ComplaintsforNetWell Healthshare

• Initial Complaint

  10/21/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  We were promised that this health insurance (yes it was advertised to us from the sales call as insurance) would cover us as long as we went to where they accepted the insurance, also places listed on their website. My husband and I were unable to seek primary care services for the entire year. And now after we have switched we are getting a years worth of backed bills that they held onto and said they never received from the hospitals or urgent cares in a timely manner. We sent every bill to them that we received and they didn't pay them or address these medical expenses until after the 90 days, and then refused to cover anything. I was refused service at a local urgent care after a back injury in March of 2024. They went back and forth with the hospital, with us saying they didn't receive the bills, we sent proof of the bills. Then they never followed up and now we are trying to make us cover the $19044.40 ER visit! The hospital we went to, was listed as in network for them. They are now trying to say that they wouldn't cover the bill because the radiologist reported not emergent at the bottom of its report, meaning I didn't have to go to surgery right then. I had an 8 mm bulging/slipped disk that compressed my spinal and sciatic nerve causing the most excruciating pain and making me be immobile for 2 weeks. I couldn't work, couldn't move. No one would see me because of this insurance and I had to pay out of pocket for a specialist to fix my back with decompression therapy. I truly believe this company gets the hospital bills, ignores them until they are past the 90 day time frame and then forces the enrollee to pay for the bills, all while collecting a monthly amount for "insurance". Why else would we be getting bills and explanation of benefits for previous urgent care visits 6 months later, mind you urgent cares who they say they have listed as "in network". They are stealing from people.

  

  Business response

  10/21/2024

  Thank you for reaching out, *********, and for sharing your concerns. I sincerely apologize for the experience you've had with our program and would appreciate the opportunity to discuss your concerns in more detail.
  Regarding your inability to access primary care services for an entire year, I would have encouraged you to use our provider list or consider our self-pay option if your provider was not in our network. We do adhere to a 90-day timely filing limit, but if you or your provider submitted the expense within that timeframe, we can accept proof of timely submission and reprocess those share requests.
  As a nonprofit health sharing ministry, netWell relies on members voluntary Monthly Commitment Contributions, which are allocated to assist with other members' share requests. We operate on a neighbor-helping-neighbor model, which is why all members must sign off and agree to our guidelines.
  For compliance reasons, Im unable to provide details about the denial of your ER visit at this time, but a team member will reach out to you soon to discuss everything further.
  Thank you for your understanding.

  Customer response

  10/22/2024

  Complaint: 22443240
  
  I am rejecting this response because:
  This is truly unacceptable.  If you go back and look though your  documents, myself and my husband have been talking with multiple members from your company and submitted all of the ** billing ourselves. So again, I believe you all just hold onto the bills until it is passed the 90 day period so you s**** people with a bill.  Then you offer to send over these bills to a debt consolidation company to negotiate the bills down, all the whole you still get paid and then they get paid to handle the service.  So crooks helping crooks.  I will be getting a lawyer to look into everything.  Also, I expect a phone call from someone soon.  This is out of control.  

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

  

  Business response

  10/29/2024

  Thank you, *********, for your follow-up. We spoke with you and your authorized representative on October 25, 2024, to discuss this matter and the next steps. If you have any further questions or concerns, please feel free to contact netWell.

• Initial Complaint

  09/26/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I now know ******** is a company that is falsely posing as an insurance company taking advantage of consumers. They claim to be a Christian health share to attract trusting individuals like me, but by posing as an insurance company to providers it allows them to defraud consumers. Insurance companies have specific regulations they must follow and standard operating procedures such as timely filing expectation of about 365 days, but Net Well requires all claims be filed in 90 days. So, providers think they are working is a longer window of time as NetWell is part of the **** and ******************* networks, but in reality, they are not an insurance company at all and are misleading healthcare providers at the detriment of the consumer. I am now stuck with about 100k in medical bills for emergency room and for being admitted to the hospital. As soon as 90 days from date of service has past, they will not even look at a claim. To make it worse they encourage providers to send everything by mail and then they claim they have not received it so they can deny the claim. I have ***** providers all swearing they have sent the claim multiple times and NetWell will decline they have received any billing. Additionally, they only give 30 days to respond to any request for information they have, so their standard operating procedure seems to be to immediately request "additional information" information in many examples I can prove they already have, and then if the information is not received in 30 days they decline. Again, I have providers swearing they mailed or sent the information and Netwell denies receiving any info.

