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Blue Cross of California Online Insurance Reviews

Company Name: Blue Cross of California
Website: www.blueshieldca.com
1.2 
Overall average rating of 1.2 out of 5, and the percentage of positive recommendations 2 %
Hi, I am having horrible experience with Anthem Blue Cross, especially while paying bills. I have to call in Anthem Blue Cross every single time to pay the bill. There is no easy way to enable auto pay on Anthem Blue Cross account. I have to literally spend 3-4 hours every single time to pay my account bill. In spite of making the payment, the account will still be in cancelled state and will not allow me to do payment via my account. God knows what that means. I think I will move away from this Anthem Blue Cross very soon. I am having pathetically tiring experience with Anthem Blue Cross every single month. This is very painful.
I signed up for paperless billing and made my first payment. Anthem never sent me a bill in mail or email. It is of course very easy to verify this with a quick mail search. I DID get emails about confirmation of my first payment and other wellness living emails. However no bill and they then terminated me. It is rather amazing to me. I'm still trying to get reinstated and then plan to hit small claims court.
I've tried calling multiple times to cancel my policy, but they keep hanging up on me. I've also contacted them through their website and received no response after a week. They auto deduct from my bank account. It's like they won't let me cancel my policy so they can keep stealing money from me. Worst company to deal with. Blue Cross is not much better though. I feel like a victim when working with health insurance companies, especially Blue Shield.
I called Blue Shields number and I provided my name, DOB and address to the screener and then she transferred me to an agent. The woman at first was polite when explaining the first option with limit doctors' visits. But when I started to ask about different plans including unlimited doctors' visits, she changed the tone of her voice and says, "health insurance is like car insurance, it's for emergencies only," and other very condescending statements she used. I told the way I felt and hang up the phone. I tried to call a 2nd time. I thought to myself I really want health insurance. I called talk to another screener and let her know what happened (big mistake!). She put me on hold with the music on for a while and then started to ring. Then I thought, now somebody will help me (big mistake again!). I went into this guy Mark's voice mail to leave a message. I called then a 3rd time. The screener apologized and after I explained what had happened to me on the 2nd time nobody helping me, she says, "We are experiencing a high volume of calls." All my calls were within 15 minutes time, another one! The number I called was 1 (866) 532-7610, in case you want to get aggravated as I did!
Despite paying over $1,200 a month (which doesn't include what my employer pays) It is still impossible to get them to pay for things. My flu shot this year had to come out of my wallet. Seriously you can't pay $31 for a flu shot at CVS. My wife has a heart condition and when she went for a CCTA to help to diagnose her condition BC decided the test was unnecessary and we are expected to pay a hospital bill of over $5,000.We have an option to appeal the bill, but they don't actually give you any information on how to contact the people that are making the decisions. It appears that they have a separate company (Anthem UM) that has to justify its existence by rejecting bills and foisting them back on their customer base. I followed their process to notify them that I was appealing the billing, and they sent me a letter notifying me that my appeal was rejected before I could even see my doctor to get information on why my wife was sent for this test. I can't wait to get rid of them. One star only because I can't go zero.
We had what we thought might be a medical emergency with our son and we have been paying for insurance for two months now and when we needed to go to the E.R. we had to call the insurance company, because we had not received any type of Med Cards and they told us we weren't in their system. Yet they had taken over $1200 in the last two months out of our payroll. They simply told us we would have to pay out of pocket. I feel we definitely need to be reimbursed for those two months.
Affordable family plan health insurance that is easy to obtain with FAQ answered online. The prices are quoted on a general basis so that you are aware prices may be slightly different according to your needs.
I needed health insurance and selected Blue Shield (through Covered CA) with a policy effective date of Nov 1. I made the "binding payment" as soon as I received the bill (online at a site specifically for binding payments). To date (Dec 16) I have not received my member ID cards or a welcome packet. Late November I received another bill for December's premium a week prior to the due date. I attempted to login to their website to make the payment but in order to do so I needed my Member ID -- which I still did not have. I called and spent at least an hour on the phone. Finally got a member ID but it did not work. They said it was a "known issue" with their website and to try again in a few days. Several days / attempts later I finally was able to register online. However unable to make a payment as their online "payment center" did not work. I was told this is another "known issue" and I was forced to make the payment by phone. I asked that they send an email confirmation -- the email came with nothing but my name - no indication of payment. Unbelievable that they are unable to get their website working. Terrible/inept customer service. I'm switching insurance companies. Big waste of my money!
For 4 days I have been trying to get in contact with someone to change my daughter's medical plan to another state because I am moving. And for those 4 days I have been transferred and rerouted to 27 different people from everywhere who has done absolutely nothing. Their customers service is appalling and all of this is for my 19th month old daughter. I wouldn't recommend this company to a DEAD person. All they care about is your payment and not the well being of the patients.
I have been paying premiums for my daughter for 5 plus years and never filed a claim or complaint, NOTHING. She moved from California to Arizona and one day she had to go to the emergency room for a fever. She found out that she had needed medication and paid out of pocket. Her bill from the hospital was $4000 dollars, and these ** did not cover one penny. We found out that she was not covered in Arizona and we were never told by anyone from the insurance company that this would be the case even though I did tell the BROKER that she went to stay in Arizona with her mom for a while, apparently he was not listening. I won't get any of my premium back for the 2 years that she has been there which equates to $135 per month times 24 month. The money was automatically deducted from my checking so I never had to worry about anything. Because I do business this way, I have never received a bill, a letter or any type of correspondence from them or the broker, I never worried about my daughter. I have been paying this premium for 2 years and now I find out my daughter was never covered. I am warning anyone who deals with insurance brokers or Anthem Blue Cross, make sure you understand everything and ask as many questions as needed. Blue Cross to me has always been a shady company because of the way they manipulated pricing for years. My personal belief, which I never had before this is that Obamacare would be better than nothing, at least the insurance companies could not screw you like this. I have never hated anything or anyone to this date in my life like I hate Anthem Blue Cross. For the rest of my life, I am going to do everything I can to keep as many people as I can from anthem as well as I am going to put it out to any congressman who will listen to my issue. Truly a pathetic company that deserves to be out of business.
Very difficult for claims that are not routine. Correcting a typo they make is almost impossible as well. Rates for 2018 increased to the point of unaffordability.
In summary this insurance is the biggest rip off ever. They've taken advantage of the new medical system in this country and have used it to increase their profit even more than before. They change the list of their allowable drugs that are not generic all the time. They'd find a way to only pay for cheap generic drugs.Customer service rating: Frequently, the representatives hang up on you. If you'd be successful to talk to someone after a LLLOOONNNGGG wait, then set aside an hour and hope that your question would be answered. The representatives are useless. They constantly put you on 3-minute holds to get back and put you on more holds...until you get fed up and hang up!Online: Only provides general answers to your questions. Otherwise it's useless. Next year I'm getting out of this insurance, but I just wanted to warn the public to never consider this insurance!
A few weeks after Medicare Open Enrollment ended, we received notice that our doctor of 25 years was no longer contracted. Too late to change insurance to a plan that they are in! Husband in the middle of treatment! Almost daily calls for 3 months now, trying to sort it out. We can't get out of Blue Shield to get into a new plan. HOURS and HOURS on hold, each call I'm transferred 3-4 times.
Anthem Blue Cross has repeatedly denied claims for doctors, then deny all claims from that date. Then they say they need more information however the only paperwork I receive is a denial notice and that it is too late to get the doctors paid. So Anthem is using more information requests to commit fraud by never actually notifying me until they claim it's too late to refile the claim. I am out thousands of dollars while they have made billions ripping off customers. They need to be barred from doing business.
This is worst customer service and company in the history of mankind. They are staffed by intelligence-impaired employees who lie, deceive, and are otherwise incapable of the basic functionality given to rocks. The website never works, but yet they're Johnny-on-the-spot to always do follow up calls to find out why you're so angry with them. They also farm out your number to third parties to do surveys against your wishes. You are truly doomed using this POS company.
In 2012 I had an operation to fix a uterine prolapse. Only out of network doctors would do this procedure. I shopped around and found the most reasonable fee for the procedure. My plan allowed 80% of "usual and customary fee" for out of network providers. They paid me 80%, however it was 80% of a fee they had calculated which was (as I found out from researching it) less than what Medicare would have paid for the same procedure in the same geographical location. They seemed to do their best to make sure they paid me as little as possible, after 10 years with no major claims.
I don't know how many times I have called this company, and my enrollment issues are STILL unresolved! They have enrolled me with the wrong Drs., clinics and coverage, and when I requested that they send me another card with the corrected information, they sent me a card with an arbitrarily assigned doctor and clinic instead of the one I chose and had already seen! I really like my Dr., and I DON'T want another one.I've worked in customer service in the past; companies rate their employees by how many calls they take each hour. If they can't get call queue down within a reasonable number, their performance ratings goes down and they can be fired. So there's no real incentive for providing quality service for the customers. There's only enough time to give people affirmative responses, promise to take care of the issue, get them OFF the line within 2 -3 minutes (sometimes more), and move to the next call. How much quality service can a representative give within that short time span, especially if there are complicated issues that involve inputting information on multiple screens?Based on my own experiences doing that kind of work, it isn't easy trying balance speed with quality, especially when the employers' focus is on speed. One of my supervisors once said, "I feel it IS a service to take the customers' call quickly so they don't have to long wait times in the queue." That's true, but not at the expense of resolving that customers' issues!I suspect that's what is going on with Anthem Blue Cross customer service. I hope I'm wrong, but I doubt it. I'm a former Kaiser Permanente member, and I switched to Anthem Blue Cross because I was very dissatisfied with their fast food industry approach to medical care. However, I never had any problems with their customer service. Now, I'm dealing with the exact opposite situation: great care from my medical providers, and ROTTEN customer service from my health insurance plan!
Blue Cross sends all claims and phone calls out of country. These people do not understand medical at all. They only give responses they read from a computer and they never write the correct comments. I had a bilateral procedure and it took a year to get the outsourced company to process the claim as bilateral not unilateral. It cost me time and money. Society needs to wake up and stop outsourcing the American jobs. If my claim was processed here in the States, they would have paid the first time because they know what bilateral means. Stop paying premiums to BC because they pay little to their employees and do not forward that savings to the member who have to pay full price.
We were excited that the country was gaining access to Health Care. Sadly, there appears to be no guidelines for the Insurance Companies. With repeated failures in navigating the Anthem BC networks, their inability to get anyone to the proper department and unable to transfer calls, everyone has waited for hours in frustration. Now, I have the great news of reporting that for our $1,351 per month, literally nothing is covered. Although we chose the Silver Plan, the 2nd highest and a PPO, we find (after the fact) our regular Dr. is not in their network... Neither is the Tarzana Providence Hospital.. Neither is the West Hills Hospital. The dermatologist was also declined, no coverage... Arthritis medications have been cancelled with no explanation.The list of negatives with Anthem BC goes on and on, and now they report that they will also be raising rates. So, I ask normal people out there, should we just go without insurance since they pay for nothing and don't even cover the hospitals in our area? What if we are really sick and go to the hospital, we will not be covered because this is not in their network? I live in the San Fernando Valley, oddly where the ABC headquarters are and wonder why I am paying over $16k per year for no coverage.
