I have Health Insurance through work. I have paid all the premiums. My kids went to regular health/well-being visits with vaccinations. We even called ahead of time to make sure we were OK visiting these doctors, and got verbal oks from BCBS. One month later, all claims were denied. The explanation was preexisting coverage through Blue Cross Blue Shield of Western NY - a policy that ended a year before. I spoke with BCBS (20 attempts at calling, avg wait 15 min, and 50% of the calls resulted in being disconnected). They looked into it, apologized and told me it would be corrected. One month later, another collection notice.
I called again to BCBS (more problems reaching a rep), they said they had no record of any phone conversation. They asked me to fax in documentation of termination of coverage. I did. This time I requested written documentation the problem would be fixed. THEY REFUSED TO SEND ANY WRITTEN CONFIRMATION that they corrected the error, would not give an explanation. They assured me it would be corrected.
One month later, more Collection Notices. Faxed in documentation again to BCBS, they claimed to have no previous records of conversations. Followed up again one week later to check. The person handling my claim is “out of the office this week.” Another representative claims that there is no record of any conversations and asked us to fax in the documents again. This cannot be incompetence. The only plausible explanation is that this is a CRIMINAL practice of repeatedly refusing to pay.
BCBS OF GA, GEORGIA -- I filed for health insurance in mid September, around the 11 or 12th. Never heard anything back. On October the 1st, I received a letter congratulating me that "I had been accepted", BCBS. The letter stated that my application was accepted on 22 September 2010. The letter was dated the 23rd of September and mailed. I received it on 1 Oct 2010. The letter stated I owed 254.00, so I called and made my payment.
A few days later, I got another letter stating, I owe $254.00. I called and gave them my confirmation number. 2 weeks later, I got another letter stating I owed $254.00 due on the 22 Oct 2010. This letter was received on 14 October 2010. So I called again, the first lady I talked to didn't have a clue and told me it was a prorated amount for the month of October... Now, my total amount was only $254.00 a month. My policy is for $254.00 a month. She couldn't help me. The second lady I talk to told me it was for September the 22 to October the 1st. She told me it was prorated for those days.
Now, I wasn't notified until October the 1st that I even had insurance with BCBS, but they were wanting me to pay for those days anyway. I didn't receive my card until October 6, 2010. Am I the only one that sees the problem here. I not going to pay you for something I had zero knowledge of having. All they could say is "We sent the letter." This is the very reason why the federal government is taking over the insurance industry. And if you think it's bad now, wait till they get it.
If I'm having these kind of problems in the first 2 weeks, just imagine trying to file a claim. So I cancelled BCBS. I asked the 2nd lady, "Why didn't they just email me or call me to notify me about the start date?" She said, "It was against policy, for them to call a customer." Guess what? She called me a few hours later asking me about my policy. What a joke!
METAIRIE, LOUISIANA -- I dealt with an inept agent from the local Blue Cross Blue Shield office in Metairie, LA. If you can avoid doing business with this agent, I strongly advise it. His business practice is unprofessional and inefficient. In the four weeks I tried to use him as an agent, he never returned a phone call once, sent an important form to an incorrect email address for me, failed to shorten a waiting period by making a phone call himself, and had an assistant phone me once for something he could have done himself.
He concluded the service to me by sending a particularly nasty email to me telling me I had been rejected... after I waited four weeks to buy insurance (expensive plans at that). For our first meeting about my plan options, he did not tell me any information I couldn't just read in the pamphlets he handed me. He sold us one of the most expensive insurance plans he offered but really did not go over the benefits or the problems with it.
He did not bother to go over my other options or to even tell me what might happen if I am denied. The drive to Metairie was a huge waste of time. BUT, it gets worse. He then never answered any of our calls in the following week and then when we finally emailed him, he said email was better for him. He emailed a very important form to my boyfriend's email instead of to mine and then never called to follow up to make sure we received it. I was waiting for it to arrive by US Mail, like he said it would.
When I finally did not receive it after a week, I left a near frantic voice mail for him. In response, I got an email saying it was attached to a former email sent to my boyfriend. (We were buying the plan together). I then asked that he please call me if something important is sent this way again.