  

  Business response

  09/26/2024

  netWell is a healthcare sharing organization and is NOT insurance. When enrolling with netWell, the member must go through many questions and signature required forms which indicate an attestation that the member understands netWell is a charitable faith-based, Christian, sharing organization and not insurance. netWell, through several member documents, including but not limited to the netWell Guidelines, is clear when discussing the sharing of the charitable funds. In order to be eligible for sharing, netWell has a fiduciary duty and obligation to verify the charitable funds are eligible. In regards to this specific complaint, netWell has recently obtained all the records necessary to review for determination and the records are currently under review with our Medical staff. netWell is committed to our Members and we are truly sorry that you have not had a positive experience. A care advocate will follow up with you to discuss your complaint. As for your outstanding issue, the review has been expedited and a decision shall be made in the next 3-5 business days. 

  Customer response

  09/27/2024

  Complaint: 22344607
  
  I am rejecting this response because:  Although I am aware this is not insurance and is a sharing company, Netwell is operating under PHCS and ******************** networks the providers are given the impression that they are in fact an insurance company and that they have the same standard and reasonable time to respond to Netwell and to provide documents as they would with an insurance company.  Netwell intentionally sets their expectations of 90 days to receive documents well below what is reasonable and customary for providers to bill.  I believe that is with full knowledge and with a malicious business strategy to be able to deny claims for not being received timely.  In addition their process for receiving information is flawed at best and at worst is intentionally set up to not receive the documents provided by the providers so again they can say they did not receive what they needed timely and then deny the claim.  Finally once you can prove they received a claim they then immediately ask for more information starting this process over again with now a even shorter 30 day clock.  In my experience they were asking for information they already had and this again seems malicious to find a way to deny a claim.  I have the means and knowledge to fight this as far as it has to go even if that ends up in court.  I am fighting this for all those that cannot.  I feel they are taking advantage of Christs name to get people to trust them when their business practices are set up to take advantage of the average person and are anything but ****** like.  When asked what information they needed and how I can help, they distracted me with seeking out information they already had when in reality they say they needed medical records to approve a preauthorization for the emergency room to transfer me to the hospital.  They never mentioned to me this reauthorization being outstanding.  This is all paperwork shuffling and administrative strategy that happens after doctors have already decided I need emergent medical treatment and to be admitted into the hospital for a life threatening infection.  But they deny it because they say they did not receive a document in time authorizing them to treat me and save my life.
  
  Regards,
  
  ***** ******

  

  Business response

  09/30/2024

  netWell utilizes the Multiplan/PHCS network to assist members in finding local providers who will bill us directly. When members present their ID cards, it indicates that we are a health sharing ministry rather than insurance. Providers can contact us for eligibility verification, and we clarify our timely filing process to prevent any confusion.
  Regarding your situation, we have received all the necessary documentation and forwarded it to our medical review team. A representative will reach out to you shortly to discuss the final determination. If you have any questions in the meantime, please let us know!

  Customer response

  10/01/2024

  Complaint: 22344607
  
  I am rejecting this response because: I do not think this business and I will see eye to eye on this.  If they admit what they are doing there will likely be civil and legal penalties for not conforming with the laws and regulations of an insurance company.   So they would never want to admit to my experience and opinion of them using this misleading situation and relationship to ***************** networks to defraud customer as it would have major repercussions and likely shut down their business.  This is part of their business strategy.  If they wanted to be a fair company and represent their claimed christian values, they would allow for ************************************************************************************************************************************************************************** the **** and Multi Plan Networks. They would also find ways to insure they are receiving and properly logging or tracking when bills are sent from insurance companies not making it so easy to decline, operating in a created world of plausible deniability to their benefit.     

  After these complaints they say they are approving some of my claims, but I will not believe it until I see it.  Also what about all the other customers out there.  Who is looking out for and warning them. 

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

  

  Business response

  11/15/2024

  
  Thank you for your continued feedback, *****. I want to take a moment to reiterate that we are not a health insurance company but rather a nonprofit health sharing ministry. We make it clear in our materials and require all members to acknowledge our guidelines when they apply. Regarding your outstanding share requests, we have sent checks for all of them. Please dont hesitate to reach out if you have any further questions or concerns.

  Customer response

  11/15/2024

  Complaint: 22344607
  
  I am rejecting this response because:  The ******************************************* hospitals and major medical with multiple layered providers involved. The constant denials for all sorts of reasons putting a huger burden and stress on the consumer os not okay.   We will not see eye to eye on this.  I hope your statement that all checks were sent out is accurate!  As of couple days ago your customer service has said that several billis submitted did not even have decision or dispositions yet let along a check going out.  Some bills sat with dispositions for around a month before you said you sent a check.   

  Thank you for your reply.  
  
  Regards,
  
  ***** ******

*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. ↩