In December 2014 we try to use our Blue Shield insurance for the first time for my wife and the insurance gets rejected. That day I call Customer Support. The lady checks, and confirms that there is indeed an error in their records and the insurance would have never worked. I ask her to check my son's insurance as well. She promises to do that and to call me on Monday to report that all this is done. We check she has the right phone number. Nobody calls on Monday.I decide to test my son's insurance. We go to the same medical practitioner. She says that according to Blue Shield he is not insured - either wrong member ID or wrong birth date. I decide to communicate the problem in written. I try to find Customer Support email address on their website. No such thing. I fill in the form I find with the text I have prepared, and click the button. The information departs somewhere. I do not receive a copy. I do not receive even a confirmation that they have received anything from me. Totally cloak and dagger. Probably for a reason. No reply from Blue Shield.A few days later I call and ask what is happening. Customer Support says everything is fine, always has been fine and I just needed some letter from them saying that I am insured to show it around. I thought that what the membership cards were for? I do not receive a letter. I call again to ask for it and finally it appears. My wife's name is misspelled. Those things seem to matter when you need your insurance to work. I decide to terminate and call Customer Support. We make sure the last day of my insurance is 2/28. I ask for a confirmation letter and they promise to send one. I do not receive it.The termination date approaches. It is good to know what the worst that could happen is. I read a bit on the Internet. People say that if you leave a credit card on file with them - they will keep billing it and then never return the money. Hmm, perhaps I should remove my credit card from there. I try to do that on their website. It does not work. I call Customer Service and they come through - I go on the site and my credit card is not visible anymore. I ask for termination letter again and they send it immediately by email. This is a good day.In the beginning of March I receive a letter from Billing, with - guess what? A paper bill! It seems there is a problem in the communication between Customer Support and Billing, or Billing does not like looking at the computers that say that I am not a member anymore. I call Customer Support and explain. They feel bad for me and promise to sort it out. I cross the fingers. In the beginning of April I receive another letter that because I have stopped paying my insurance is terminated on 3/31. Good news and bad news, right? At least Billing knows I am not insured anymore. Of course, I have the correct expectation that Billing will start bullying me for March payment.Before I manage to pick up the phone - I receive another letter. That is a bill for April and May, saying that now I owe them over $2K. My curiosity spikes. That means not only Customer Support does not talk to Billing, but perhaps Billing has a bug in their software which never stops billing anyone who is in their database. I call again and get confirmation that I have not been insured with them since March 1st, and they will notify Billing. I truly hope they use a different channel this time. I am trying to get a loan, and those people can really break things if they touch my credit rating by (another) mistake. The more I deal with them the more I am starting to believe they owe me money back for an insurance that never worked, and perhaps some compensation for the time I keep losing dealing with them.
Blue Cross/Blue Shield business is appalling and if it was not such a large conglomerate it surely would have gone bankrupt because of their business practice. My story... For the past 2 years my prescription cost was $0 out of pocket. Come January 2017 my out of pocket rose to $535. Called BC/BS and waited on the phone for 35 mins on two occasions. Ok, I understand everyone is busy but really 35 mins!!! Third time was a charm as I got thru within 5 mins.Went thru the menu and spoke with someone that deals with prescriptions. Told him since my conversation is being recorded I first I need to complain and it's nothing personal against him but rather for the company he works for. I said, "please let me know what kind of company is BC/BS that changes the conditions (I see it as a contract because a premium is being paid for service rendered) without notifying the customer first? I was paying nothing and now all of a sudden I'm paying over $500 a month. This is terrible customer service and because it is cost prohibitive, when I become ill (or die) for not taking my meds, I'll see BC/BS in court."Enough said and as protocol dictates I started asking him what are the alternative meds I can take. I started with the 3 that cost the most; $394, $89 and $27. He gave me some alternative meds I could take and then I stopped him to ask a few more question. "How do you know what alternative meds to recommend? There is a chart that cross references to similar medications. So, for one of my pills the only alternative medication you are recommending is 10 mg; 20 mg is not available. Since I am taking 20 mg does that mean I double up on the medication or is it formulated to meet the 20 mg strength?" He could not answer and said he could transfer me to a pharmacist. I said "OK but I have one more question for you. Are you a Dr?" No. "If you are not a doctor how can you safely recommend an alternative medication?" I am allergic to sulfur and how does he know any of these alternative medications do not contain sulfur. He said I should speak to their pharmacist and will transfer my call. As the call was being transferred it was dropped. I think they tried to call back within a minute but I was so pissed off with the answers I was getting I really did not want to speak with anyone.So, I spoke with one of my doctors and he gave me enough samples of the $394 meds until there is a fix; whatever that may be. For the $89 meds, I am still waiting to hear from my other doctor and according to BC/BS there is no alternative medication. This experience is almost as bad as the EpiPen and my heart goes out to everyone that is experiencing similar medical cost problems.
My doctor filed a claim in May 2014 for a 4000.00 procedure which I had to pay for out of pocket. Blue Cross of CA said they never received the claim (for 3ish months) even though my doctor showed proof it was faxed and mailed. I mailed the claim myself 2 months ago and they finally received it but now say that because it was filed more than once that it will be denied. Filed a grievance October 6th and was told I'd be contacted within 5 days. I called THEM today (10/21/14) and waited on hold for 30 mins to be given the number for my grievance coordinator (Wilbur **) and a phone number that is disconnected. I called and waited on hold for 30 mins a second time to get the correct number to be told he is on vacation and that a decision has been made but that I cannot know that decision until it has been sent to me in writing (some time in the next 30 days). This is the worst insurance experience I have ever EVER had. I have spent countless hours on the phone with people who give no information, transfer me to numbers that eventually hang up on me, and who are always reluctant to give their name. This cannot be ethical or legal can it???
Blue Cross is threatening to drop us as a provider based on a patient’s fraudulent accusation. They gave the patient inaccurate information and she has run amok with it. They keep asking me for corrected claims which I have submitted 27 times. Every time they call on the patient's behalf they can’t even pull up claims that I have submitted both electronically and mailed in. I worked an hour and a half with a Blue Cross representative to change this person's diagnosis to suit her, not the doctor or the provider who evaluated her. The patient herself is being permitted to choose her out diagnosis. A person in grievances named Michelle called us yesterday and told us that they were dropping us as a provider based solely on the patient's grievance which keeps changing every time something gets changed. Michelle states that she has no record of that and has no access to those records. Boom, we are non-compliant in a grievance that the patient refuses to drop. She calls Blue Cross 20 times a day. She has called our office over 50 times, sent threatening letters and routinely sits in our parking lot just watching the office. Blue Cross never even commented or reacted to our complaints of being harassed. Blue Cross is a very low end payer who puts the patient in the controlling seat as far as billing and medical records are concerned. That might be okay if the person is balanced and mentally stable. But we need protection and accountability from this insurance company when they goof and give the patient inaccurate and unauthorized information and they are allowed to run with it. I just want to say "Thank you Blue Cross for dumping a provider of 13 years based on a fraudulent and ever changing complaint."
I call Blue Shield customer service from time to time and a simple request or single question can take up to 45 minutes or longer due to language issues and a complete lack of knowledge by the agent. They need to put you on hold every time you ask a question so they can look it up in their book and try to figure out what it is you are asking about. They literally know nothing and have zero training. Blue Shield outsources these jobs to save money, but if they hired people who spoke more than just a few words of barely discernible English in a heavy accent, the phone conversation would be all of about 5 minutes. Wouldn't that also save money? They would have to pay higher wages but it would not take an hour to answer a single and very basic question. There is only one explanation. Blue Shield is paying its outsourced workers three cents an hour. Blue Shield should be ashamed of themselves. Single payer now! End for profit heath care!There is no way the government could be any worse than corporations at providing health care because health care corporations have hit rock bottom and can't possibly get any worse than they already are. Or can they? Either way, we need to try something else because this system is entirely dysfunctional and Americans are paying outrageous amount of money for some of the worst health care on the planet while executive sit on their yachts off Monaco counting their money and laughing at us.
1 1/2 yrs with Blue Shield of Calif as member.. then moved out of state so "required" to cancel policy and obtain coverage residency in another state. Fine. I followed procedures as directed. BSCA sent a letter mid April 2015 confirming cancellation and policy paid in full, no balance due. Now - May 2015 -- receive bill from BSCA for approx. $2,300, and stating policy active. HUH? Tried calling "24" customer service several times... Recording "Technical difficulties. Office now closed". Again.. HUH? Had nothing but trouble with BSCA from the beginning, now this. I'll fight tomorrow IF they answer the phone. Stay away from BSCA... bad history with them. Aarrrgghhhh! (Again). So glad I was "required" to establish coverage elsewhere. Be very very careful.
I am an employee of a doctor's office and I have called BC/BS numerous times to get coverage for a young patient's enteral formula. I make these calls frequently to all of the insurance companies and BC/BS is so dysfunctional that we can never manage to get through to anyone who knows the procedure. The other companies, especially Oxford, are a breeze. Every person you speak to at BC/BS gives a different answer, some of which make no sense (e.g., we don't have a fax machine - you have to mail a letter of request). The next person gives you a fax number. Every person wants to transfer you 3 or 4 times and they all tell you to choose option number 2 or option number 6, but when you are transferred, there are no option numbers at all. Then when you finally get to someone, they have no idea what steps are needed and it is not uncommon to be disconnected during the process. The patients are frustrated and we are frustrated, and the only one who benefits from not training their employees is BC/BS because no one can ever figure out how to get services or supplies covered.
Don't do it!!! BUY ANYTHING ELSE but coverage from this company!! We have the most expensive Platinum coverage available but it's next to worthless!!! Wife has been trying to find a in-home PT, prescribed and authorized, for two weeks. NO ONE WILL TAKE THIS INSURANCE!!! I don't write reviews, check, but this has been a nightmare of no responsibly, no availability, and no accountability, never mind just no help. Our lives are forever changed as a result of her injury. This company added insult to our misfortune at the most stressful time of our lives. Buy their horrible coverage and you too can learn this lesson.
This medical insurance company is the antithesis of "health". They have screwed up my billing so many times I have lost count and wasted at least 40 hours trying to straighten things out on the phone, only to have them bill me incorrectly again and again. It baffles my mind how these crooks are allowed to do business. My wife has hot flashes and they denied the doctors order for hormone therapy saying it was "medically not necessary". How does the insurance company get to tell the doctors what is medically necessary? I am diabetic and whenever my doctor prescribes the most effective drug they deny coverage. It like they want us to be sick. The stress of trying to follow up with the incorrect billing is bad enough, but to be constantly contradicting the doctors recommendations and denying coverage left and right after we pay over $1400 a month in premiums is just plain evil.They are more than happy to keep cashing my checks and screwing me on the back end. I will be cancelling my insurance with them ASAP. Another scam that ALL of these companies get to use is called open enrollment. Why should healthcare be locked in for an entire year? People should be able to choose who they like, so when horrible evil companies like Blue Shield of California take your money and then don't provide service, you can cancel. Let the open market decide who is best. I bet the rates would drop then too. We will be cancelling and telling as many people as possible to never use Blue Shield of California PPO. The absolute worst of the worst. I had Kaiser before... HMO... wishing I still had it. They never screwed up the billing.
Blue Cross cancelled my policy after I called to renew for 2016. I have been working with them for 3 months and they keep coming up with excuses as to why it's my problem. I have run out of critical medications and they have no interest. Health care has become a horrible American business. I hate this company.
