Saturday 23rd of December 2017 10:04:45 AM
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.