ComplaintsforAIM Specialty Health
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Complaint Details
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Initial Complaint
05/09/2023
- Complaint Type:
- Order Issues
- Status:
- Unanswered
Location: ******************* ********************************************************** My company has been doing with ******************* for about 1 1/2 years and they have been really slow in paying throughout the time we&#**;ve done business with them. On 1/20/23 they asked for an invoice for South City house pocket folders, and they were supposed to cut us a check upon receiving the invoice that was sent to ***********************. The agreement was that we wouldn&#**;t be able deliver the product until they payed. They were not upfront in telling us that they needed approval from administration first. We would&#**;ve not put the job in production if we would&#**;ve known they needed approval first. They have still not paid the invoice.Initial Complaint
03/18/2023
- Complaint Type:
- Order Issues
- Status:
- Unanswered
AIM Specialty Health denied coverage stating that my routine health care service provided at *** Health Southeastern was not in the *** system and was therefore out of network. This company routinely has no penalty for denying coverage for desperate people trying to attend to their own health. The insurance was a *** exclusive network and yet they denied coverage at a *** hospital. These routine scans and blood work then led to collection and damage to my credit report. People need to understand the nefarious practices of this company and understand their rights to hold them accountable. Contract number *********.Initial Complaint
11/30/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I am a physician conveying a concern that interferes with care for many of my patients. AIM specialty health makes determinations regarding insurance coverage for sleep studies. They repeatedly deny coverage even when there are clear indications based on accepted medical standards. Although they may allow for "peer to peer" review to be conducted between ordering health care providers and physicians on their staff, this process is time consuming and arduous, clearly creating further obstruction to coverage of necessary procedures. Although documentation supporting the need for requested procedures is submitted in advance of the peer to peer review, this is seemingly not reviewed in any meaningful way. There is typically an extended period during which I am kept on hold when waiting for the peer to peer review to take place. Finally, during the peer to peer review there is often a lack of either knowledge or insight, and the sense that the primary goal is to deny coverage. Although this has been a repeated experience of mine when dealing with this organization, the most recent example took place today 11/30/22 at approximately 8:45 am with ************************.Initial Complaint
08/18/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
My complaint is that i have been unable to get an authorization for DME **** supplies in over a year because i do not meet compliance guidelines. I currently have BCBS of Texas as my Health Insurance and buy **** supplies from AeroCare AKA Adapt Health ************ ( MY oder number is *******. MY Cpa machine was originally purchased by me and Aetna TRS Insurance 3 years ago. I won the machine. BCBS of ***** is requiring that i use machine 70% of the time- my current supplies are dilapidated - tape on headgear - i have no more filters/ nasal pillows worn out/ tubing worn out/ mask worn out. **** is uncomfortable to use. I am currenly at 65% usage and have met my coinsurance and deductible. Starts up on Sept. 2022. I own the **** and do not agree with the compliance use to get new **** supplies. Please advise ID # ************ gROUP# ******Initial Complaint
06/28/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I had patellar realignment knee surgery on April 8, 2022. I am currently still in a brace and learning how to walk again. My surgeon has prescribed physical therapy 3 times per week until I see him again on August 11, 2022. My insurance company, Empire BCBS, is not authorizing my visits in a timely manner, which forces me to go several days to a week without a visit. This is affecting my recovery.Empire staff told me that AIM staff does the auth, implying that Empire has no control over auths. This doesn't sound right at all but two representative told me this. Empire only approves me for 6 PT visits at a time, even though I need 3 visits per week. The visits run out so quick and Empire takes so long to authorize new visits. This is the third time post surgery that I have needed to miss 2 to 3 visits in a row because Empire has not authorized timely the visits requested by my PT provider.I had the worst experience today when I found out that Empire's most recent authorization was only for 1 visit. So in addition to missing PT all of last week, I am only getting 1 visit this week. I have spoke to about 3 different Empire representatives about this and they each give me a different story. They either blame the PT provider or they blame their 3rd party auth system, AIM. When asked if they had a number I could call to speak with an AIM representative the Empire representative said NO. I NEED TO SPEAK TO WHO HANDLES MY AUTHS. Yesterday I had an Empire representative on the phone with my PT provider. The Empire representative said on the visit request form the PT provider could choose the number of visits to request and **** a request as urgent to get it authorized faster. The PT provider tried this later in the day during my visit and those options were not available on the request form.The only conclusion I can draw is that Empire (and possibly AIM) hires unqualified staff, does not properly train their staff, or cares more about money than their members' health.
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Customer Complaints Summary
6 total complaints in the last 3 years.
0 complaints closed in the last 12 months.