I have an individual services term life insurance policy obtained in CA. I have spent numerous phone calls and have been reroute to almost a dozen representatives who could not provide me the basic information on my policy. Their customer service is horrible. I finally spoke to some from IL where I live who was able to give me partial information but not all. The service people in CA have been rude. Have had me on hold for long periods of time only to route me to another person who can not help me. I was also given invalid phone numbers to call that aren't even anthem related. The last person I spoke to said they would mail me the information. I hope it does arrive but I have doubts since I have been diverted instead of helped by their customer service department in over a half a dozen phone calls. It is unacceptable to be billed for a policy and then not be able to confirm even basic information about it. There is no content on their website so I must call to get information. The number I have been given over and over is 1-800-333-0912. I have called that number only to be told by the person not the other end to call that number.
BSCA's website is down all weekend and they give you a customer service number to call specifically to access benefit information. I proceed to call and answer automated questions for 20 minutes about what my call is about. When I get to the call center they tell me they can't answer any questions about benefits. BSCA wasted half an hour of my time when the website states contradictory information that customer service is open to answer these exact questions about benefits. Why even tell your customers you can answer specific questions if you know you can't? Horrible customer service.
Researched the various plans. Checked with my existing doctors and provided Blue Cross with my doctors tax ID #s and NIP #s. Important that I continue to see my doctors. All were in network. I signed up for Anthem Blue Cross Gold 80 PPO, although high monthly premium, the deductible was supposed to be 0. Over the long term it made financial sense. I've only had the policy less than 30 days. So far, one doctor's visit, one lab, two prescriptions, and one request for authorization. NOTHING has been approved! NOTHING!!Turns out that the card I received from Blue Cross reads Gold 80 PPO, but it also has "Pathways" written on the front. This is considered a network and none of my doctors contract with the Pathway network. None of this is indicated on their website and after hours upon hours with their customer service reps, none of whom understand the details of their plans, I am stuck with this plan as Open Enrollment is over. This is fraud and nothing less! If I want to see my doctors, I will need to meet a $5000 out-of-pocket deductible, and only then, maybe, they will start paying 50% after I pay a high co-pay. They clearly misrepresented their plan/product. This is unethical and I question why as a consumer we are powerless to hold them accountable.
I was assisting a colleague who was frustrated in the process and lack of response from Covered CA and Blue Cross. There were issues with uploading documents and file corruptions. Now the Blue Shield cannot find the file that was electronically transmitted. For the folks who have the same experience file a complaint with the California Department of Health Insurance. This is what they stated on their website; "Health Policy and Reform Branch - The Health Policy and Reform Branch reviews, analyzes, and develops policy positions on health insurance issues within the Department. The Branch focuses on the Patient Protection and Affordable Care Act, the recent federal health care reform known as the ACA, which was passed by Congress and signed into law by President Obama on March 23, 2010..."
Blue Shield you never cease to astound me with your incompetence. They have twice missed my bank's automated payments on two separate months--payments that went through and were processed on time---sending me letters threatening to close my policy, making me call customer service numerous times (because I never seem to get the same answer) and making me jump through hoops for proof of payment.Last time it was a fax and after the first fax went through I called customer service for the third time to make sure they received my information, only to find that I needed to provide all my information in a certain way. Today, again, I receive a letter that they did not receive payment. Again, I had to get on the phone, calling several times because the first answer I got was "Oh everybody got this letter and to disregard it because it was a mistake." I can smell BS a mile away. Again I call and was told to email proof of payment.I'm a busy person. My husband has advanced liver cancer. I don't have the time or the emotional strength to have to deal with this on a regular basis. We can't afford to lose our policy over their incompetence--a policy which is the second highest expense in our household budget--first being the mortgage.
I really don't know where to begin. There is so much I hate about this company. First when you call their customer service number the voice recognition is dysfunctional and many times I find that I have to constantly repeat myself to get it to understood. I enrolled in their dental plan as I am already enrolled in their supplemental Medicare plan. Before I did I wanted to get information about the benefits of the dental plan sent to me. On numerous occasions I called them and was told that it would be emailed or mailed to me but I either never received the info or they mailed me the wrong information. They also kept sending some mail to my home address instead of the PO box that I had designated as my mailing address. This went on for several weeks.When I finally faxed in my enrollment form they couldn't tell me if I was enrolled or not. I called many times and even talked to supervisors who could not tell me or who never called back. Not knowing if I was enrolled I had to pay out of pocket to a dentist for a tooth extraction. However, half way through the 3 month billing cycle they sent me a bill and membership card. So I was enrolled but did not get to use it because of their incompetence.On top of that they gave me the wrong dentist instead of the one I had requested. When I called to try to straighten it out I was shuffled back and forth between customer service and dental over and over again as no one seemed to know what their responsibilities were. I decided I had enough and called to cancel the policy and was told they would have to mail me a disenrollment form and then I would have to wait 7-10 days to receive it where I would have to fill it out and fax it in and hope that somebody there can verify that they received it. Where have I heard this story before? I can't wait to change providers at the end of the year.
This is the fourth time this has happened in less than 18 months. I have documented phone calls with dates and representatives. Hours spent on the phone. It HAS to be something by design to delay or prevent covering services and placing the onus on the patient to "prove" that he or she paid by jumping through various hoops and spending hours on the phone. I went so far as to cancel my sons insurance and change insurance companies all together leaving them owing me a refund of over $730.00 in payments which they admitted they received but never applied. I got a reference number and was assured I would receive the refund on Feb. 13 (a full month after I requested). It's Feb 24th, still no refund. Not even processed. I phoned tonight for a different matter. I received a cancellation notice on my policy, despite my premium being sent, and cashed each and every month via auto payment. I now had to provide proof that I paid, via fax with specific instructions. I spent over an hour on the phone talking to representatives in another country who are completely handcuffed by the organization they have the severe misfortune of working for. To be told that the onus was on ME to provide proof that I paid every month so they could submit to their IT department to reinstate my coverage is negligent to say the least. This is no mere oversight or one off error. I say again, this is the 4th time this has happened. Do you know what happens when you have a routine mammogram thinking you are covered only to find out your insurance company has not applied payments? Yes, now I have to deal with my health care provider and send them a retroactive reinstatement letter so they can re-bill, but who knows how long that will take! I was told I would just have to "wait" for them to process. And the reason for the delay in refunding for my sons account? "They've had so many requests, I just have to wait for them to process.” Just makes me wonder... with my experience and all of the other similar experiences I've read about, WHY is this happening? WHO is accountable? As a nation, a first world country, HOW is it we have become so beholden to a government placating lobbyists for a large FOR PROFIT organization. Aren't there any attorneys willing to delve into the real lives being impacted, the wrong doings and illegal practices and "incompetence by design" that these insurance companies are perpetuating? This is WRONG! If ever there were a cause worth fighting, you have my full support.
Anthem is suppose to be my primary insurance and told me they were secondary. They don't do what they say they are going to do. My doctor hasn't been paid for claims as far back as February and here it is December. Really, Anthem. Wait time is ridiculous, they say they will make you priority and don't. They say they'll call you back and don't. Trying to get to a supervisor or manager is a joke!
I pay $155 per month for my insurance, which basically doesn't do squat except pay for most of my medications. Today, they let me know they were raising my rate by $40/month. Why? I'd love to be given an actual valid reason because I've yet to hear one. What did I do? The coverage is bad enough as it is! Why did you raise my rate by $40/month?! Is it because I passed a kidney stone two months ago, which you guys didn't cover anyways?
We have a high deductible of $7000 for both of us. We met that deductible in June plus the co-pay max. of $2000. So the $9000 per year out of pocket has been met. I was diagnosed with cervical cancer and had to undergo a hysterectomy plus radiation and chemo. The hysterectomy procedure was preapproved and so were the radiation treatments. When they submitted the bills, Blue Shield of CA kicked them and did not pay almost $40,000. They will screw these health care providers any way they can. My advice is go somewhere else for insurance.
I recently got hired at a new employer and enrolled in Blue Shield of California. While attempting to log-in to the Blue Shield website I realized I was accessing old insurance information. I have been covered by Blue Shield of California many years ago by a previous employer. I called technical support to request them to update the information and so began six months of repeated phone calls and endless frustration. At first Blue Shield told me to contact my HR department to resend the information. I gladly accommodated that request though that was unnecessary. I then called back and told them that was not the problem. Blue Shield then said they needed to delete my profile to start fresh. "No problem," I said. Even after deleting the profile the online system still thought I had a profile in the system. Basically I am stuck in log-in credential hell. "Register as a new user," they tell me, but then it says I am already in the system. Log-in as existing, I try, and the system doesn't recognize me. I call them every month to see if the problem has been fixed and all I am told is this is a known problem. Oh great. Known problem. Why is it taking over six months to simply fix my log-in information. I depend on on-line access to my health plan information. What a joke. It is so frustrating I am close to switching health plans next enrollment period (unfortunately that is 12 months away). Anyway.....What kind of major insurance company can't fix this in a timely manner. Totally unacceptable.
I am a neuropsychologist in Northern California, who has been burned every single time I've seen a patient with Blue Shield insurance. I was a hospital-based consultant and had to stay on the panel to be compliant with my job. Now that that job is over, I am off that panel and couldn't be happier. Blue Shield routinely gives authorization for services that are (or should be) covered under a patient's plan. The clinician (such as myself) provides the services in good faith and then once the claim has been submitted, eventually receives a letter from BS denying payment for one reason or another! Over and over and over again. They also violate their own contract with clinicians by sending partial payments (20% of the claim or less) directly to the patient. I have never once had a patient pay me after BS has sent them the check.I have taken patients to small claims court and sent them to collections. I no longer accept Blue Shield and am no longer on their panel. I tell everyone about my experiences with BS because you need to know that there are many good clinicians who will no longer provide services to you because of the practices of this company. Thinking about paying money for BS insurance? Think again.
Had Blue Cross through my employer. Since I am retired living on social security have to be real careful about insurance cost. I paid for healthcare for 40 year. Rarely use it.
