Complaint Review: Moda Health - Portland Oregon
- Moda Health 601 S.W. Second Ave. Portland, Oregon USA
- Phone: 503-243-3962
- Web: https://www.modahealth.com/
- Category: Health Insurance
Moda Health Fraudulent insurance practices Portland Oregon
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MODA Health has decided, after having already paid the medical claims and considered them as being in network, to revist these paid claims (some dating back to 2014) and to no longer cover them, and to now consider the claims as being out of network and to decide that the price for the procedures exceeds the price that they MODA Health considers allowable for that proceedure (however they no where have a list of prices that they consider as acceptable prices). They also are requesting that the facilities/hospital reimburse them for the excess that they have paid.
In the new EOBS they put all of the financial responsibility on the patient and they take away any PPO discounts that they had previously allowed. They then decide not count all of the patient responsibility as part of the out of network care in the maximum out of pocket for out of network. According to MODA Health even when they say that they cover 50% of claims for out of network treatment, it is only 50% of the price that they consider is acceptable for the procedure.
This report was posted on Ripoff Report on 02/19/2016 09:52 PM and is a permanent record located here: https://www.ripoffreport.com/reports/moda-health/portland-oregon-97204/moda-health-fraudulent-insurance-practices-portland-oregon-1288802. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content
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