Trover Solutions, Inc. review: Possible Identity Theft Scam 91

Got the same letter. My employer pays an arm and two legs to provide me with health care. My injury began to bother me at work, but really it is an arthritic condition, , not an injury at all. If I told these bums that it started on my work shift, they probably would be trying to sue workman's comp, or my boss. I bet this would really please him (NOT). I intend to show my boss tis letter, so he knows the real dilemma this company could so easily put him in. This ambulance chasing is the main reason health care costs as much as it does. The lawyers get rich suing to collect.I do not intend to respond to this letter at all.

Ok. Here are the facts. When you purchase insurance directly or through your employer you enter into a contract. That contract has a clause about potential subrogation rights and your agreement to cooperate. Unwillingness to cooperate may forfeit your rights for payment of claims. There is always a contract and you can always ask to see it. Just ask your HR rep or insurane company.

Your insurer pays a subrogation recovery company (HRI/Trover is not the only one) to review your claims. Claims submitted by a provider (doctor, hospital, ER, etc.) are reviewed based on the standard diagnosis codes put on the claim. If the code used indicates an injury that MIGHT be accident related your name and address kick out and you get a letter. The letter is only asking you to confirm or deny if an accident ocurred in case another party is legally responsible for claims resulting from an injury. If you are in a car accident and someone else hit you sometimes your medical bills get paid by the car insurance company rather than your health insurance company because they are legally responsible. That all. This is not a scam. It is not fraud, identity theft or phishing. Lawyers are involved at times because a matter of law comes into question regarding interpretation of contracts and fault. It happens everyday.

Often you do need to cooperate else your insurer may stick you with all the bills because you are contractually required to. Your insurer is too busy paying your claims and dealing with all the BS of HIPAA and healthcare reform to do subrogation work themselves. The people that work at these places are just like anyone else. Doing a job to get paid and support their families. There is no conspiracy. If you don't like the way this works then you have to change the legal system and healthcare and other insurance. Good luck with that.

I found HR (aka Trover Solutions) also intrusive with its "Cheri Hall Manager" form signature. I hate HR and that "HIPAA" leverage sentence. nearmj

Bank of America can not talk to you about your sister account unless you have a power of attorney.

You have stupid and uneducated consumers. I bet if the insurance company cancel this clown out she/he/it would be on the phone calling.

I too was very skeptical about the letter and kept ignoring it. it just didn't feel right. so finally I called my insurance company directly and talked to a representative and she assured me that it is legit and its ok to give the information requested. I called about 5 mins ago.

Please do reply to them. I called BlueCross, my payor, and they confirmed that Healthcare Recoveries represent them. They are just here to verify if your injury was caused by any other party that may be at fault, that's it. My insurance also said if i dont respond to them, they will keep sending 4 letters and if i dont respond to the last one, they may withdraw the money given to the provider/hospital, which I believe can then end up on you. So best is to cooperate and respond to their queries. They don't ask any personal info other than about how the injury took place etc.

Got a letter. Claims treatment date as "an accident/injury". Doesn't pass the smell test.

If my insurance company wishes to inquire me about medical history it can send me a request that is not operating out of a PO box

If they're legit they should acquire methods of acquisition that don't resemble mail/identity fraud..

Healthcare Recoveries is not a scam in the tradition sense of the word, but neither are they your friend. If you were injured by the wrongful act of some third party, Healthcare Recoveries wants to know because they would like to potentially recoup some of what your own insurance company paid to you. But what they gloss over is that ordinarily they are not going to try to get it from the third party whose wrongful act injured you. They are going to get it from YOU when and if you try to recover from the third party. They do this in two ways: (1) almost all health insurance contracts give the insurance companies a contractual right to seek reimbursement in these situations; and (2) to prove a case against the third party, you will need documentation regarding your medical bills, which these guys won't give to you unless you jump thru their hoops to make sure they get paid. When they talk about cost containment they are talking about taking money that would otherwise go to the injured party who had used the insurance that he had already paid for with his premiums. Those who call them "ambulance chasers" have it 180 degrees wrong. That term is usually used for Plaintiff's lawyers, lawyers who represent people who have been injured. Healthcare Recoveries helps the insurance industry by trying to take money out of the pockets of injured people.

