Ambetter Sunshine had previously approved a medication as medically necessary. And then in October 2021 they decided that the medication was no longer medically necessary based on the information submitted by my doctor. The information was exactly the same as they had approved before. My doctor filed an appeal.
It is now June 2022 and I still cannot get a resolution or talk to anyone about the case. Ambetter only has a P.O. box to send appeal letters to. The people on the customer service phone line can barely speak or understand English. They do not have any information on prior authorizations or appeals.
I did send a request by mail in February 2022 for an independent review and a request for all documentation used to determine Ambetter's decision. That request has been ignored. I even filed with the BBB and Ambetter refuses to reply there, either.
Sunshine Health Reviews
Ambetter Sunshine had previously approved a medication as medically necessary. And then in October 2021 they decided that the medication was no longer medically necessary based on the information submitted by my doctor. The information was exactly the same as they had approved before. My doctor filed an appeal.
It is now June 2022 and I still cannot get a resolution or talk to anyone about the case. Ambetter only has a P.O. box to send appeal letters to. The people on the customer service phone line can barely speak or understand English. They do not have any information on prior authorizations or appeals.
I did send a request by mail in February 2022 for an independent review and a request for all documentation used to determine Ambetter's decision. That request has been ignored. I even filed with the BBB and Ambetter refuses to reply there, either.