I am usually very patient when companies flub here and there, and errors/lack of communication are to be expected now and again when dealing with large companies. But I have to say that (BS) Blue Shield of California has serious issues and dis-function with their operations. I had the Blue Shield Bronze Plan in 2015, and I went through the usual eligibility process through (CC) Covered California, and all was good. However I had a life changing event at the end of 2015, and had to reapply through (CC) for the 2016 year.Due to the life changing event and having less income, I qualified for premium assistance with (CC), so I was actually able to afford an upgrade to (BS) Silver Plan, which should be a simple change in plan coverage right??? (Wrong!) I will put in everything in chronological order regarding the chain of events: 11/12/15 - Received confirmation letter from (BS)/(CC) confirming my eligibility for premium assistance and coverage under the Silver Plan for 2016. 1/20/16 - Called (BS), because I was locked out of the member portal since January 1, and wanted to make my premium payment for January. (BS) accepted my premium payment, and had to conference in (CC) on the call because (BS) claimed they never received my eligibility information from (CC). Paid my premium for January on the phone with (BS). 1/26/16 - (CC) verified that they sent (BS) my eligibility information, and (BS) confirmed my eligibility.2/2/16 - Went to pharmacy to get prescription with new membership id card from (BS) with new Silver Plan Policy # ending in **. Pharmacy said (BS) activated and cancelled this policy# on the same day (January 1), so I had no coverage. Called (BS) and they claimed that there was an internal glitch on their end, and they don't know why policy was cancelled, they advised that they needed to escalate to their Issue Resolution Team (IRT), and someone would call me back within 5-7 business days to resolve. 2/17/16 - (IRT) called me back and said that the problem was that they issued me a new Silver Plan Policy number ending in **, and this was the correct policy #, that I needed to use, and I should discard my original Silver Plan membership card ending in **. So I did. Problem was resolved.2/18/16 - Member portal still showing old Bronze Plan information and unable to make premium payment on new Silver Plan in portal, called (BS), and made both February and March premium payment over the phone with (BS). 3/13/16 - Went to pharmacy using my new Silver Plan Policy # ending in ** as instructed, and the pharmacy said, "Sorry, (BS) activated and cancelled this policy on the same day (January 1) too."3/14/16 - Called (BS) and they said that they never received my eligibility from (CC), therefore they cancelled my policy. (CC) was on this call with (BS) and myself, and they verified that my eligibility was sent to them on 1/26/16, and (BS) operator acknowledged the receipt of eligibility. Per (BS) operator, the original case that was sent to their (IRT) was closed out as resolved. Therefore, (BS) would have to open another case # in order to resolve. Was promised a call back from their IRT within 3-5 days. Never received a callback. 3/18/16 - Since I received no callback, I called (BS) and was promised a call back from IRT by the end of the day. Received no callback.3/21/16 - Called (BS), operator placed me on hold so they could escalate issue to their supervisor per my request. I got disconnected when they did this and had to call back. Called back, and gave them all the reference numbers and case numbers, history of the issue etc... Placed on hold again. They advised that IRT should call me back by the end of the next day, and if they didn't then I should send their (IRT) an e-mail, and the case number. Which I did. 3/23/16 - No callback or e-mail response received. Called (BS) back and requested to be connected with a Supervisor or Manager. Operator forwarded me to team leader. Team leader placed me on hold and called IRT. Team Leader said that IRT promised to call me back by the end of the day. Of course, never received a callback. 3/28/16 - Received an e-mail from (IRT), stating that my account was reinstated.4/1/16 - Received another set of membership cards in the mail. However, these membership cards have the original Silver Plan Policy number ending in **, the very same policy number they originally told me not to use at the beginning of this fiasco back in February. Therefore, since I am unsure what my policy number is, I called (BS), explained the situation, and now they show that both Silver Plan Policies #'s are now showing as active, but I do not know which one I am suppose to use. Therefore, (BS) has now had to open another case number (this will be the third one) and now have their Eligibility Team review this new case and verify which is the correct policy number I should be using. I am suppose to call (BS) back in 7-10 business days to follow up.I cannot believe the incompetence. It is not a difficult one, as I simply upgraded my coverage, but this has resulted in 4 months of total nonsense and chaos, and endless hours on the phone with (BS). I am not complaining about their call center operators, as they have been as helpful as they can be as I know that they are limited in what they can resolve for you, but the special teams that they have to escalate these issues to are the ones who really stink. Ironically, I feel like dealing with (BS) is causing me health problems that I am trying to insure myself against. Maybe that's their goal. Beyond frustrated!!!
According to my insurance agent, BCBS has "shut down." This occurred when BCBS tried changing programs during enrollment, causing everything to crash. My family and I have been trying to complete enrollment since December and have had no luck due to this crash. My family members are also having to pay FULL price for medications and doctor visits until BCBS is "back up."Now that the registration period is over, both my sister and I are stuck without insurance plans for the new year. This is absolutely insane and unfair given that it is NOT OUR FAULT BCBS crashed during the enrollment period. And forget about trying to call BCBS, NO ONE will answer your phone call. I've talked to people who've been on hold for 3-4 hours at a time. I finally got a hold of an "agent" this past week who claimed he "does not know anything about a crash" and "sorry, but the registration period has ended." The whole Obama Care is a failure and has caused many to lose out on being covered by a proper insurance. I hope that out of the goodness of their hearts they extend the registration deadline. Will be seeing more about this issue on the news I'm sure.
My wife, a long time Blue Shield customer, died on 27 of November, 2015. I called BS to inform them that she does not need any coverage, and to stop charging my account. B.S. took 850 for December. After four more calls and apologies, BS charged me again, this time 910 dollars, for January. Then, after I complained, representative asked for a death certificate of my wife, to be sent by fax. I did it, and two weeks later they still didn't got it. I been told that process of getting a fax is 4 weeks long. Finally, I asked for somebody from US, and I got B.S. representative Megan, who took my e-mailed documents, and promised quick resolve... On 5th of February message arrived saying that my money will be on my account in five to seven days. Today is March 10th, no money, and Megan stopped answering my messages... What I'm going to do next? Any ideas?
Due to lay-off from work in 2017 I obtained insurance with Blue Shield through Covered CA. So far nothing but problems and unfortunately when calling in to customer service I reach non-US based help desk who are very difficult to understand especially with loud environment they apparently work in. I've asked multiple times for US-based rep to call me back. Each time they indicate call-back within 24 hours but is now a week later and I'm still waiting. Called again and was told call-back within 24 hours but I'm not holding my breath. Such a disappointment after 5 years at United Healthcare where all their support is US-based. Shame on you Blue Shield.
This has got to be the worst insurance company out there. Every representative provides FALSE INFORMATION. No one really knows what is covered/not covered/who covers what. I guarantee if you call 5 different times with the same question, you'll get 5 different answers. They have made my pregnancy so extremely difficult on many levels. Wrong info about what is actually covered and wrong info on what medical supply company is sending my (supposed to be 100% covered) breast pump. I'm 3 weeks postpartum and have no breast pump because this "insurance company" gave my doctor a medical supply company that doesn't even service my area nor do they have breast pumps. Ridiculous.
Yesterday you left a message on my telephone stating "Your check was sent back to you for that second payment that you submitted and it looks like you already cashed your check so you have a wonderful day". The check that I received (and subsequently cashed) was in the wrong amount. I received and cashed a check for $208.40, which is the price of my silver plan premium. However, the check I was suppose to receive should have represented the price of my bronze plan, which is $209.16. So, technically Anthem still owes me the difference of $0.76.The story of how Anthem Blue Cross has mismanaged my money since November 2014 has become SO convoluted that I am going to write the whole thing down. I feel like a crazy person trying to explain my grievance to whomever I speak with over the phone, since the story is complicated and no longer easy to follow. This written grievance is my last effort to straighten out the multiple errors committed by Anthem Blue Cross employees, costing me over $200.00 and 30+ hours of telephone and email time. Update: I now just received a letter in the mail: Notice of Grace Period, Intent to Suspend Coverage and Prospective Cancellation. This letter is in error unless my premium covering me for the month of March is already way past due.The story begins: On November 10, 2014 at 11:15 am Pacific time, I spoke to Edgar who took an initial payment of $209.16. This payment was for my Anthem Bronze 60 PPO plan (ID **) effective November 1, 2014. On December 1, 2014 I called Anthem to make a monthly payment and inquire as to why my new policy was not represented on the Anthem Blue Cross website (I initially intended to pay online, but couldn't because I didn't see my new policy listed). The woman I spoke to on the call was Claricce **.Claricce told me that I did not have an active Covered California plan because no initial payment was ever received, and that receiving the initial payment is what activates the policy. She said that nowhere could she find proof that I had ever made a payment of $209.16. She suggested that I fax evidence of my initial payment to Anthem, so that is what I did. On December 1, 2014, per Claricee's instructions, I faxed proof of initial payment to the fax number she provided me # 866-931-1829. Nothing ever came of this fax.On December 11, 2014 I spoke to Rikki, a specialist in the processing department. Rikki asked me to email her proof of payment - ** - so I emailed Rikki the Bank of America Transaction Details that showed the $209.16 debit from my account. Rikki confirmed that she received this email and after a while of trying to track down my payment in Anthem's system, she discovered that Edgar (who took my initial payment) did not process it through the initial payment portal, but rather, the regular payment system- this is why my policy was never activated (and therefore not covering me).Rikki told me that I could apply that payment for the intended effective start date of November 1, 2014. However, since my policy was never activated and I had been told by multiple Blue Cross employees that my policy had been basically non-existent, I didn't want to apply my money toward uncovered time. Rikki said this was completely understandable and that Anthem would refund my $209.16 and cancel my Bronze policy. She then advised me to resubmit my Covered California application and attempt the initial payment again through the correct initial payment portal. Essentially I was starting over from scratch.As advised by Rikki, on December 12, 2014 I spent several hours on the phone with Covered California, updated my income information, picked a plan, and made a payment. I selected a new health plan for 2015 (Anthem Blue Cross Silver 70 PPO multi-state plan). The total monthly premium after the monthly fed tax credit is $208.40. I paid the initial payment online by following the link from Covered California to the Anthem site. The payment confirmation ID # is **. The plan has an effective date of January 1, 2015.On January 3, 2015 at 9:35 am Pacific time (still no reimbursement check in the mail) I spoke with Veronica ** in the new enrollment department. I called the sales department because I had no luck connecting with anybody in member services. I told Veronica that I had just received a billing statement in the amount of $419.08. The current charges to my account were $418.32 (monthly Bronze premium x2) plus a balance forward amount of $0.76. The first intent of my call was to understand my bill, and what the charges represented. The second intent was to check the status of my reimbursement check, which I still hadn't received.Veronica was attentive; she took notes including my Bronze policy number, Rikki's email address, and payment confirmation numbers. Veronica assured me that she would email the senior manager of member services, but that that she does not know when they would be in contact with me. I told her that I did not feel comfortable giving Anthem Blue Cross any more of my money until I was certain that my Bronze policy was cancelled and I received reimbursement for the policy that was never activated.On January 15, 2015 @ 11:45 Pacific time I spoke with Kenneth call tracking # ** and he sent an email to the billing/payment department asking if my BRONZE plan can be retroactively cancelled. He said that if so, a reimbursement check for the amount of $209.40 will automatically be generated. On January 23, 2015 I received a call from Kenneth- he said that a reimbursement check was mailed on Jan 20, 2015 and may take 2-3 weeks to arrive at my doorstep.Kenneth also mentioned something interesting; he said that his system shows that my Bronze policy was active October 1, 2014 through December 31, 2014. I only made one initial payment on November 10th, so why did I have three months of coverage?! I explained to Kenneth that on October 28, 2014 I spoke with Eleanor from Covered California who had to withdraw and re-do my application because I accidentally put that I was a naturalized citizen. Since I hadn't made my initial payment yet (and it was now October 28) she would make the effective date November 1, 2014. This worked out well because my previous Anthem Cross Premier PPO plan was effective through November 1st.On January 26, 2015 I made a second payment in the amount of $208.40 on my Silver plan via the online BillPay service. I have a confirmation email of the payment available on request (although I already emailed it to Juana). On February 3, 2015 I received a check in the mail for $208.40. This was NOT the amount of the initial payment I paid via Edgar on November 10th, 2014, which was $209.16 - the amount I was supposed to be reimbursed. My concern was that I was being reimbursed the price of my silver plan monthly premium.Even after having made an initial payment for my silver plan on Dec 12, 2014 and a second payment on Jan 26, 2015 (to cover the month of February) I was still receiving a bill from anthem saying that I owed $208.40 for the month of February. So at 8:40 am Pacific time on February 3, 2015, I called the Anthem billing department to ask why I was being billed for February still. I spoke with AJ call tracking # ** and he told me that he saw my January 26th payment, BUT NOWHERE IN HIS SYSTEM DID HE SEE MY INITIAL PAYMENT FOR THE SILVER PLAN. It is VERY CURIOUS that my initial payments for both my Bronze and Silver plans could not be tracked in Anthems system. AJ said that because the system showed that my initial payment was never received, the payment I made on January 26th was applied for the month of January.AJ said I would have to show proof of initial payment (made on Dec 12th) which I must email to his billing specialist at **. I did this immediately, attaching Transaction Details from my bank indicating that the amount of $208.40 posted on December 16th. AJ said that Juana will call me back tomorrow to let me know that proof of payment was received. I did receive a call from Juana, and she left a message saying that I cashed the check already.In sum, I believe I was mailed a reimbursement check for the wrong policy. Why did I cash the check? Because after three months of trying to get reimbursed $209.14, I finally got my money back, albeit short by $0.76. I am losing faith that this will ever be properly resolved, and am prepared to cancel my Anthem silver policy and enroll with a different insurance carrier. Anthem Blue cross owes me the difference of the error in reimbursement ($0.76) and it should be noted that I have paid TWO premiums for my silver plan, covering me through the end of February. Since one of these has been refunded in error, I am happy to pay it again, but only with the understanding that Anthem then owes me for the Bronze initial payment.I am willing to wait through the end of February for this problem to be resolved. I am also willing to work with Anthem and email any proof of payment, etc. that is requested of me. If this is not resolved by the end of February, I have full intention eating the cost of Anthem's multiple errors, canceling my policy, and sending this grievance to the California Department of Consumer Affairs.