How can they prove they sent any letters by regular mail? This is like Phishing on the internet hoping for a response. My 3rd letter? prove it. If I am required by my insurance company, why isn't my insurance company asking? Did I sign for any letters? What letters?

I got my first letter, did some research and found this complaint board, and decided just to ignore it. When I received letter number two I got a little annoyed. Then I got the final letter/threat so I called the 800 number. When they asked me where the accident occurred I told them it happened at 9390 Bunsen Parkway, Louisville, KY...Healthcare Recoveries headquarters in Louisville... :) I haven't received another letter in five months.

HRI is a legit company performing a legit function. Insurance companies are legally obligated to take a "pay and pursue" methodology when an individual is injured in an accident. Imagine if your insurer refused to pay for something until you proved it was their responsibility.

Lets say you get hit by a drunk driver. Your insurance company pays for you to get treatment. No questions asked. You insurance company is then forced to either eat that cost, or pursue the true responsible party themselves. The doctors don't care because they've been paid. You don't care cause you're not getting billed. Your insurer just shelled out $50, 000 for your medical bills, it is their right to try and recover that. HRI does the leg work of collecting from the responsible parties.

The only people who should be put off by this are people trying to hide something. If you fell down your neighbor's steps cause they are broken and dangerous, but you don't want your neighbor to be responsible cause you like him. Or you don't want to tell them it was an auto accident cause you think your auto premiums will go up...that is insurance fraud. If you don't have anything to hide, you don't have anything to worry about.

Also keep in mind that "finding" these things is very much like finding needles in a haystack. HRI basically combs through diagnosis codes to find things that could have been the result of an accident. That is why chiropractic and physical therapy tend to be false positives. It's all part of the process. If there is no accident, just tell them that, and I promise you they will go away. They only make money when they are making recoveries, so if they figure out there is no opportunity to recover, they move on to the next one.

I've been in the healthcare insurance industry for 15 years. I've never worked for HRI or a competitor, but I can assure you that nothing illegal or immoral is going on.

Called them and all they wanted to know is if the injury was work related. It looks like they are fishing for an additional business avenue for additional compensation. It is possible that it is legally legit, but still corrupt. I would just say it was a personal injury, if anything at all, and give absolutely no other information.

I will not be calling them. If this company has been hired by my insurance company, the insurance company has all the information they need in regards to what happened to me and if it was or wasn't work related. I am not providing any information to a third party. Should my insurance company call me and inquire, I will ask why they did not ask for this information in the beginning. As, my reason for visiting the ER was not accident related, nor did I have an injury. If my insurance company cannot relay that to their third party subrogators, it's not my job to.

I used to work for BCBS... yes, HRI aka Trover Solutions is contracted by BCBS to review our medical claims simply to make sure the treatment our members had was not the result of a accident or injury where a third party is responsible. No one like to pay for things they aren't responsible for, including health insurance companies. If you are in a car accident or injured on another property, then that is why people HAVE auto and property insurance... to cover those types of injuries! So yes, HRI saved BCBS MILLIONS of dollars and recouped those funds back to us in effect helping to keep our premiums for our members lower. Just answer the letters people and stop freaking out and thinking you know it all already. Yes, you explain to the doctor and hospital what happened... but most of the time that isn't all the information a health insurance would need to know they aren't responsible for the treatment. Furthermore, the health insurance only receives a medical code and not some kind of written statement detailing the injury or accident you sustained. The code may say "MVA NON COLLISION, " for example, but that doesn't tell us ANYTHING. We have no idea what auto insurance, if any, is at fault... so we pay your medical claim and hope that we can get refunded from Geico or State Farm who should be PAYING FOR A CAR ACCIDENT THIS IS WHY YOU HAVE CAR INSURANCE. HRI does a great service for us... it may not be the most glamorous job, but it is a MUST. Every major health insurance company out there uses a company like this.
PS if you lie to your health insurance about the reason for your treatment if they inquire then that is INSURANCE FRAUD and is illegal.
We would only inquire if the doctor uses a trauma code like the one above, or your treatment was really expensive.

