Qualcare inc. Review

Called for verification of benefits, the lady who picked up (operator) did not say business name or her name, I had to ask her where I was calling to make sure I dialed correctly. I told her what I was calling for and just told me hold on and did not tell me she was connecting me anywhere. I waited on the phone with the crappiest hold music ever (and I thought classical or instrumental music was bad) I was on hold for over 45 mins unfortunately had to hang up since it was time to go home. I started call 4: 43 PM and was on hold until 5:30 PM when I hung up!

Deserves no stars. High premiums, high deductibles, and zero responsibility for the care of their customers. Can t walk, need surgery or scan? Apparently not their problem.

They never sent out my renewal to me or my broker. Insurance expired bc qualcare changed my expiration date. They said the woman quit and renewals didn't go out. didn't know this even happened until I needed it. They said they r reinstating....but little too late, my scripts were denied...had the A plan and script 1...paid in full the entire year in advance. . Finding another Co first thing Monday morning. Stay away, this company is by far the worst. I will be calling the insurance service office to request an audit of why this would happen.

This is the worst insurance company for providers ever!!!! I am In-Network with 4 panels and surprisingly, have had no problems getting reimbursed in a timely manner. Qualcare takes 30-45 days to review the clam and get a check out. This is outrageous!! Also, wait times to speak with a representative are abysmal. I am going to take myself off this panel. I never want to work with them again!!!!!!!!!!!!!!!!!!!

No stars - horrible insurance. Won't pay for the most common needs of a diabetic patient, makes no difference. Takes forever to settle a claim or to get an authorization. But then, I don't have much choice because Qualcare was chosen by my employer. If you have a choice, pick anything other than Qualcare.

Completely ridiculous, cannot get my 1095 from QualCare and have to get it from my prior employer. Nobody can send you one from QualCare as the send them to the employers. My prior employer does not return phone calls or emails or test messages, Guess I get a lawyer or pay the fine through my taxes. yet again i have to bend over and screwed . Completely unfair to the little people . VERY VERY FRUSTRATING

I called to verify eligibility and benefits for a patient and found the person who helped me to be efficient and helpful.

Half of my claims are denied with this company despite the providers being in network so then I get bills in the mail all the time. The latest one they denied due to "not having medical neccissity." Turns out that lack of medical necessity ultimately helped to diagnose a serious problem and let me get the treatment I needed. Good thing that providers don't listen to these idiots. Plus, there is a serious lack of providers in network.

I don't know why it would take 4 months to get an insurance card. I called twice and still have not received them. Also, the reps on the second call were nasty in their tone. Probably it would be better to outsource that department to a country where people value their jobs and customer service.

If I could give them negative stars I would. I am provider for this company and I have never experienced such horrible provider relation services. Over the last few weeks I tried to call them several times just to confirm client benefits. I waited over 30 minutes each time and had to hang up (because who has time for this???)
Finally today I got through after ONLY 35 minutes, and then the Customer Service person Sorona couldn't even answer my question without putting me on an additional hold for 20 more minutes.
Considering that they reimburse less then any other insurance panel why would any provider stay with them???