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@m039153

Catherine, I understand and share your concern but I don't want to place too much focus on online reviews. Nowadays, there are negative reviews online for every company, even Mayo Clinic. Mayo Clinic leaders want our plan participants to continue receiveing the high level of customer service that they are used to. Contract negotiations are currently underway and the final contract will include performance guarantees for measurable customer service issues like time to answer the phone, claims processing speed and claims accuracy. If Medica is not able to meet their performance metrics, they will forfeit a portion of the fees that they charge for providing services to the plan. We don't anticipate there being an issue but we will be monitoring to make sure that they deliver on their commitment of quality customer service for our plan participants.

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Replies to "Catherine, I understand and share your concern but I don't want to place too much focus..."

My experience so far is that Medica has been given total control of administering employee insurancce with very little oversight, including decisions on benefits that differ from what the medical plan says. Mayo HR does not seem to be able to answer benefit questions. In addition, the EOB forms have information that is less than correct, such as "Medica negotiates discounts with doctors" I doubt if that's the case. They are a Third Party Administrator of the benefits authorized by Mayo Clinic. It also takes a very long time for providers to get paid compared to service previously provided by MMSI.

My comments are based on actual experience, not online ratings. I've found Medica very non-tranparent in answering questions about benefits. One CANNOT speak to a claims processor and their "customer service" call center often cannot answer questions. I'm trying to get an answer to how Medica treats hearing-aid & associated cost benefit under the Mayo Medicare Supplement insurance. I need new hearing aids. Mine are 6 years old. The company I have used previously for my hearing aids tells me they are getting reimbursement for less than the $5000 benefit detailed in the plan document, and they have spent hours on the phone with Medica trying to figure out the criteria used to pay claims. The handling of these claims seems to be very subjective and inconsistent. Mayo HR call center personnel said they have been DIRECTED to forward ALL benefit questions to Medica. One cannot get a straight answer from either Mayo or Medica on this topic. I requested a complaint form from Medica so I can address my questions in writing, which will also be directed to HR Director at Mayo. I was told by Medica the complaint would "have to be addressed in writing". Very disappointed in how insurance benefits are being administered by Medica.