My wife has had her third letter from Cheri Hall. This is a version of modern day insurance ambulance chasing. If the primary carrier has the information, they should share it. If they don't, they can get it. Her primary carrie never once mentioned Trover or said information would have to be provided. The employer, with whom the carrier has the contract, has never said any information had to be provided to a third party. Cheri and her ilk are low life predators. If the primary carriers need subrogation, they should do it on their own, or advise the contractee to advise the individuals who are covered. But no, it's just a version of "we'll get money for you and take X%." These people are performing legal functions, but that doesn't make them any more than human detritus.

Phelpsovic, it is the health insurance companies who contract trover solutions to do this work for them. There is nothing wrong with it, and is a necessary function of health insurance. And many health insurance providers do a lot of their own subrogation, they just use Trover solutions to get the information they need to handle the subrogation claim and recovery from third party insurers such as auto, work comp etc.

I recently received a letter from them that said I needed to contact them with regards to an injury, and on the letter there was a similar looking symbol to the Blue Cross Shield. However, after contacting them and how much information they wanted (I didn't give any) I became suspicious. Also, they said in the letter they were being outsourced to by Blue Cross but after contacting BCBS they said that they don't know who that company is. It has a lot of the same appearance as an identity theft scam. Be very mindful

Well good news for New York residents. On November 13, 2013, Gov. Cuomo signed an amendment to the anti-subrogation laws, which now makes it illegal for health insurance companies to get subrogation from the insured for the very event that the insured's policy covers. After all, you pay premiums to pool the risk, when the risk is realized, even at the negligence of a third party, it provides pure profit for the insurance company.

It was - almost - legalized theft! If I sue a third party to reimburse my out of pocket medical expenses, and the insurance company isn't part of the lawsuit, nor are they paying legal fees, then they shouldn't get to stick their hand in my pocket for any settlement! So glad this law passed!

That's the first thing I felt, My HMO has my Information why this 3rd party still wants some more info. from me? Those letters are very stressful because it has Law Office name on their letterhead. I contacted MY Healthcare provider HMO and I was told I have the right to ignore them, if I am not comfortable releasing information. HMO or healthcare providers hires this group to further investigate if there's another party liable that cause you your illness or something, but i think that's funny because they can all obtain that from HMO etc...And then I spoke with Brian or Ryan of Trover Solutions and he patiently explain to me how it works, and he said those are automated generated letters. Any trauma testing or related issues will trigger this letter automated system. He actually didn't ask any questions after he hears from me that, all I have is routine test requested by my doctors. And he Promised that those automated letters will stop. All HMO healthcare providers should stop this non sense please.

I received a similar letter and have filed a BBB complaint (with which Trover has no membership by the way) and will be complaining to my insurance provider . Their veiled threats in the mail are nothing more than ambulance chasing by some sleaze ball lowlifes.
They use bush league implied threats in their mail to get you to answer their spam.

Toss the mail in the can, forget Trover. Just a bunch of bottom feeder lawyers.

Check this out - I was rear-ended while I was parked, not moving, standing still and these vultures have me paying for this accident., my HMO that I pay $251.00 to each month was paying for this accident also, I was paying a co-pay and now, Bluecross Blueshield wants their money back and filed a Lien against ME for $10, 469.00, not against the Insurance Companies, State Farm Insurance Company and the other drivers Insurance Company - Allstate Insurance Company are their Obligation and Responsibility. Somebody messed up on my case, there was a Gentleman that spent 6 days in the Hospital, had his jaw wired up for 14 weeks, and you guessed it - he lost too, what our Legislators, A/K/A Lawmakers wouldn`t do for a couple pieces of Silver. Do their Children, Grandchildren and Great Grandchildren know that their Parent, Grandparent or Great Grandparent are stealing off of their Classmates, Friends and Parent to enrich themselves, somebody should charge them with violating their Oath of Office and send them - you know where. I can`t get Brand necessary Percocet as it retails for $955.97 for a months supply of 120 tablets. It could possibly be produced for $55.97 and that leaves $900.00 floating around for the Politicians to grab - neat huh ?

