geha.com

GEHA has turned into a game show

The new GEHA obviously hires customer care employees who know nothing about the medical field. I used to be able to speak with knowledgeable personnel, but now across the board they have no working knowledge. They answer questions knowing they're committing errors and only if I press for more information, they will place me on hold over and over to get the answers I need. Asking for a supervisor seems to be the only sane thing to do--that is--if you can get to talk with a person who follows through and competently. Providing medical codes with the claims is like playing a game show. Even if the doctor writes the full diagnosis and treatment, if the "right code" isn't given, you lose! No guidance is given to find the right code. You simply lose the game! I found all the codes I needed in abundant supply by doing a search on the Internet and then chasing after my doctor to resubmit the claim with the right codes. Then I had to locate the supervisor again who said the claim would be covered and processed right away. It sat for another month and I could not get a call back from the supervisor. Finally, customer care placed me on hold multiple times and the claim was magically processed while I was on the phone. I was given the wrong amount that would be reimbursed (10% payment of the claim amount!), so she put me on hold again and came back and said I would be getting 3 checks instead of the one she first quoted. However, all three checks only add up to less than 50% reimbursement even though the every climbing out of network deductible had been met. It still remains to be seen if I will receive payment. I can't understand why there are 3 checks when all the office visits were bundled into one member submitted claim. The amount of hours I put into this has been staggering.

Date of experience: Feb 23, 2026