BUT, then it gets worse. When my doctor failed to fax a complete form for the application, he emailed me and asked me to call her and have her resend the form. He could have saved time and possibly kept our business if he just would have called her himself and skipped about six extra days and extra phone calls. He was completely ineffectual and the whole business left a bad taste in my mouth for this company. We are taking our business elsewhere.
On April 20th, a letter was written to me to advise me that my Medical Coverage with Blue Cross Blue Shield under Cobra was cancelled as of March 1, 2010. As you can see, this is 6 weeks later! In the last six weeks, I have had several expensive tests at the hospital and have seen two specialist for a medical condition. All of the tests were pre-approved by Blue Cross during the past 6 weeks.
I was not aware that my coverage was cancelled, even though they accepted my payments and cashed my checks, and now I will be responsible for thousands of dollars in medical bills. This is an atrocity! Something must be done about Blue Cross Blue Shield and they need to be held accountable for their lack of service to their customers. I lost my job a year ago, and having insurance has been critical to my survival. What now?
PROVIDENCE, RHODE ISLAND -- I highly recommend that you look elsewhere when considering BCBS of RI as your healthcare PROVIDER. After the birth of our third child, my husband took the day off of work so that we could take a special trip up to Blue Cross in person to add our daughter to our insurance plan. We did this, so as not to have any "mishaps" in light of all the health insurance nightmares attacking Americans in every state.
We purposely asked, more than once, if all of the paperwork needed was there, since we did have a home birth and did not have the blessing from administrative staff at a hospital. We clearly did not have a competent or experienced agent, but she assured us that our file was complete and that we took all of the necessary steps to insure our infant daughter under our EXISTING plan. I continued to receive bills and paid my premium on time.
A month passed and I brought our daughter for her next checkup and lo and behold, our daughter was not in the system. When I called about it, they did not even have record that she was born. At that point, the application period had ended to add new family members, and now we would have to go through underwriting to have our daughter added. Also, in the meantime, we would have to pay the highest premium for that month plus a month in advance to the tune of $3226.67, paid in full immediately, or we would lose coverage for a family of FIVE. We are self employed of a new business and at that point did not have access to that kind of money.
Talking to BCBS representatives was like communicating with people speaking a different language, they all looked at the same file and they all said something different. I spent days on the phone trying to sort this mess out. They sent a letter claiming they just needed paperwork, but clearly when speaking to an agent looking at our file, they had never even heard of our third child.
They simply used our lack of paperwork from our pediatrician, as a cover. Since we were getting a discount under the Plan for Individuals and Families program, they apparently did not need our business and dropped us as members. It was the most shocking case of incompetence and negligence that I have experienced with a business.
I have proceeded to warn people about this business and tell them to look elsewhere. But I am afraid it is just the health insurance industry as a whole. It is robbing the American people blind. They have used the safety and vulnerability of our loved ones against us. They have us by our throats and by our checkbooks. We, as a people, need to speak out!
MINNESOTA -- So I have had health insurance with Blue Cross for about 10 years and have had no major health problems. Last year, I found out I needed minor surgery. It cost BCBS about $10,000. I figured I finally got about 3 years of premiums back - so to speak. I take it they didn't like that because just after my surgery when my premiums were due, they didn't send me a bill. I called when I realized it was 2 weeks late and they said that "somehow" their computers had "lost" my city and state, so when they mailed my premium bill, the post office sent it back to them. Yeah right.
The customer service person asked me my city and state, typed them in, and said "hmmmm that's weird, the computer says that address is fine". Duh, you have been sending me bills to that address for 2-1/2 years with no problem. Somehow after I had surgery, they "lost" part of my address. How convenient for them it would have been if I had been one month late to pay.
They would have cancelled my insurance and not allowed me to reapply for 2-3 years. They blamed it on the post office, yet no one at BCBS tried to contact me to tell me my bill had been returned. I would like to know how you get the job of the person at BCBS who goes through the computer erasing parts of the addresses of people who have too many claims. Betcha he/she gets paid a lot of money.
LOUISVILLE, KENTUCKY -- We have paid for TWENTY FIVE YEARS for Blue cross Blue Shield (Anthem) insurance plan through my husbands work. Our adopted son was diagnosed with very early onset schizophrenia paranoid type with homicidal intentions (he repeatedly has tried to kill us and 7 other adopted sibs). He was admitted to residential facility and evaluated by the state of Missouri mental health that found him to be SO DANGEROUS that they state he is legally NOT ALLOWED to return home, yet Blue Cross says after ONE VISIT with a psychiatrist, in which son denied visual/auditory symptoms (he always does so that he can get out and try AGAIN to kill us), that son "no longer meets medical need".
