AUSTIN, TEXAS -- I had a mistake not to call to the insurance (BlueCross BlueShield Health & BlueCross BlueShield Dental) to find ahead if my dental office in or out of network. I went to my dental office for years. This time I went there just for the basic teeth cleaning ($297.00 total with X-rays). The dental office has submitted the claim to BlueCross BlueShield Dental Federal Employee program. The dental insurance has declined the claim. That dental insurance is a secondary insurance compare to BlueCross BlueShield Health Insurance.
First the claim should be submitted to BlueCross BlueShield Health insurance because an underwriter sits there. If Health insurance would approve the claim it would send the claim to dental (BlueCross BlueShield Dental ) for coverage. Because my dental office is out of network the health insurance has denied the claim. The dental insurance has denied the claim too. And this is for a basic teeth cleaning once a year, NO other dental procedures during a year. And I pay for dental and health insurance every 2 weeks.
I will change the dental insurance and possibly the health insurance as soon as it will be possible. Draw YOUR conclusions from my story. DO NOT CHOOSE BlueCross BlueShield Dental Federal Employee Program unless you like to donate your money to them.
RHODE ISLAND -- I had a cracked tooth and it was hurting so went to the dentist to see if it could be fixed. Since the tooth was cracked they said I need a crown which makes sense to me. However Blue Cross blue shield which did not even see my tooth, says no based solely on the X-ray which did not clearly show the crack. I guess I have to have to be in pain and let the tooth break halfway off first before they will cover. I will be cancelling my dental insurance and take out the discount program offered at every dental office as it pays better than dental insurance these days. Save your money and do not take out Blue Cross Blue Shield Dental Insurance.
QUINCY, MASSACHUSETTS -- So BCBS Dental acts like they care about prenatal care by offering 3 cleanings a year to pregnant woman. What they don't tell you is that 8 months after the cleaning, you will still be calling BCBS (weekly) to send payment. After customer service told me 3 different providers had to fill out the documents saying I was pregnant, they still denied the claim.
Long story short (and it is long given the many MANY calls required to Blue Cross Blue Shield), I actually only was able to get 2 cleaning that year. Not only was I denied service that I was entitled to, but they still are not paying my dentist for the cleaning!!! This has been the most stressful experience I have had with an insurance company. I highly recommend staying away from this company and will advise my staff to do the same!
I carry Blue Shield PPO. Moved to a new city (Blue Shield raised my rate based on my new zip code). Was recommended to a new dentist by a friend, so I decide to check to make sure I was covered before seeing said dentist. Called Blue Shield to see if I could see the dentist under my plan. Was told yes. Called dentist to see if they accepted Blue Shield. Was told yes. Both were lying. My bill for cleaning, x-rays, and two replacement fillings is now $1,410, of which Blue Shield paid a little over a hundred. DO NOT PURCHASE BLUE SHIELD INSURANCE.
COLUMBIA, SOUTH CAROLINA -- I went to the dentist for preventative care (x-rays, cleaning, exam) and in the Blue Cross handbook, it stated it paid 100% for those services. I called to ask Blue Cross and they confirmed this to be true, and I also asked if I had to go to a network provider, and the agent said there weren't any network dentists, and I could go anywhere. So I had a booklet stating 100% would be covered and a verbal agreement that 100% would be covered. About a week after I went to the dentist, I received a bill from the dentist and it stated that the insurance had only paid 37% of my claim.
This is what Blue Cross paid: $21 on a $73 exam, $31 on a $75 cleaning, $40 on a $93 full mouth x-ray, and $12 on a $38 bite-wing x-ray. Leaving me to pay $175 on a $279 bill, which I thought would be 100% covered. I am angry because I checked the booklet and with the agent, and thought I was safely covered. In today's economy, people can't afford surprises, and that is why I am filing this complaint as a warning for others. I believe they should pay the rest of my bill and will complain and post on sites until they do. Do not get Blue Cross Blue Shield dental insurance!
MASSACHUSETTS -- My 4 yr old son had to have oral surgery. It was to be done at a hospital, due to the extent of care needed and his age (he had to be "put under"). After receiving a pre-authorization letter from Blue Cross/Blue Shield that listed the providers name and date of services, they denied the claim. $7306.07 for the anesthesia and hospital facilities. That, in combination with the $3400 bill from the dentist, is outrageous. We would have never agreed to this treatment if it was covered by both the dental insurance and health insurance. Now, we're stuck with this bill and it is an extreme hardship for my family.