Coventry Health Care of Kansas had more than its share of unhappy customers last year.

According to the state Insurance Department’s newly released annual compilation of complaints, 122 Kansans filed formal, written complaints against the Kansas City, Mo.-based company in 2003.

No other health maintenance organization had half as many complaints.

“I hope Coventry is aware of these numbers and is trying to figure out what they’re doing that has so many people unhappy with them,” said Kansas Insurance Commissioner Sandy Praeger. “If they’re not, they should be.”

In a statement e-mailed to the Journal-World, Coventry Chief Operating Officer George Wheeler noted that while the complaints represented “a fraction of 1 percent of our total membership,” they are, nevertheless, “taken seriously” and “quickly addressed.”

Praeger said that while the number of the complaints filed against Coventry was significant, they did not warrant intervention by her office.

“Their complaint ratio is 0.69,” she said. “We usually don’t get involved until they’re over 1.0.”

The ratio is based on a formula that compares the number of complaints with the size of the company.

Last year, Coventry collected $182.9 million in premiums, making it the second-largest HMO behind Preferred Plus of Kansas, which had $222.3 million in premiums.

Complaint study offers insurance insight Coventry tops complaint list for HMOs Kansas Insurance Department

Twelve complaints were filed against Preferred Plus of Kansas in 2003.

Other large HMOs listed in the compilation:

• Premier Blue, $91.1 million in premiums, 12 complaints.
• United HealthCare of the Midwest, $73.9 million, 37 complaints.
• Blue Care, $51 million, 3 complaints.

The compilation does not list the nature of complaints, but notes they may involve coverage, claims handling or delays in payments.

All complaints included in the compilation were filed in writing and investigated by the Insurance Department. In same cases, the department ruled in favor of the policy holder; in others, the insurance companies were exonerated.

In Lawrence, Coventry insures 1,475 people employed by USD 497. It is Lawrence Memorial Hospital’s third-largest source of income, behind Blue Cross Blue Shield and Medicare.

LMH officials in May convened negotiations with Coventry to resolve disagreements about billing procedures and the firm’s refusal to pay for treatments other insurers cover.

“We’ve made some progress with them,” said Gene Meyer, LMH chief executive. “But it’s an ongoing process. That’s about all I can say.”

Coventry began insuring employees of The World Company, which owns the Journal-World, on April 1.

Coventry’s topping the 2003 complaint list came as no surprise to Kelly Barker, a teacher at Southwest Junior High School for the past eight years.

Last Aug. 14, Barker’s daughter Zora was born six weeks premature.

“It turned out the (LMH) emergency room didn’t have our current address on file, so all the doctors’ bills were sent to our old address,” Barker said.

“By the time we got it all straightened out, 60 days had passed,” he said. “But Coventry said they didn’t have to deal with bills after 60 days — it’s one of the ways they keep their costs down.”

Within a few months, Barker said he and his wife, Danielle, who’s also a teacher, started getting calls from collection agencies.

Barker spent the next several months exchanging letters, telephone calls and e-mails with Coventry officials.

“They paid the last bill in May, I think, a good eight months after Zora was born,” Barker said.

Barker said he and Danielle had resolved their differences with Coventry.

Several teachers said the Barkers’ experience was not unique. But in recent months, they said, relations with Coventry had improved.

“We’ve set it up so there’s a person we can call when people are having problems,” said Valerie Powell-Johnson, chairwoman of the Lawrence Education Assn.’s committee on fringe benefits. “That has increased satisfaction, and problems, when they come up, are being resolved faster.”

Powell-Johnson said it was unlikely that past frustration with Coventry would lead to switching to another company.

“They had a zero percent increase in premiums this year,” she said.