What Trover Solutions are is a company that tries to find a way to recover money for insurance companies by either getting another insurance company to pay or having the person that was injured reimburse for their treatment. There is millions and millions of dollars at stake for your insurance company and for Trover. They get paid by finding reasons to recover money from you or another insurance company. The key is that they get paid by your insurance company and only when and if they recover money will your insurance company pay them. How fair will they be if their entire business relies on getting "the cash". So for their own sakes they must attempt to recover as much cash as they can. Every person that receives a letter needs to disregard the letter and force the company to bring you to court. If they bring you to court, that's a huge if, you counter sue for harassment and court cost. Only then will this company, who's legal staff is in the same building, will be forced to quit harassing people.

The whole arrangement between "Trover" et al and health care providers is sleazy. I received letters similar to the above. In my case I had a very personal post-surgical reaction to a hernia operation and should not have to discuss this with some ### from a law firm I did not hire. I do not trust their claims to "sensitivity" or confidentiality and neither should anyone else. If you were damaged by information provided them recovery would be virtually impossible. That this "business arrangement" is allowed under HIPAA shows how slimy and powerful the insurance lobby is, and how little courts care about consumers. I will gladly confirm to my doctor or any licensed health care provider my insurer (Kaiser-Permanente) that there was no accident or any third party insurance payment made.

I don't believe that anyone has any legal responsibility to respond to this sleazy bottom feeding firm and they should not. If your insurer directly questions with a qualified provider you then you should respond, but not otherwise.

Thanks to Lifelock for providing this board!

I would like to know "why" is my personal medical information being distributed to Trover Solutions? My injury was in no way the result of an accident or someone else's fault. Where is the confidentiality, and why are they reviewing my medical expenses and claim? How is my information kept private? I have my doubts about answering a letter that is not certified and only has a P.O. Box 37170 on it. All of my information concerning my injury was given at the hospital and signed by me. [Heart attack] I have no idea what Trover Solutions can, or will do with any of my medical history, etc.. BEWARE

I called Trevor solutions back today, they sent me the same letter in the mail. There's a bunch of invasive questions about what happened at the doctor, and how you were injured, or if you think your injured. Don't call them back, waited 20 minutes just for them to ask all those invasive questions.

I contacted my Health Care Provider before even considering calling Trover Solutions back. They confirmed that they contract with Trover to act as subrogators in the event a third party might be involved in the claim. So, I called Trover, told them is was just a condition that developed, and that was the end of it. No big deal. They had a lot more information on hand than they revealed in the letter, which is good. It shows they are protecting PII.

As long as Americans support for profit health care, this is what you will get. Companies out to get rich and deny coverage at every chance they get. But Americans had a chance to get Universal health care with Clinton, but you sheeple believed the crap from the AMA and the Phama industry. I had universal care and if you watch Sicko, take it from me thats accurate. But Americans are to greedy and brainwashed to ever let Universal health care start in America. People in debt are afraid to make waves. so keep your profit so called care and work your selfs to death and get minimum wage and 1 or two weeks vacation if your lucky. I prefer my 5 weeks a year and no debt, and have a real doctor not some business man pretending to be a doctor but actually working for the for profit insurance companies.

Received inquiry from Trover re medical bill in April. Somewhat irritating when they opened with "this is second attempt", even though it was their first to my knowledge, having received nothing prior to this. The complaint initiated above by Amanda Hopper seems to have validity because it asked for identifying info, which they should already have. My letter asked for nothing but follow up on reason for treatment. I, of course, went to the Trover website to validate their existence and position in the health care industry, as well as the BBB. I now understand that they are an auditing service assisting in ferreting out scams, overcharges, and mis-categorized conditions, not to mention people who doctor hop to secure controlled drugs. The company cannot possibly include all this info in a letter, so it is good that their website explains their purpose. There is nothing wrong with the insurance industry confirming claims, which is not unlike government audits of Medicaid/Medicare providers.

I received a letter from this place for services my wife received two months ago. The letter states, in part, "according to our records, the services may have been the result of an accident or injury."

Uh, my wife had a laproscopic hysterectomy due to two huge masses on her uterus. It was no accident, unless two aliens invading your body are grounds for appeal. Good job, Trover! Get a dump of all claims processed and send out letters. You might want to consider adding the diagnosis code into your queries.

