signed an assignment of benefits, we will have to pay the provider. If he did not assign the benefits, or if he submits proof that the bill has been paid, we can reimburse him.

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

  Administrative Concepts

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

  Customer Answer

  Date: 04/26/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  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. 
  
  Regards,
  
  *********************
  

  Customer Answer

  Date: 04/22/2024

  I paid for this policy through a company called avibra for almost three years the issue started when I had submitted two claims for two separate accidents the company claimed they never had them due to being out of work due to injuries and surgery I had my doctor submit the claims again in December 2023 called several times and even had to make a bbb complaint to get a response I went back and forth with a representative that contacted aci provided their email and told me to submit the claim because it did not have to be submitted through my doctor and they claim they could not find any files I submitted information a third time and now the company is basically trying to get out of paying for the two claims I submitted a claim for ******* 25,2023 for a left shoulder injury and a claim for March 28,2023 due to a motor vehicle accident that occurred while I was in a shared ride company car I sent the invoice showing the balance and a second invoice showing it wad paid and I was seeking to be reimbursed they are refusing to process this claim I have contacted the claim director several times through email and by phone he does not return call or reply to emails ..I have reached out to the director directly because of the issues with the first claim I had issues with and due to them both being litigated and had a lawyer I had to go through getting medical records etc he emailed me directly and we talked once or twice now I am not being assisted I reached out to avibra again and asked for a supervisor I emailed the person who told me to resubmit my claim and cc'd the director so he could see the response and I have yet to hear from anyone ..my resolution is to have both claims processed and to reimburse me for the emergency Room visits

  

  Business Response

  Date: 04/25/2024

  I have traded voice mails and had many e-mails back and forth on requirements to get her claims reviewed/processed since 4/22.

  I think we are on a path to getting them resolved and have assigned an examiner to work with her. ************** has provided additional information but I am sure we will need more information regarding the accidents suffered to properly review the 3 claims submitted. 

  We will continue to assist her in getting these completed.
  

  Customer Answer

  Date: 04/25/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 19637900
  
  I am rejecting this response because: I have provided additional information for the accident that occurred on March 28,2023 I am still waiting for additional information from the providers and hospitals to have the other two claims received. Ni did speak with the claims director and he seems more than willing to help resolve this ongoing issue but the timefrane of processing the claims I was told was ***** days they waited over a montg to ask for additional information and if I was not persistent with requesting an update they would have continued to ignore my calls and emails 
  
  
  Regards,
  
  *********************
  
  
  
  
  
  
  
  
  

  

  Business Response

  Date: 05/15/2024

  We are continuing to correspond with insured in an attempt to resolve these claims. There are three claims involved, and we do not have the necessary information to move forward with any of them. She has been advised of the items needed to complete each claim and a ******** Service Supervisor is trying to help resolve the claims.

  Customer Answer

  Date: 05/17/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered] 
  
   Complaint: 19637900
  
  I am rejecting this response because: I have provided company with documentation every time they asked after over a month of having this claim they decided to ask for additional information I provided and sent it back on April 24,2024 after that because they will never process and never pay me the reimbursement owed to further delay and prolong they then asked for information I didn't have but I did provide them the claim number from that company insures lyft and a discharge letter from the attorney I retained  I contacted aci two days ago and I was told they have ***** to review that document despite the fact it wad sent in at the beginning of this month they pended the claim waiting for information they already have and refuse to review they denied parts of the claim for medical services that wad part of the accident claiming it was routine medical care and not an accident when it wad dated for the date the accident occurred 
  
  
  Regards,
  
  *********************
  
  
  
  
  
  
  
  
  

  

  Business Response

  Date: 05/20/2024

  We have been in contact with ************** as well as her insurance carrier and policyholder to advise what is needed to process her claim. Some items she states are bills, do not contain the necessary information to process the claim, and there is other information needed as well.

  A letter is being mailed to her today (5/20) outlining what is still needed, and why.

   

  Customer Answer

  Date: 05/22/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 19637900
  
  I am rejecting this response because: I will follow up with alternatives resources they will never process this claims  and prolonging this claim  intentionally to eventually deny it it has been 60 days and they continue to ask for information  I will now file a complaint with the department of insurance 
  
  
  Regards,
  
  *********************
  
  
  
  
  
  
  
  
  

• Initial Complaint

  Date:10/31/2022

  Type:Billing 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 canceled my health insurance to only have this company still take my payment electronically. They said they can not refund. This is not acceptable business behavior.

  

  Business Response

  Date: 11/09/2022

    Administrative Concepts is a Third Party Administrator contracted to administer claims. We do not have any part in the sale or collection/refund of premiums. The insured should go back and contact the party that sold her the insurance.

• Initial Complaint

  Date:10/06/2022

  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.

  2/18/22 we purchased a medical insurance policy from healthcare.gov due to my husbands new job. His new employer's insurance policy woild not go into effect until 4/1/22. we purchased this policy to beidge the gap between the 2 coverages as not to be uninsured.my provider sent medical phys therapy claims as instructed on their ID card as directed 4 times. They have not paid 1 claim. Every time I call they say they have not received any of the claims. When I call, you get a recording saying its in process. we can never speak to a person there to address our concerns.I have attached 2 statements showing I paid policy premiums for Feb and March 2022.

  

  Business Response

  Date: 10/13/2022

  Administrative Concepts is a Third Party Administrator contracted to pay claims for this Limited Medical policy issued by ***** **************** Insurance Company.  We have searched our records and have only one call to our call center on 9/29/2022 during which we advised no claims for PT have been received. We have 2 claims on file for *******, both of which have been considered  Attached is our EOB for reference.  If they wish to file additional claims, have them sent to [email protected]. 

  Customer Answer

  Date: 11/16/2022

  Complaint: ********
  
  I am rejecting this response because:That is NOT what they told me when I signed up. they told me all visits were $50 copay.
  

  
  

  Regards,
  
  *****************************
  

  

  Business Response

  Date: 12/01/2022

  As previously stated, Administrative Concepts (ACI) is a third-party administrator contracted to process claims on the policies provided by the Insurance Company. It is our understanding the ******************* filed an Insurance Department Complaint, and it was responded to by the sales entity that provided the information ******************* is questioning.

  ACI should not be involved in this dispute.