Horizon Blue Cross Blue Shield

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Condoning overcharge
Posted by on
NEWARK, NEW JERSEY -- I had health insurance with Horizon Blue Cross Blue Shield of New Jersey (Horizon).

In network outpatient lab work was provided by Laboratory Corporation of America Holdings (Labcorp).

Due to the limitations of the policy, there was a limit of $500.00 per year for this benefit.

During October 2010, I visited my primary doctor, blood was drawn and sent to Labcorp. Horizon was billed for four (4) tests - two (2) were paid in full, one was paid partially and the last was not paid. The Explanation of Benefits sent to me did not show the remaining balance for out patient testing.

For the partially paid test, Horizon was billed at $104.00, allowed amount $20.21, paid $1.85. The last test was billed at $66.00, allowed amount $11.68, not paid.

When this first started, I offered to pay the unpaid contract amounts of $30.04 - not accepted.

I see no reason why I should pay more than five times the contract amount for a test. Also, I have not worked since January 2008 and can't afford to pay $66.00.

If you have Horizon for health insurance or any other health insurance that uses Labcorp as the exclusive out patient testing service, then you should look for new insurance or if employer provided ask for new insurance.

If enough of us stop using Labcorp and the insurance companies that cater to this company we could put them out of business.

Provide feedback to government agencies;

Federal Trade Commission http://www.ftc.gov/index. shtml
call 877-382-4357 or visit https://www.ftccomplaintassistant.gov/FTC_Wizard.aspx?Lang=en to file a complaint online.

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For NJ start at http://www.state. nj. us/
In New Jersey contact NJDOBI at
https://www16.state. nj. us/DOBI_UIC/servlet/Servlet. idxServlet?div=%27INS%27 (insurance form)

For Consumer Affairs download the form at http://www.nj.gov/oag/ca/ocp/ocpform.htm and mail.

For other states find the state web site or check the phone book for government listings.

If you have already posted here, contact the agencies listed above.
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User Replies:
Anonymous on 12/08/2011:
The unpaid contract amounts are a write off. Nobody pays that. It's written off because that the lab is in network with your insurance. Most places will work out a payment plan with you. Have you asked Labcorp about a payment plan?
just me on 04/04/2013:
If lab corp is a member of the BBB do not file a complaint with them . Business pay a fee to become members of the BBB and the BBB will not jeopardize their income to help anyone.
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Blue Cross of FL are Crooks and deny responding to Corpore & US Dept of Labor
Posted by on
I was in there plan through my company as a supplement in 2009 and it was a PPO but they put me in an HMO and when I figured this out in June 2009 they told me I was going to out of net work hospitals and doctors. I verified before I even signed but but they made the error and have lied to me, passed me to another claims processor who wasn't a Supervisor, they won't send me corrected EOB's for 2009, the Area Manager won't return calls. I have the US Dept of Labor involved and they don't reply to their calls either. As far as I'm concerned they need to be investigated by the Federal Government for non compliance of paying claims. I was told by someone that worked for them at one time that at the end of the day if they haven't finished the claims, they shred them so they deny to the patient/client that they never received they. We have caught them with a done right light but they are crooks, plain and simple and I paid out $13,000 in 2009, a little over $5,000 was in network and not doctors and as of 7/26/10 they still tell me that I haven't reached the out of pocket maximum because they were miss processing claims and only applying a certain percentage to my out of pocket which is illegal. What ever don't sign up with these people they are crooks and you will resent it
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User Replies:
goduke on 08/25/2010:
The whole "shredding claims" things is just bogus, as virtually all claims for the past several years are filed electronically.

That being said, the Dept. of Labor can only help if this is an issue between you and your employer.

First, you should involve whomever at your company is responsible for handling the benefits. If you signed up for a PPO and somehow got put in an HMO, they should have a record of it and be able to get it straightened out.

Second, you can contact the agency in your state that regulates insurance companies (in many places it's called the dept. of insurance). They would be the folks who can pressure BCBS to do the correct thing.
Anonymous on 08/25/2010:
Good info Goduke. It seems that many people are getting screwed around by their health insurance companies--more than ever. It really makes me wonder how many people never question the payment or denial of their claims because they don't have time or don't understand (like the elderly). I'll bet the insurance companies save a load of money when they are constantly making "mistakes". I wonder how many of these "mistakes" just slip by? People are getting beat down by these companies.
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