I HOPE THIS IS THE CORRECT PLACE TP…
I HOPE THIS IS THE CORRECT PLACE TP POST MY CONCERNS WITH DETEGO HEALTH!
I am filing a formal complaint regarding my experience with America's Choice Detego Health as a current member.
I have experienced ongoing delays, poor communication, and unresolved claim issues that have negatively impacted my financial standing and resulted in the loss of two of my primary doctors.
A claim for services dated September 3, 2025, was approved by Detego Health, yet my provider still has not been paid. Additionally, another claim dating back to 2024 remains unpaid, even though Detego Health stated that two checks had been submitted and mailed, which were never received by the provider.
I have been attempting to resolve these issues since February 2026 and have made numerous calls to customer service and the escalation department. On the few occasions I was able to speak with supervisors, I was repeatedly told they were still “waiting for an answer” regarding when payment would be issued. Considering these claims date back to 2025 and even 2024, this response is completely unacceptable.
Each time I contact the company, I am told someone will return my call, but I have received no follow-up, no meaningful updates, and no resolution. Due to these delays, I have now been sent to collections for bills that should have already been handled.
In addition, I recently received an Explanation of Benefits (EOB) stating there was no authorization for services I received in November 2025. This information is inaccurate, as proper authorization was obtained before the service was performed.
I am extremely disappointed with the services provided by Americas Choice / Detego Health, especially considering I pay out of pocket for this coverage. The lack of accountability, communication, and timely claim handling has been incredibly frustrating, stressful, and financially damaging.
At this point, I had no choice but to seek assistance from the State Insurance Commissioner’s Office and other appropriate regulatory agencies.
I hope this complaint encourages the company to address these issues immediately and provide members with the level of service, professionalism, accountability, and responsiveness they deserve.
3 September 2025
Unprompted review