If my insurance carrier (Highmark) hired these folks, they are wasting their money.

You guys really should get the reports from the insurance companies. While understandable that there may be another party responsible for payment of medical costs. The average person hurt on the job will report it to their immediate supervisor who should in turn fill out an incident report. The injured person will tell the treating facility what happened, where it happened, when, and how it happened. Same thing with other types of accidents. Pains that manifest then intensify over time with no specific notable incident are also related to the provider. In all cases the insurance companies have the medical information and incident reports. While 'most'
(monkey see, monkey do) policies do have in the finer lighter colored allmost invisible print a provision that you will assist them with recovereries if other parties are responsible. This is what they are looking for. Again the insurance carriers should have given Trover/G&S/whoever this information. Without it the letters fall into the realm of fishing expeditions. I for one know the difference between work injuries, injuries sustained in car accidents, bricks falling on my head, being transported to Oz. Amazing how, while chiding the public for honesty. Corporate underhandedness and greed steadily increases.

I got a bad feeling about the letter too. So I called my insurance company directly and they confirmed Trover Solutions is a company they work with. And yes, they want me to call them. It makes sense to me that an insurance company would want to get out of paying if possible. In my case it was a broken ankle. So if it was a car accident then maybe the other driver's insurance company would be responsible for the bill. Or if it was a work related accident then Workers Comp would pay. I'm going to call. NOT A SCAM.

Absolutely a scam.

Clearly Trover Solutions has no legal standing to view your complete medical records -- which would include your description of how your injuries occurred. If they did, they would know whether they might be able to sue someone else for your medical costs.

At a minimum they are tricking consumers into thinking they need to comply with their requests for information, which they absolutely do not. I do not work for Trover Solutions, yet they want me to do their investigative work for them, and for free?

My time has value; stealing, it under false pretenses, to enrich their company, is criminal.

Gibson & Sharps litigates cases on behalf of your insurance carrier that has a contract in place with Trover. I used to work for Gibson & Sharps. Gibson & Sharps is supposed to be a stand alone law firm with their own HR, Finance, etc. However, they use Trover Solutions HR, Finance, etc. Trover Solutions is a client of Gibson & Sharps yet Danny Gibson is listed on the KY Secretary of State as being a Secretary for Trover. And, Danny Gibson overseas a couple of the departments at Trover. If an hourly employee gets stuck on an emergency and the employee ends up with a little over time they don't pay the employee. Gibson & Sharps allows the HR department at Trover harass and threaten their employees with the loss of the employee's job in front of Trover's Compliance Department and nothing is said or done. I know circumstances where a managing attorney failed to file suit on a case and the statute of limitations ran. So, to get the suit filed the attorney filed in a neighboring jurisdiction so the client a/k/a your insurance carrier wouldn't find out. Gibson & Sharps and Trover are jokes! I think the Louisville Bar Association and the Employee Labor Cabinet needs to be made aware of the shading business practices.

I received 2 letter for separate claims and here's what I did... looked up Trover in BBB listing. They're rated A+ so quite a bit of legitimacy right there .Called the toll-free# > gave the event#'s > when asked for personal info I verified ONLY my name and explained that the claims in question were definitely NOT the result of any accident or injury > the associate totally accepted that without any objections, said she would note it in my file so I wouldn't receive any further correspondence on these claims > DONE!