Since I became eligible for Medicare, I have been enrolled in Anthem Blue Cross Senior Classic F plan. When attempting to review information online, to prepare for the current open enrollment period, I discovered Anthem was showing a different lower current premium for Plan F, for my age 70 and area 6, than I have been paying. I am paying $240.70 a month (paid bi-weekly $481.40), and the current premium Sold for Effective Dates On or After June 1, 2010 is $158.36 a month. A difference of $82.34. I called Anthem Blue Cross, somewhere around the end of October or the 1st of November, to ask why, and was told that there is a new Modernized Plan F, that the Senior Classic F, is no longer available, and since I didn't apply for a change in plans when the new Modernized Plan F became available, they continued to charge me the Senior Classic F higher premium. I asked what the difference was in the two plans, and was told there was no difference. I was told that if I switched from the Classic Plan F to the new Modernized Plan F, I would not be able to switch back, so I asked to receive information, so that I could compare the two plans, so I could make a decision.I received a brochure that listed all their plans, and there was only a Plan F, and a Plan F High Deductible (which is another plan not related to either that I am referring to here). Nothing about my current Senior Classic Plan, so that I could make a comparison. I called 800 333-8338 again today, and talked to someone in member services, and after explaining what I wanted, she (Sissy or CeCe or something like that) switched me to Tiffany in another department, and after explaining again was switched to Sherry **, a Health Care Adviser, who understood exactly what my problem was but said I needed to talk to a Supervisor in member services. She, very kindly, got Corine from member services on the line, who I have spoken to in the past. Corine insisted that the information for the new Modernized Plan F was sent to me during Anthem Blue Cross open enrollment period, which was effective March 1, 2011 (totally different from Medicare's open enrollment period), and her computer shows that I was sent the information January 1, 2011. Now, I save everything that is sent to me, and I do not have the information she claims was sent to me. I received, and have the information on my Prescription Part D coverage, but nothing for Classic or Modernized Plan F. Corine's response is that I should check with the post office, and my mail carrier. I might add that I have a very dear friend, who has the same Anthem Blue Cross coverage, at my recommendation, and she never received anything regarding changes to Plan F either.It appears that there are actually two open enrollment periods we are talking about, since this new Modernized Plan F plan was effective June 1 2010. I, not only did not receive anything for their enrollment period January 1 to March 1 2011, I also did not receive anything prior to the June 1, 2010 effective date. I believe that I have been paying a higher premium, that Anthem Blue Cross changed the plan, and did not notify me and continued, unethically, to collect the higher premium.
I had gone in for my annual pap, which is covered by my insurance. I have barebones insurance which I paid $340/month out of my own pocket since I am self-employed. While at the doctor’s, after the procedure, she asked if there was anything else she could do. I showed her a small wart on my thumb. She said she could easily take care of that. Within 5 minutes, she had used liquid nitrogen to "burn" off the wart (which eventually didn't work).Well, fast forward till I got my bill. My annual was covered minus my copay of $40. However, the 5-minute, in-office wart removal that didn't actually remove my wart cost $452! What? $452. Why is the insurance company billing that much? For something that didn't work, a service for which I thought was voluntary, and for which I could have gone to Walgreens and purchased the same thing for $25 over the counter?I was shocked. Can this be possible? I switched insurance companies. I now have a lower monthly payment. However, I still don't understand who sets these prices. $452 for liquid nitrogen?
I am the CEO/Executive Director of a small, non-profit medical clinic that provides medical/dental for its employees. Anthem Blue Cross would never have been my insurer of choice but this plan was inherited from the previous CEO. Normal procedure to delete coverage for an employee is supposed to be done by faxing a form. In mid-October, I faxed this form for an employee (to be terminated 12/1/14) who would be 65 in December and eligible for Medicare. In December, I received a billing and he was still on it. I sent the premium less his portion. I received absolutely no correspondence or billing to date. I went to the dentist (out of network because they had terrible provider options and the company was paying for the highest end plan) on January 30, 2015. The dentist office called for eligibility and I was covered. On February 20, I received a claim form from Anthem stating that I was not covered for any of my $583 routine check/cleaning. It took me 2 weeks to reach someone in accounts receivable (they make you leave a message and "say" they will return call in 24 hours - never happened). I called claims and spoke with Sandra (who transferred me to Tressie because she did not take care of small groups). Tressie told me this: The entire policy was cancelled 1/1/15 even though they had cashed my check; They applied the check to December 2014. I had additionally noted on the remittance that I was sending the amount less the one employee; Although I had faxed the cancellation for an employee mid-October and could prove the fax receipt, she could only cancel 1/1/15 because it was received 1/20/15; I had to pay for December and January, then get reimbursed for January; If I wanted to cancel 2/1/15, I needed to reinstate policy and pay for January & February, then get reimbursed for February (she would cancel me as for 2/1/13).Tressie transferred me to accts. rec. since she could not reinstate. I was forced to leave a message again (knowing they didn't return call the 1st time). I called the next day 2/27/15. Spoke to Nile to reinstate. He said that Tressie was wrong and the policy could not be reinstated even though we received no billing for January nor any cancellation notice! Nile further stated that he could not do anything and my employees would have to pay for their January visits, that it was too bad we didn't get any billing or notices. He offered no alternatives for anything and did not care that this would be reported. In summary, Anthem dental has questionable policies and procedures in place to ensure that insureds are notified of coverage or issues of coverage; Anthem requires "up-front" money for insureds who have cancelled in a timely manner but have not been cancelled in their system; Anthem does not notify insured companies that there is an issue with eligibility; Anthem does not address "referrals" in a timely manner and many of the so-called contracted doctors state they do not take patients; Anthem does not address individual or small businesses in the same professional manner as larger corporations; and Anthem has verbally iterated that they do not care if negative comments are posted. I will pay a small increase in premiums and switch our company and family to Delta Premier.
Co-pay increase. I picked up my prescription that is normally $20. It has gone up to $50. How on earth can a 110% increase be justified?
When I call to confirm my benefits, primarily my deductive and out of pocket max, Blue Shield confirms what I believe... My deductible is $4500 and my out of pocket max is $6250. Prior to my surgery I call once again to confirm my benefits, and AGAIN they assure me of my deductible and out of pocket max. So now that my surgery is complete and my claims are being processed I see that my deductible is $9000! What???!! I call them and they explain "this is a very common misunderstanding." My individual deductible no longer exists if I have more than myself on this plan. But yet every time I call (including this time) I'm told $4500 is my deductible. Saying I have a $4500 is a flat out lie. And if ** says "this is a common misunderstanding" then why isn't Blue Shield doing anything to help clear this up. I'm told to file a grievance complaint but we all know that this will not change a thing. They should be ashamed on their purposeful way of intentionally misleading me and the countless others. Shame on Blue Shield and I will be telling and posting my story everywhere! And I will file a complaint with them and update this posting just to prove my point that they won't do a thing but deny this.
Dealing with Blue Shield over the past three months has been nothing short of a nightmare as I attempt them to pay for a medication claim. The problem with Blue Shield is that no one takes even a modicum of responsibility. Therein lies the brilliance of Blue Shield. No one takes accountability. It's always someone else's fault. That way, no single department or employee has to deal with the blow back. The one division that I've been able to reach, without having to spend some 60 minutes on hold, has been the Payment Department. The Payment Department has been readily available. I dial the 800 number and am speaking with a Blue Shield employee within two-and-a-half minutes. Blue Shield is perfectly willing to take their clients' money, but when it comes to resolving even the most mundane issues, they make us walk atop miles of smoldering coal. Blue Shield has never called me back. They've never provided a legitimate response, save for boilerplate, to any of my e-mails. Never. I get the sense that this is business as usual. Don't make the same mistake I did. I wish I'd have just gone with Kaiser. Stay away from Blue Shield of CA.
They don't ever pickup their phone. I have called them several times and every time (I gave up more times than I can count) they had put me on a long hold. Right now I have been on hold over 30 minutes. This is just one issue. They never pay their share. They told me that if I suspect I have to ask for them to review again because the computer does this!!! And the computer is often wrong. How is it that they have no problem with resource when it comes to making us pay but when it comes to covering us they have a computer decide to pay or not pay? And why don't they pick up their phone? Can't they at least get one of those systems that allow you to punch in your number so someone can call you back? How backward is this company? I wish I had a better choice. Is there a way to give them a minus 5 stars?
My employer changed our company insurance plan to Anthem Blue Cross from AETNA, effective 8/1/2016. I provided all the necessary information so that deductibles would carry over from AETNA. In mid-September, I went to an in-network lab for lab work that my doctor had scheduled. The billed total was a little over $1400. In October, I received a bill from the lab stating that the claim had been denied. I went online to look at the EOB and found that the claim was denied pending my answers to a questionnaire about Medicare coverage that Anthem claimed to have sent me. When I still hadn't received that questionnaire 2 weeks later, I called Anthem, waited through the interminable delays, and explained my problem. The rep said they'd send another copy.A week later, no questionnaire, I called again. I explained that I do have Medicare pt A, but I haven't signed up for the rest since I am employed full time and I have insurance through my employer. This second rep was polite and helpful. She took the time to call Medicare, got the proper information, and said she would submit it to Anthem. She assured me this would take care of things. A week later, no progress, the website said the claim was still denied, and now there was a second denied claim for the doctor's appointment that followed the lab work. Same explanation, they were awaiting the answers to the questionnaire. The one I still have never received.The rep I spoke to on the third call somewhat rudely advised me that I needed to be patient because it would take 30 days to make the change (30 days to make a simple change as to whether I was covered under Medicare? What the heck?) Since then, I have been monitoring the EOB online. Until this past weekend, there was no change. Then, suddenly, the lab EOB disappeared and only the doctor visit EOB was visible.A few minutes ago, I checked again, and I found an "adjusted EOB" which now states that they have denied the entire $1400 charge and that I am responsible for that charge. There is no reason given for the denial. I am flabbergasted. I have no other insurance that will cover this claim. I have paid my Anthem insurance premiums through my employer on each paycheck. I went to an in network provider. What is their problem? Can't wait for them to deny the doctor visit as well. I used to have good credit scores. Wonder what they'll be when Anthem is through with me. And my employer made this change because the Anthem premiums were a better deal for the employees. I was never thrilled with AETNA, but I never had problems like this with them. No wonder Anthem is cheaper. They keep premiums low by denying legitimate claims. I've emailed them this evening. I'm lodging a complaint with my HR department tomorrow.