BCBS refuses to accept statements son made to his roommate that he "is going to get out to kill his mom" as evidence son is still medically/psychiatrically unstable! This insurance is defrauding the public, they will directly cause the deaths of NINE people so they can keep your money. Think of the mental anguish a schizophrenic endures and that they will deny care that is covered in their policy!
NORTH CAROLINA -- After my husband was laid off his job in late June, we were told we would go into state continuation insurance instead of cobra. My husband dropped his plan, but as his spouse, I was allowed to keep the policy. They kept raising my price on my policy until I could not pay it, I was told by BCBS that I could go on a federal plan that started on September 1st. I said great because I would have to pay only 35%.
Well, now they say that I do not qualify because my husband stopped his policy too soon. But they don't tell me until two months later. Now, I cannot get any insurance so I am extremely upset with BCBS. For one person, I was paying 734.49 monthly. There is a lot more complaining I could do but I just hope this helps someone to use a better insurance company.
FORT WORTH, TEXAS -- Blue Cross Blue Shield of Texas accepted me for health insurance in January and attached a rider for a nonexistent condition. To appeal the rider, I had to submit my medical records. Four days before the policy was to go into effect, the rider was removed, but the policy was cancelled for another nonexistent reason. Again, I wrote an appeal, 3 pages with 13 attachments including a letter from my doctor. My appeal did not ask for acceptance of insurance. I wanted, and still want the denial of insurance, to be removed from my record. In addition, I filed a complaint with the Texas Department of insurance.
Blue Cross again responded with a denial of coverage. I DO NOT WANT COVERAGE WITH BLUE CROSS! I WANT THE UNWARRANTED DENIAL OF COVERAGE REMOVED FROM MY RECORD! It is obvious that Blue Cross never read the appeal, looked at the attachments, most specifically the letter from my doctor.
After reading the numerous complaints regarding Blue Cross, I feel that I have somewhat "dodged a bullet" as apparently they are infamous for late payments and refusal of claims. In addition, my complaint with the state insurance board yielded this, "cannot compel them to change their decision to extend your coverage". Again, I don't want their coverage!
Sad isn't when the insurance company is allowed to ruin your chances of quality health care and even override your doctor's diagnosis? What's more, the government lets them do it. I will be posting my story wherever possible and I encourage anyone else to stay away from Blue Cross.
BOCA RATON, FLORIDA -- I had recently chosen BCBS as a health care provider. I went through the long process of filling out an application with an agent over the phone by the name of ** (I think this is a fake name, everyone at BCBS is Clark). She was very sweet and professional. I sent my application on 1/21 at the address that was given to me, only to find out today, 2/14, that it was sent to the WRONG address, causing delay. The CSR that I spoke to was so uneducated, she knew nothing. Had the worse communication, did not answer any of my questions, then put me on hold, came back and said the same thing she said to me before.
When I asked to speak to **, she gave me extension. I asked if she could transfer me, she said “No,you have to call back.” I asked if I could leave a message for that extension, she said I needed to call back. I called back the 1800 number and was routed to a live operated. I was not able to input an ext. I spoke to a gentleman who transferred me directly to **. ** answered and was rude to me right off the bat. She was so aggressive in her tone, as if her and the prior CSR had known of my prior conversation. She was so rude in explaining the details.
When I asked her why it took so long, so said that I sent the application to the wrong address. "Don't forget, this is the same stupid idiot that faxed me 20 some pages of fax." I was stunned to hear her say I sent it to the wrong address, as if I magically knew the address of BCBS. Now she tells me that the application process started on 2/9/06 instead of 1/21/06 when my application was sent. Can you believe these people?
The paper trail, the long process of getting a policy. Just imagine when I become a policyholder, I'll probably never get customer service or the TRUTH!!! Because they hire people who don't know what the hell they're doing, and refuse to admit it, or at least do what they were hired to do, and research and find the answers to their customers. I'm beginning to wonder if this is what I want to battle with. Do I really want a company as incompetent as they are to handle my health needs? Yikes!