I too received a 3rd notice (after trashing the first as all codes in my record were clear this was not an accident, just plain vanilla illness). However, this is a GREAT example of the bigger picture about how our healthcare system works and why it is almost double other industrialized healthcare systems in the world. True story--The US system has evolved into a complicated monstrosity that likes to assign "blame" for health events. When you go looking for who to blame, that's complicated, requiring specialists like HRI. Complication = Expensive. HRI (and Trover) are legal, as a cog in the machinery, part what makes our system so costly. Insurance companies have all sorts of delay tactics to keep from paying and if they can delay long enough, (industry average to cover the same person is 18 months), the covered person will likely move on to the next insurance company for one reason or another.
Subrogation is a fancy name for musical chairs for our healthcare dollars. There's PLENTY of money out there, it's just going into the pockets of a very few who design how the game is played, not the covered people. When people need healthcare services, they need rest to recover, not paperwork = additional worry. Letters like this, complicated rules about whether health insurance companies will or won't pay for certain services is too much to ask of someone who didn't go to medical school, especially when they need care in order to get back to business of everyday life.
The employee who posted here showed an interesting viewpoint--thanks for that insight. However, after having been in healthcare for almost 20 years, as well as experiencing universal healthcare in several other countries, I can assure you, the idea of BLAME rarely comes up in Canada, UK, Czech Republic, Costa Rica, Australia, New Zealand, Belgium, etc. They just treat people and move on. It's more straightforward, and simple = less cost. So I don't buy the statement that HRI "saves" healthcare dollars. It's another shell game that keeps things expensive when taken in context of how US healthcare is overall organized to favor paperwork over actual care.
You can argue how bad universal healthcare is with plenty of examples of people who had bad experiences with it. There are equal stories here in the US. The data show our healthcare is far more expensive ($7000-$8000/year per person VS. $3000-$4000/person in the next most expensive country. You can also argue we have the best healthcare in the world. However, data that measures overall health, at several age points, say the US ranks way down the list on those measurements too. These data come from a variety of places, one of the most compelling from the World Health Organization. (which itself needs to be careful about how much they publicize as they are well funded by the US). The US never even ranks in the top 10. Not childbirth and newborncare, not diabetes, not hip replacements, the list goes on. Also, NO ONE WHO LIVES IN UNIVERSAL HEALTHCARE COMPANIES GOES BROKE BECAUSE THEY GET SICK. People may lose their ability to make a living due to illness (which is tragic to be sure), but hospitals are not among creditors knocking on their door for payment
Ouch Amercia. Embarrassing.

I received the same type of letter in the mail.
To Amanda Hooper, who took pains to explain that they are a genuine organization - with all respect Ma'am, if your company is genuine and not one of those phishing scams, please hire a better business analyst or sales manager who is in touch with clients enough to know how your seemingly innocuous letter is going to interpreted, and that you won't be clarifying our grievances on a complaint board's website.

However, I suspect that is not the case and your company is cheating people.

Even if this was legit. Why wouldn't Kiaser inform us this was coming. Or better yet solicit this information them selves. Just toss! There is nothing they can do. If they can't deliver the information promised Kiaser won't use them. My problem is how did they get they initial information about me. I never gave Kiaser permission to share this info.

All I have to say is that I rec'd a letter from Trover Solutions and I get a scammy feel from it. We have some medical debt that we've been working on paying, none from an accident or injury but from illnesses, seizures and from an apendectoomy one of my sons had. We also qualify for aid from various hospitals, but when I fill out the paperwork (exactly according to their requirements) we get denied. The size of our family and our income guarantees we get a discount, yet these places refuse. I am paying everyone monthly, but only what I can manage on our budget. I finally got a settlement letter from one of them and they will cut the remaining bill in half. I am going to be able to pay that one off soon. I think this Trover Solutions is just another debt collector and this is what I got from the
BBB Business Review, CONSUMER COMPLAINTS, THIS BUSINESS IS NOT BBB ACCREDITED, Trover Solutions, Inc.[protected]

I am just now dealing with this company, Trover Solutions, Inc. I received two letters, both during the holidays. The second one, with a "confidential and private" notation on the envelope.

The letter, like the first, gives a fictitious treatment date and the name of a "provider" that I have never seen. I looked up this doctor and he is a radiologist. Moreover, he does not work for Kaiser!

On another website dealing with a complaint about this company, a lawyer suggested that it would be wise to call the insurer and verify that they actually requested Trover assistance. Well, some of you know Kaiser ... so, I am on the 3rd call, going up the chain. I'll try to return and give follow up. I must say that the first person at Kaiser that I spoke with verified that they do indeed use Trover and that I should go ahead and contact them. After I explained the fishy nature of the letter and the multitude of online complaints, she agreed to give me the contact for their Kaiser liaison ... who is away until Jan 26 (today is the 8th). However, she did leave her supervisor's name, and I called her, too. Alas, I had to leave a message.