Do not sign up your parents for BCBS of IL. My parents had to leave the country for a vacation and used up their once a lifetime for vacation override in December 2015. They had to leave again for a funeral in March so the insurance refused to pay for the medication until March 2016. Come March, the insurance decided to change the policy themselves in February because it is within their own right once a new calendar year starts. So now, a medication that use to be covered is now $450 because they changed their mind on how much they want to cover.Because my parents are out of the country and they don't speak any English, I have not been able to figure out how my mother can tell the insurance agent to allow me access to talk to one of their agents. Every time I call, I either get sent to the wrong department or they say it's above their knowledge on how they can help me. I finally got fed up 3 hours and 12 minutes later when a gentleman by the name of Shawn flat out say "I can't help you. I need your mom to talk to me." What got me really mad was that he refused to call out of country to gather this information. He asked to talk to my mom and it doesn't help matters that she doesn't speak any English and she doesn't know how to use the computer. So now, I asked him for the number to the pharmacy service desk and he also flat out refused to give me that number.When I requested to speak to the supervisor, all she can say is "Calm down or I will hang up on you." This is what you will have to deal with. No one is empathetic and everyone refuses to help you. Now I'm frantically worried about my mom's uncontrolled diabetes when she's in another country and the fact that she's grieving a loss of a very close friend and all I can do is say, "I'm sorry mom, but $450 for 30 days' worth of pills is more than I can afford to pay this month." I'm still battling with this issue and no one on corporate can tell me why they decided to change her insurance and they won't tell me any definite information on when her medication will be covered again. I really can't wait to re-enroll her in something different once she comes back!
I received a printed benefits package when I signed up with Blue Shield. When I call customer service at Claims they direct me to their website. The wording on the website is different to that of the package I received. They have been getting away with increasing my co pays. I have asked them to tell me which page on the hard copy I received is that wording on and they can never answer my question. They have changed the wording on their website to suit themselves. Every time I call claims I get a different response.
Blue Shield of California uses "sign up billing," when submitting an application directly to them for individual health insurance. They immediately charge the card so a consumer has to ask for a credit if they decide to withdraw the application. Beware! They have still not credited my Visa card for a month's worth of health insurance for my family. We are using COBRA instead and the next day, after submitting an application to Blue Shield, we decided not to go with their plan. I have called them at least three times and each time they say it has been escalated, they give me a resolution number, or tell me they don't know why billing hasn't submitted a credit to my Visa. I have filled out a form for Chase Bank to dispute the charge and have informed Chase to block Blue Shield from taking further monies from my card.
Blue Shield made an error with my billing and now is making me pay for their mistake. They won't work with me at all over the issue. I have spoken with several customer service agents, wasted hours of my time with no help at all. I am very dissatisfied with their service. According to them I was covered then all of a sudden I was not and now I am left with medical bills I can't pay. I do not recommend them for insurance.
According to my EPO Blue Cross I had a co-pay of $60.00. I paid that but received bills for more money owed. After finding out that the EPO is limited to a small amount of providers, even after I went to a place that was stated as being a provider of BC EPO, paid my co-payment, I then received a notice that I STILL OWE MONEY!!!!!! On my card there is a PPO logo that is readable, however the EPO logo is barely readable. All the doctors, when shown the card, say they accept it but then find out it is an EPO instead of a PPO. This plan is completely useless as also hardly any payments that I have paid go towards my ridiculous deductible. This plan is not transparent as to what it offers and who accepts it.
Tied with cable companies for the worst customer service in the world. Very hard to get a person, pretty much impossible to get to a person that knows what they are doing, utterly impossible to get to a person that knows what they are doing that you can actually understand what they are saying. They are the simply the worst.
Happy with the plan... Incredibly disgusted with the organization. I've been trying to get an Insurance card from these people since January 1st, 2015. I literally have hours into this "project" and still no card! And that's just the start... Terrible, terrible company.
I was out of the country and ran into financial troubles and did not pay my premium for two months. They sent me my new card and a statement which I was prepared to pay upon my return. I called them and they told me they would return my call in 7-10 days. After 12 days I called and they said I received the wrong information and would receive a call in 30 days. After 33 days I called again and they told me it would be after 40-45 days. I asked if this is because of the new legislation and they confirmed that it was. I own multiple properties and need to be covered in case of a catastrophic accident. Out of the country it doesn't matter because there I can easily afford health care. I told this company they were lying to me and they had another term for it. I'm seeking a new provider.The government should either stay out of health care or simply provide a universal plan to all its citizens. I've come to find out that I can get an excellent plan in Asia for $60 a month that includes almost everything. You get excellent care beyond what you get here. I'm moving probably at the end of this year. ** this place and ** Blue Shield. Their coverage is garbage along with their customer service.
My cardiovascular surgeon says I need a procedure to remodel my heart to normal size. I can't live a normal productive life right now due to my condition. I need to have this surgery and have been denied twice. They call it "experimental." I don't feel that helping me live longer is considered "experimental".
I have been diagnosed with a large fibroid. My doctor recommended I have surgery asap. I have no insurance, so I applied to Anthem Blue Cross. I chose the best plan for me, and also the most expensive one $450.59 a month. I applied on November 13th 2014 and I requested coverage starting December 1st 2014. On November 16th I received an email from Anthem Blue Cross thanking me for my application. On November 26th, I received no more communication from Anthem. I called them, spoke to one of their agent, and he told me that my application was misplaced, apologized, and guaranteed me coverage by December 1st. December 1st came around and I still had no coverage. From December 1st to December 5th, I made several calls to Anthem and every single agent I spoke to, told me they had no record of me. On December 5th, I spoke to an agent named Rachel. Again, she told me they had no record of me. In frustration I mention to her I will contact my attorney in regard to this matter. She immediately found my application. "It was lost in limbo". After apologizing she guaranteed me coverage by the end of the day. The end of the day came: I still had no health coverage. She called back on December 7th, apologizing, and guaranteed me coverage by the following day. The following day I still had no coverage. I called Anthem again on December 9th. Rachel was not in, spoke to Dean, to find out that Rachel never processed my application. Dean guaranteed me coverage by the end of the day. End of the day, still no coverage. Today I called again and asked to speak to a supervisor. Kiana answered my call. She personally guaranteed me coverage within 48 hours. I demanded to have it in writing in an email. I had never received that email. Today is December 10th. I have no insurance, Anthem is aware of my need for surgery and do not want to insure me, breaking the law in doing so. I had been in touch with the California Insurance Commission, which they urge me to file a claim. I will contact my local Congressman in regard to the matter and I have no other choice but to hire an attorney and file a lawsuit against Anthem Blue Cross. I will not recommend Anthem Blue Cross to anybody.
They bill me, I pay the premiums, they accept the payments. (Note that in several cases they have sent bills only after the due date. I complained about this and got a form letter in response). Then they claim I'm not covered and refuse to pay claims. When I call, I spend hours on the phone with employees who admit that I am covered and can't figure out why the claims are denied. This company seems to exist solely to take money and not to actually provide any health coverage.
So I only called to understand some terminology on the website. I spoke to a sales rep by the name of Megan. She would not even talk to me until I gave her all my information, so I gave it to her. First question she asked is if I had any health issues, I said yes and told her that I am HIV positive. She quickly changed the conversation that I would not be able to find insurance or I would have a hard time getting insurance. I told her that was not why I called. I just wanted to understand terminology. She wouldn't even hear my questions. She just assumed that I was on my deathbed pleading for insurance. Thanks, Blue Cross, for totally discriminating against me for the illness that was given to me by **. I have to deal with it for the rest of my life, where you get to turn a blind eye.
I had a Grand Mal seizure that knocked me out. I was taken by ambulance to the hospital where I could be treated. I woke up in the hospital. That night with the tests, separate exams etc added up to over 41,000.00. Blue Cross covered 80%. Medicare picked up the other 20%. I got the summary of everything they covered. It was all 80% because they are my primary insurance. The bad reviews are stupid. Try giving a bad review after what I went through! They are the best ins. I have ever had!
This is by far the worst insurance I have ever had. I am diabetic trying to get my supplies for 3 weeks now and the authorization is still pending while I am running out of supplies. The customer service people don't care. Of course what health insurance company does care about its members? This one is by far the worst of any. Do not buy this insurance. It's a waste of money and nothing but trouble.
I am a Medical Biller in California. The 2 worst companies I work with are Blue Cross and Blue Shield. There are so many examples of bad customer service and shoddy processing, it would be hard to know where to start. Errors on the EOB's (explanation of benefits), outright delay tactics so that their interest bearing accounts bear more interest. One example; One of our patients has managed care coverage in Sacramento, however, she was seen 89 miles away from Sacramento, so Blue Cross was supposed to cover the claim. Blue Cross made us send the claim to the HMO, get the denial, send them the denial, then we got another denial stating we needed to appeal first! Per their contract with the HMO, any service further away than 30 miles was then Blue Cross responsibility. This is called DOFR- Division of Financial Responsibility. Contracted! But we were supposed to appeal the contractual denial. Customer service is non-existent. We are seeing the Covered Cal Exchange paying for almost nothing. The worst part of both Blue Cross/Shield and indeed all insurances is that there is no government agency to oversee and make them straighten up their act. The California Insurance Commissioner cannot MAKE the insurance companies do anything. They can recommend, they can say "Bad Insurance Company". There is NO Federal agency overseeing insurance companies, which should tell us all that the insurance companies have some of the most powerful lobbyists in Washington and the money they spend. SHAME.
I hate that I even have to give a star. This is by far the worst insurance I have ever had. Thank god my husband and I switched over to Oscar (which is AMAZING) - as we are now trying to conceive and I couldn't imagine having Anthem Blue Cross in our current situation. My story- I FRACTURED my ankle about 8 months ago. I went to the clinic that ANTHEM instructed me to go to. When I got there they said we were not up to date on payments (which we were as our payments were automatically deducted every month and we always checked to make sure it was operating correctly). So they said they couldn't see me. We called Blue Cross and since it was a Saturday there was NOBODY there to help us. Long story short (some yelling ensued at the clinic - which was out of character for us), we ended up leaving WITHOUT BEING SEEN. At this point I didn't know my ankle was fractured since I didn't have x-rays. I stayed off of it until Monday. Monday morning I called Blue Cross (since there was NOT ONE PERSON there to help me over the weekend - because people don't get sick on weekends, right?). Again, they instructed me to go to the same clinic that had turned me away on Saturday. We told them what happened. They said they would make sure it wouldn't happen again - as we were up to date on payments. SO, we go back to the clinic. Not kidding... They said the same thing. They couldn't see me because we were not up to date on payments. SO we bring up our payment log and show them. We also have Blue Cross talk to them. They say "sorry - we can't see you, go to a hospital." We leave. We don't go to a hospital because we can't afford it and because we PAY $680/month FOR INSURANCE. Back on the phone w/ Blue Cross. They tell us we can go to a clinic that is 33 miles from our house and they're sure there will be no problem (no joke). For anyone who lives in LA, you know that 33 miles is about 2 hours or more of a drive. We tell them that doesn't work. So they make some calls and send us to a closer clinic assuring us that we will be covered. We hobble over to that clinic and guess what? THEY WON'T SEE US BECAUSE THEY DON'T TAKE OUR INSURANCE. I wish I was kidding. My husband said ** it and we ended up paying OUT OF POCKET for my x-rays. The staff was so accommodating and they felt so bad that they ended up only charging us half of what we had to pay (which is unusual and we were SO grateful). I found out that I had a fractured ankle and with no thanks to this AWFUL insurance company. EVERY SINGLE PERSON we spoke to had NO idea of what they are doing. It was honestly scary. What if we had a real emergency?? What if I was pregnant?? Thank god we got new insurance at the beginning of this year. This was a scary experience and I don't know how this company intends to stay afloat and keep customers. Dangerous, scary, uninformed and irresponsible - how I would describe Anthem Blue Cross.
