Complaint Review: Strategic Resource Company - SRC An Aetna Company - Columbia South Carolina

Twice I have been insured with SRC in a year's time, covered while a contracted technical writer and more recently as a contracted professional consultant (I was employed by two different companies). My first experience with them was horrible, and lasted about eight months. The coverage was for myself and my wife.

To put our frustration into one simple image: in eight months, despite at least four phone call requests, we never, ever received a permanent member card. At six months, our temporary card expired, and SRC promised, but never sent, a permanent card. That is the most simple of reasons why I believe that SRC is horrible, and they have been, in our experience.

Another unreasonable practice by SRC is that they provide the most illegible statements and bills I have seen, in memory. By contrast, for a short time between SRC coverage I had another health coverage, and their statements were straightforward, actually demonstrating plainly what portion I owed and what they would pay, with clear identifiers of providers and claims. SRC bills, aside from being scattered, gray and hard to understand, seemed to nearly always cause their own CSRs to struggle as well. SRC CRSs tend to speak in jargon, rather than respecting the fact that not everyone works in billing or in insurance.

A recent terrible experience, now that we are back with SRC (sadly), was addressing our having a brief lapse in coverage (three weeks), and being told by SRC rep, on the phone, that the lapse meant my preexisting conditions term would not regard the prior ten months of coverage. In other words, my record of coverage began two weeks prior to that call, n ot two weeks and ten months. I argued about what I had read and understood (in fact, 60 days of no coverage would impact continued coverage, not three weeks). She said she would confirm and call me back about the lapse.

I never heard back from her.

This discouraging news she left me with, however, led to a rather vigorous search for alternative health coverage. We figured spending eight months paying for little solid coverage were enough. That search ultimately failed due to down payment timing (in other words, I couldn't afford to be approved and have a $400+ first-month's coverage cost pop out of my account that month).

Very recently we called SRC, to argue against a bill we were getting for lab costs, from the prior time we had SRC. It was almost a month after that failed insurance search. We were still concerned that, by SRC's estimation, we were out of luck where preexisting coverage was concerned, so the calls were made with an existing tenor of discouragement.

Two hours later, TWO HOURS! - after calling SRC at least five times, I started to get some answers. Once I had to call back due to someone either putting me on hold without saying so or hanging up, once I called back due to someone transferring my call before I had finished trying to explain what I needed to get an answer about. These folks long ago established their eagerness to do nothing, whether that is an institutional fault or many individuals' faults, so I didn't want to hope for the best.

The final time I talked to someone, my fourth call to SRC, the CSR, named "Robin," could in fact verify what we were told earlier in the day about a preexisting condition, in the first call to SRC that day. That charge had begun bouncing from the lab to us seven months earlier. SRC never made it clear to the lab nor us that they had determined they would not pay for it. In fact, they didn't seem to really understand it themselves until that very day. That was totally stunning to me. And a bit late, as the bill from the lab was a "final" one.

What's worse, while we were sure to send SRC a health history form, to aid them in preexisting conditions decisions, they said they never received it, and that was the reason why they would not pay for that lab visit - for lack of that information. So the preexisting condition was that their form was lost in the mail, apparently.

The totally frustrating - nearly maddening! - thing was, it took seven months to make this clear? Granted, the lab is inept in this, too, as they first sent the charges to Aetna proper, not SRC.

But, I contend that it is yet another issue about SRC and Aetna, too: If SRC is an Aetna company, how is it that the two seem to not communicate at all at the customer records level, in order to sort out lots of confusion that put customers in the middle of their insurance and providers?

I still wonder, even though I was helped quite well by Robin at SRC CSR (a refreshing difference) is: where, exactly, is the customer service in this equation? It appears the customer is the one doing all the work to solve coverage issues.

SRC is a fine example of why health coverage in America is an absurd, shameful mess. Yet, insurance companies are still doing quite fine. It appears that so long as the customer is willing to do all the hard work of getting insurers and providers to meet somewhere favorable to the customer, then they will keep sticking us in the middle while taking our money for little coverage until we can get past that "preexisting coverage" line. While the preexisting thing is hard enough, that SRC's typical CSR person seems to not know or want to refer to the most basic policies while on the phone makes it all the more frustrating, and discouraging.

Florida-writer

Orlando, Florida

U.S.A.