I was placed on hold at Anthem Blue Cross, and the music they played while on hold sounded like a trombone player falling down the stairs during a hurricane. Another song sounded like dogs having their teeth drilled at an auto body shop. Clearly, these songs are cacophonous in order to get you to hang up. But we won't hang up. We'll wait to uncover your corrupt business practices as long as we need to.
I transferred my medicare plan over to Blue Shield 65 plus HMO plan several years ago. I just received a letter from them on September 29, 2016 in the mail but the letter was dated October 2, 2016. It stated that Blue Shield 65 Plus HMO won't offer our Medicare plan in 2017. It also stated that this means our coverage through Blue Shield 65 plus will end December 31, 2016 and that we should make a decision to take action about Medicare coverage by before December 31, 2016 or prescription drug plans will not be covered. In addition we should look into choosing a plan before February 28th 2017. There was no other explanation for why this was happening. I called the customer service line and they told me I should be receiving another letter stated that if I want to continue Blue Shield 65 plus I must fill out another application and pay a $29 premium monthly. So I asked the customer service rep "I thought they were no longer handling medicare or taking over medicare". The representative told me they would still be an HMO with medicare but I have to pay a $29 a month premium in addition to what I pay each month for Part B Medicare out of my social security check. I said this is extortion of senior citizens who are on HMO because they can't afford supplemental medical insurance on fixed or low incomes. There was no explanation for the increase or what it would improve.Blue Cross 65 plus has hoodwinked seniors into this plan knowing that they would be increasing. Also I am under Hills medical group which takes Blue Shield 65 plus but does not take straight medicare. I may have to find a new doctor which I am very upset about. Something needs to be done about Medicare, and these HMO plans that they sell out to. The newly elected Vice President Margaret Anderson of Senior Marketing is obviously stupid and not very good at her job, otherwise she would not have to send out two letters confusing people.
My daughter has knee injury so the orthopedic doctor wants an MRI, which needs to be pre-approved by Blue Cross. Here we are 3 days later and nothing. My husband was on hold for an hour already today and I have been on hold for nearly 30 minutes. We pay approximately $1,500 per month for their premiums. Something needs to be done. This is unacceptable.
I was happy to finally have insurance. Chose Anthem Blue Cross through Covered California. Everything was okay until I actually had to use it! I had bronchitis and found an urgent care close to home on their website under my plan, only to find that ABC decided the urgent care wasn't a provider. Then I went to a doctor that was listed on the website, only to find that ABC decided that he wasn't a provider either. Since I was enrolled January 1, they've dropped all the urgent cares near me, and the only urgent care they allow is 10 miles from my home in one of the worst areas of LA. After I enrolled, there were NO hospitals listed within 20 miles of my home. Their website claims that the doctors are updated weekly, but they can't guarantee they will be a provider because, they claim, the doctors remove themselves from the plan. NOT TRUE. All doctors I've been to accept the insurance only to find they have been dropped by ABC. Worst insurance company I've ever encountered. Dishonest. Rude customer service reps. Covered California is getting ripped off.
This heartless company denied paying my ob gyn yearly visit even though I was covered and had already called and spent half a day making sure the Dr. I was going to see was covered under my policy which I was told yes by the insurance co. and the Dr. But sure enough I got a $350 bill saying coverage denied. So I called again... and waited and waited and waited --- 1 HOUR AND 48 MIN ON HOLD!!! AND THEN WAS DISCONNECTED!!! THIS IS NOT A HEALTH CARE SERVICE, THIS IS A COMPANY USING MAFIA LIKE PRACTICE TO TAKE OUR MONEY FOR NOTHING.
As a provider, I have needed to connect with Anthem Blue Cross to resolve and complete patient claims. I have spent hours being re-directed, disconnected, unanswered, and ignored. The email and phone systems are completely dysfunctional and I am frequently met with responses that state, for example, "I'm sorry, I didn't hear that, please repeat your information." I repeat, I type it in, I repeat again (I speak clearly, and I have a good phone connection) and the system consistently drops my calls. This has been going on for over two months, and has occurred with 5 patients now who are awaiting care. The stalling/stonewalling I have faced from Blue Cross is inexcusable, especially given that people's health and well-being is involved. I am concerned that this avoidance is a deliberate attempt on Blue Cross' part to deny assistance to providers and patients who have legitimate claims and have done their due diligence to follow the rules, only to be met with a gridlock of ineptitude and inertia.
Their accounting is screwed up and they take too much money, then not enough... I was notified by Blue Shield that they were going to terminate my account for non-payment. However, I had overpaid last year and they were supposed to start taking automatic payments which I signed up for when they had it figured out. Long story short, they never sent me any bills or took any automatic payments from my account. I tried to pay online and it said that I had no payment due. I called and the automated system said no payment is due. Then I called one day after the date they were threatening to terminate me (only communication I received in over 6 months) and I was no longer in their system and when I got a hold of a Rep to make my payment, I was told I was terminated and there was nothing they could do. That was my first case and grievance and I have spent countless hours on the phone getting a different person with a different story each and every time. "Yes, you are correct, it was our fault and you are being re-instated. I have escalated your case and you will get a call in 24 hours." It has been 8 weeks now and still they can't seem to get it corrected, even though they say someone is working on it. I call every day now, hoping that the squeaky wheel approach works, but it hasn't. I have filed grievances online and still nothing happens. I am getting threatening letters from medical billers that are not getting paid. This is not fair!!
I have been trying to get my refund from Blue Shield since last May 2015. Here is just my 2016 contact with them. I call, I get references, I get the whole 7-10 days processing and just excuses. I asked if they were going to refund the interest. 1-888-319-5999. Previously called in Jan. 4, 2016. At that time I was to receive a check back for $638.16. Called today 03-09-2016. Called Blue Shield regarding refund still due from May 1, 2015 - $659.54 Minus 1 Day ($21.38) = $638.16. Covered California plan ** Jan 1, 2015-April 30, 2015. Current Plan **. Effective May 1, 2015-April 30, 2016.Blue Shield rep got Covered California on the line to get them to check on status. Blue Shield says they only show payment through Jan 31, 2015. Katnis asked me to call back in 7-10 days to check to see if they received notice from Covered California, so they can issue a refund to me. Called on May 2, 2016 to find out where my refund is. Spoke with Mark and he reviewed the ref# **. Prior agent (Katnis) worked on the incorrect member number which is why I haven't received the refund. Mark spoke with Tina in the back office and she is putting in for my refund. Mark said I would receive the refund the same way that I paid for it (i.e. my savings account). He also said it would take 7-10 days again to receive the refund.Called on May 18, 2016 @ 4:16 pm to find out where my refund is. Spoke with Riza and she reviewed the ref# **. Riza is checked all the notes. Connected me to another department and I spoke with Christine. (Their direct number is 1-855-836-9705.) Christine was checking the status on the refund. She came back on the line and said they were still processing it. I argued that it has been over the 10 business days (today is the 12th day). I asked her to go find out WHY and that I needed the refund NOW. She put me on hold to go check after trying to tell me it had not be 10 business days which I counted for her (from May 4th to today May 12th 12 days). She came back and said there were delays. I told her I needed my $638.16 now and there was no reason for this to be delayed. It is a simple refund not a claim or anything difficult. The rep keeps telling me she is calling the "back office" and they have "so many" claims that they need another 4 days. I told her that this is unacceptable and I wanted the refund tomorrow May 19, 2016. I let her know that I really need the money desperately. I will post again when I find out the results. They are a horrible company.
I filed a claim for reimbursement for a medically necessary compounded prescription mid-July. Blue Cross told me the numbers for the medications were wrong, so I called my pharmacy and fixed them. Then they told me "there were not enough zeros" on the prescription numbers so I added zeros and mailed the paperwork back (even though they could have easily added the zeros themselves). They returned the paperwork to me four times after that saying the numbers were still wrong -- even though they were not. Every time, they sent me the entire claim back -- a huge bundle of paperwork -- asking me to resubmit the entire package. I spent hours in line at the post office mailing this paperwork back four times. Just now (mid-October) they told me that as of July 1 they will no longer pay for any compounded medications. I've spent hours on the phone with their customer service people, hours in line at the post office, time and money only to be told four months later that they will not cover any compounded medications. What a waste of time, money, people, and paperwork. Unbelievable.
This is the worst insurance company I have ever had to deal with. When I switched plans they continued to charge me for both the new plan and the cancelled plan for over three months. After hours and hours of trying to get through to them on the phone -- one day I spent 7 hours dealing with them -- they finally resolved the issue after three months. Six months later I finally received a refund.It is extremely difficult to get any support. You will wait on hold for long periods of time and finally reach someone who cannot help you. They will tell you that they cannot reach other departments and you have to hang up and call again.You are not allowed to speak to a supervisor. I have asked many times after getting nowhere with support only to be told that there are no supervisors, or I get the same canned response. My payments and copays continuously rise. My prescription drug prices continuously rise and they suddenly stop fill prescriptions for certain medications causing my doctor to try and find a substitute. My doctor is the one who should decide which medication I use -- NOT Anthem.Their website is the worst I have ever seen. It is difficult to find what you are looking for and you eventually have to give up and call them back, ask for a different department and wait for hours. Prepare to be constantly spammed too. You will be called at all hours of the day to take part in surveys and special plans. You have to call the support people, sit on hold for an hour, and tell them you do not want to receive offers and surveys. Then you have to call them and repeat that at least three times before they stop calling you.
I’ve been with A-Blue Shields for over 29 years never had an issue until 2006, I am a cancer survivor, but I’m not sure I can survive the health care cost, my story: I had a wonderful policy at approx $425.00/475.00 per month Before my battle with cancer after the police kept going up in price until it reached $1695.00/$1800.00 and it was going to take another increase and was no longer affordable by any means but due to a pre-existing condition I could not change, when I called they explained that my policy no longer existed and the price was going to continue to increase no matter what until everyone was switched to a different policy. Well not being able to afford it I had to downgrade my policy to a Bronze that may as well be a plastic garbage bag, my rate went down 500.00 per month but my deductible increase immensely 7000/4000? After the downgrade they started to increase my monthly from $500.00 up to $996.00 now with still a 7000/4000 deductible. It’s just not affordable, yes I own a home but I don’t own it making payments. My health insurance issues have been going on for over 12 years but come on $996.00 for 1-one-☝️ person is insane, and the coverage is less and less, and the deductible same. It’s just not right, work hard follow the rules and no relief in sight, at age 60 may have to sell my 1st and only home just to pay health insurance, you can see how people develop bad credit and there life's starts to spiral downhill, lose your homes and live in the streets, Last; after all this try and get a decent Drs app with a new Dr with Blue Shield's coverage and not have to wait 30 to 45 days for an appointment. It’s just not right.
Blue Shield of CA is the biggest rip off there is in America. I have been insured with Blue Shield of CA through my employer for 13 of the past 15 years. I have insured myself and daughter. I am currently unemployed, like many in the country, being recently laid off. I tried to purchase insurance through them just for my daughter. I chose the Active 35 that would fit her best because she is a club soccer player. This past year was rough, she got injured twice. So in 15 years of paying a Blue Shield state company as for two years we were in South Carolina and still used Blue Shield, she had seen a doctor 3 times for injuries that were declared sprains. I was honest on my application and signed the policy for $165 per month. Two weeks later, I received a notice about a tier rating and an increase in the monthly cost. The new price is $890 a month. Yes, you read it right, per month, just for my daughter. I filed an appeal and I was denied. This is insulting, ridiculous and should be outright illegal! Shame on Blue Cross!
We have been with Blue Shield of California as the health care plan for our family for 16 years through both employers and individual plans. My wife recently left her job so we turned to Blue Shield to enter into a PPO plan to cover our family and it's been three months of hell. They have demanded payment for the first month, cashed our check two months ago, and we still don't have an ID or insurance cards. We call weekly and it's the same thing -- our application is still "in process", yet they have our payment and we are forced to go to doctors without coverage and then have to pay out of pocket. This company should be shut down. I can understand occasional bad customer service but this is so consistently bad that it must be policy. I can't believe that a health care provider can be this bad and still generate billion dollar profits - $2.4B in 2014. What a scam!
We had Blue Shield of CA when we lived in CA 5 years ago and it seems to be working just as poorly. I went to their website to get a list of primary care physicians (PCP) in my area who are accepting new patients. What an awful website it is. There are very few reviews of doctors by patients. There is no hyperlink to a DR's website page or practice group so one can read up on him, i.e., where did s/he go to school, graduate, etc. Some of the DRs returned by the search are specialists, not GPs or PCPs. For example, I got two oncologist/hemotologists among the first 8 results forcing me to sift through the six pages of results it gave me one-by-one. Some DRs returned by the search are NOT accepting new patients even though the BS says they are. The search process defaults to your home address and forces you to enter an entirely new address (street #, name, type, city, state and zip) which is often necessary if you are searching for a DR close to where you work. What a waste of time to reenter completely new information. There are no pictures of the doctors. Some of us want older, more seasoned DRs; others patients may want younger, hipper, cooler ones. There are no ratings of the medical groups. For example, is Sutter Health's office in Albany easy to deal with or hard? That's an important factor in choosing a physician because finding a good physician with a bad front office is a recipe for unhappiness. Finally, I was searching for a PCP and guess what, there is no search term for a Primary Care Physician. There are search terms for DRs that have a Family Practice or practice Internal Medicine but there is no way to search for a PCP. Someone needs to dramatically rethink BS' website and bring it out of the stone ages. Even BS' customer survey about its website, which I filled out, is atrocious. The user filling it out is only able to see about 12 words of text at a time making it incredibly hard to write constructive feedback. All in all, a highly disappointing experience. It doesn't seem as if BS has progressed at all in the five years our family has been away. I gave all this information to BS in their survey and told them I was going to post it on Yelp and other consumer ratings sites to socialize this problem with the others.
We are forced back onto this insurance once again! Last time we had it they paid EXACTLY 0 dollars for anything the whole time we had them. They rejected EVERYTHING including my blood pressure medicine which is a generic medication.
We received a letter saying we had not paid for health insurance. We have attempted to call them on 4 different numbers and always get the same recording. They are too busy and then the phone hangs up.
I have been covered through Blue of Shield of CA for just over eight years. Several of my medical providers are out-of-network providers by choice and because I find providers who are contracted with BSofCA are often less willing to spend a reasonable amount of time during my visits, and they seemed fed up with their profession most likely due to the lack of fair reimbursement from insurance companies. With that said, when I do visit an outside provider and submit a claim for reimbursement, 90% of the time payment to me is delayed for up to 4 months. Not to mention the fact that I have repeatedly fax copies of claims for processing because BSofCA cannot find record of previous fax submissions by me. Then they insult you by paying .01 percent interest to justify the delay.In my opinion, insurance providers are greedy and corrupt beyond comprehension for most of us. If you have a problem with BSofCA, file a grievance first with BSofCA then with the Dept. of Managed Health, link below. If enough people take a stand and go through the process of filing complaints, we have a better chance of changing the system for the better. You can also write to your local state representatives.
I switched from Covered California with Blue Shield to a regular policy with Blue Shield in March of this year. It's been one nightmare after another with them and it just keeps getting worse. Blue Shield deposits my premium checks every month but stopped crediting them to my account three months ago. I have spent an inordinate amount of time on the phone with them about this issue. The last supervisor I spoke with told me that they had recently changed their billing system and that's why my payments weren't showing up. He told me that everything was alright and I should just put a different code on my next check rather than using my account number. Well, tonight I get a message saying that my insurance was CANCELLED and that I had 48 hours to pay them $1700 or my account would never be reinstated! This includes a $548.17 "reinstatement fee". I have a complete paper trail of every premium check I've sent which they have deposited (I send them 10 days early too just to make sure). I have lost sleep and time from work as a result of Blue Shield's negligence and ineptitude. They outsource their calls to a call center overseas and the people are not trained. I very much look forward to finding a different healthcare provider once this is resolved. Shame on Blue Shield! I have filed a complaint with the Insurance Commissioner as this has gone much too far.
My husband and I bought an expensive "Preferred PPO" with no deductible from Blue Shield of California. WHAT A MISTAKE. None of our doctors will now take the insurance because BS will only pay Medicaid rates of $35 to the doctors, and have increased the burden of paperwork on the doctors. From the few doctors in my area that are on the list, many I wouldn't send anyone to or they are just starting out. When I sign on to the website for my plan and pull up a list of Chiropractors it gave me 4 in a five mile radius. I was happy I found mine on there. WRONG! My plan doesn't cover chiropractors. Okay, but why do they show up? I called BS and was told they can do physical therapy on me but not adjust me and I would be covered. What? I also found out that my small list of doctors for my plan included In Network and Out of Network doctors but doesn't state which is which! I asked and was told to check with BS before I go. There is no way to tell. One call took 1-1/2 hrs to complete (59 min 17 sec to get a live person) and today was 45 minutes with a 7 min wait. I then asked how often they update their list and was told they are working on February's list of doctors so the website is 3 months old. If it is true that 70% of the doctors are jumping ship it will get uglier. I can't change plans because the government has me locked into this plan (enrollment period closed). No wonder all the insurance companies' stock went up the day after the ACA passed! We have to buy insurance and get poor service and a sad list of providers and the insurance companies get their money and many of us won't use their doctors. So sad.
My husband and I are Blue Shield Gold subscribers via the Covered California Exchange. We felt so lucky when we were able to select Blue Shield as our health care coverage when I retired from The County of Orange where we had wonderful coverage by Blue Shield. After talking with the Blue Shield representative we began our new plan April 1, 2014. Being enrolled in this Blue Shield plan has been a huge disappointment. I no longer receive the outstanding customer service and the excellent care that I got as an Orange County employee covered by Blue Shield. Here are some examples of the treatment I have been receiving:In May 2014 it came to my attention that I was being overcharged for one of my prescribed medicines. I called the customer service line on my card and was left on hold, then got disconnected while the matter was being investigated by the representative. I had to call back multiple times, be put on hold again, only to have to start over with another representative who could not give me a satisfactory answer. I was being charged $70 rather than the plan designated $50. After many hours, I finally spoke to a representative who confirmed that the medication is formulary and I was to be charged 50.00 for the next refill. On 8/28/2014 I was charged the $70 again!I was due to have another medication refilled, one I had been taking for quite some time and under my new Blue Shield plan would have been charged $70 because I was told it was not formulary. I learned through my pharmacist that it went generic prior to the request; therefore, the price would be much less expensive. I called the Blue Shield Gold representative phone number once again, was on hold for long amounts of time, got disconnected, and when I finally did get an answer, was told that Blue Shield had not yet updated their computers to show the medication as generic. No one offered to help me to find a way to get the price lowered to the generic cost.I have been diagnosed with Macular Degeneration and have been seeing Doctor Stephanie ** at the Gavin Herbert Eye Clinic at University of California in Irvine for over a year and a half. When I found out that Dr. ** was not on the Blue Shield Gold network, I asked her to review the eye doctors on the network and there was no retina specialist able to provide the treatment in our area that I need. I am losing my vision and am trying to avoid complete blindness. In May, 2014 I contacted the Blue Shield Gold Customer Service call center where I spent many hours on hold and spoke to various representatives who gave me varying answers regarding continued care for my condition. Each one had a different explanation on how to process a continuity of care request. Initially, I was told I was to send in the form. I did that and then on follow up, they told me it was lost. Then I was told that my doctor would have to send in a Continuity of Care form, that she would have to call a special number to get a fax number to send in the form, a number I was not permitted to have. All of this was a very time consuming process and ate up hours of my time. When Blue Shield did write to Dr. ** to request my records, Blue Shield put my husband down as the patient, confusing Dr. ** and UCI, creating another delay. Latest communication I received from Blue Shield on Sept. 4 has denied continuity of care with Dr. **. I continue to lose my vision this issue drags on unresolved.Due to another medical condition, I was referred to a Urogynecologist. This is a very specialized field and I called every urologist and gynecologist listed on the Blue Shield network, and no one provides the services of a Urogynecologist. I was referred to Dr. Patricia ** in Mission Viejo who is on the private PPO Blue Shield network and not on the Exchange. I had to pay hundreds of dollars out of pocket because this doctor is not on the network and because there is no other doctor with her specialty on the network. I will need surgery l and will not be able to pay for such a procedure out of pocket. This is another example of the lack of specialized doctor on the Blue Shield Gold network. I just received notification that the appeal for this doctors services was denied.Feeling sick is stressful in itself. However, that stress pales in comparison to how I feel regarding my healthcare coverage. Blue Shield Gold does not have enough specialty providers on the PPO network causing me huge concerns and anxiety about how I am going to receive the treatments I so desperately need. Also Blue Shield’s inability to provide educated and professional representatives makes me question whether to continue to be a Blue Shield consumer. I am disappointed in Blue Shield’s lack of concern for my welfare and I need help in getting these issues resolved so I can get back to living a healthy productive life. I have read Blue Shield of California’s Mission Statement, “To ensure all Californians have access to high-quality health care at an affordable price.” Now ask yourselves, with all that I have experienced with Blue Shield’s inability to provide me with the health care I need, does it appear to you that Blue Shield is living the mission statement?
I had BS coverage with my husband in 2014. My sons had a separate BS policy. We wanted a combined policy in 2015. On Jan. 2nd I noticed our new BS cards had my husband as the primary. Only 2 cards were sent not 4. I called BS. They said I was not on the new policy and my husband was on the old policy AND the new one. I was told to call Covered Ca. Covered Ca said they sent correct info to BS Dec. 18th but would sent it again. I called BS again 1/14, 1/21, 1/27 and 1/29 still no fix. BS blames Covered Ca and Covered CA blames BS. Finally I get a conference call (one hour and 10 minutes) with promises of now it's definitely fixed! Here we are 2/10. Not fixed. I am on hold as BS tries to get Covered Ca on conference call AGAIN. Now they promise to call me back!
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