ComplaintsforBlue Cross and Blue Shield of North Carolina
Health Insurance
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Complaint Details
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Initial Complaint
10/17/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My father suffered a stroke in 2023. My mother and I have filed claims with BCBS and were clearly told these would be covered. Over the last 8 months the process has been going in circles processing and re-processing, one claim approved, others not sure what is happening. When speaking with customer service we were told these already should have been approved and paid. Somebody needs to look into these and finalize these claims properly because we are wasting months and hours speaking to customer service. My father is ********* ************. Subscriber ID ************.Business response
10/17/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
10/02/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My mother passed away on March 29, 2024. I called BCBS to stop bank drafts April 16th and to request a refund for the premium collected in April. Two premiums were collected on 4/5/2024: $****** and $291.00. They said they would stop all bank drafts and refund money. Check received from BCBS for ****** in mom's name. 5/7/2024 BCBS withdrew $291.00 premium. Called BCBS in *** and they apologized and said they would refund money and stop automatic bank draft. I asked them to issue checks in my name. Put Letter of Testamentary in mail per their request. 6/5/2024 BCBS withdrew $299.00 premium. I called BCBS and they said they did not receive letter of Testamentary in mail. They said I could fax it over. I faxed the letter to them. They also advised that I stop payment to them through my bank. 6/21/24 I paid a fee of $31.00 to stop payment to BCBS to my bank. 7/8/2024 Called BCBS. They said they received the Letter of Testamentary. They said I should be receiving a refund for part of March, all of ****** *** and June. Case number ******** was opened. 8/1/2024 Called BCBS to check the status of refund. I was on phone for 2.5 hours after being transferred multiple times and hung up on 2 times with no resolution. 8/7/2024 I called BCBS. They state that 2 checks have been issued in the amounts of $650.60 and $249.16 that day. 9/5/2024 I called BCBS to check the status of checks. They said they should have been expedited. I was put on hold and then disconnected while on hold. I called back. BCBS said it should take 30 days from 8/8/2024. I should wait until Monday and call back if I did not receive checks. 10/1/2024 Called BCBS to check status of checks. They said they could not tell me anything because their system was updating. They would call me back tomorrow.Business response
10/02/2024
BlueCross NC will contact the complainant directly regarding their concerns.Customer response
10/02/2024
Complaint: 22366408
I am rejecting this response because: My complaint is against BCBS not this company.
Sincerely,
******* ****Initial Complaint
09/18/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
Blue Cross Blue Shield has approved payment directly to me, for an ambulance ride that occurred 03/22/2024 in ****************. Since April, when they approved the claim and payment for the claim. I have been waiting for the check in the mail. i have called a total of 4 different times since April in regards to this issue. They have said that they have "voided and reissued" the check twice, but do not know why it is not getting to me. it is now September 18th... nearly 6 months later.. no payment has been received. And when asked if there can be an investigation into why i am not receiving these checks, they answer was no. We can only keep voiding and reissuing the check. At this point there seems to be issues within the company with regards to sending reimbursement to clients. I asked if there were alternative ways to submitting the money , ie. digital or to my bank. The answer is no. just a check. When asked what will happen if i still do receive a check in 30 days, the answer was we will void and reissue. How can this be escalated for investigation? or can there be alternative modes of delivery when clearly one is failing?Business response
09/18/2024
BlueCross NC will contact the complainant directly regarding their concerns.Initial Complaint
09/17/2024
- Complaint Type:
- Billing Issues
- Status:
- Resolved
This bill was paid and we are still getting letters stating that we owe them money.I called and spoke to ******* and she left a phone message stating that it was taken care of in august.I received a letter dated September 11, stating that this is still pending and this is the 3rd notice,We wrote a letter and included a copy of the check that was cashed. Nothing seems to be addressed.We paid the amount owed in June!Please help sort this out.Business response
09/17/2024
BlueCross NC will contact the complainant directly regarding their concerns.Customer response
09/17/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
***************************Initial Complaint
08/27/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
I cancelled my health insurance in January 2024. I had already paid my bill for February so I was issued a refund of $157.21. They suppose to send me a check but it never arrived. I called back after 30 days like they told me to and they cancelled the check and reissued another one. That check also never arrived. This process was repeated several times. I moved throughout this process and updated my new address before I moved to assure there were no issues. The representative did not change my address. I have been on the phone with customer service over 20 times now each time being tied up on the phone for over two hours. Thats a lot of time wasted on the phone. I am extremely upset. I want my money back. It is now almost 8 months later and I still do not have my check. I have talked to two different **********s as well. I have 7 different reference numbers about my case. The first ********** said they tried to send me one electronically and said it went through. And they closed my case. It did not go through. I got in touch with another ********** named ****** who is now in charge of my case. We got on the phone with my bank and my credit card company to verify that the check did not go through. She assured me this time everything was processed correctly and that I would get my check just like the rest of the people said. I still do not have my money. If this was the other way around debt collectors would be after me. I am so frustrated with this company. For a multi million dollar company cant refund a $157.21 check for a middle class working person. Its ridiculous and unacceptable. Here is the latest reference number that will get you in touch with ****** who is now in charge of my case. She has been nice about the situation but ultimately has not gotten my money to me. Please help. ****** (In charge of my case)50885511 (Most recent)************** (Phone number)Reference #s past 8 months ******** ******** ******** ******** ******** *******Business response
08/30/2024
BlueCross NC will contact the complainant directly regarding their concerns.Initial Complaint
06/19/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
I was sent a letter from a collection agency due to an error on a claim for March 28. I resolved the error, however I am unable to check if it satisfys the **** system and that the collection is released. I have tried to reach the agency many times and they simply do not answer the phone. I tried to reach BCBS customer service but the agent kept answering my question incorrectly and refused to allow me to speak with a manager. Also tried to use the online system, however BSBS i tech support was unable to help me resolve website issues to get into the account. Could you assist?Business response
06/19/2024
BlueCross NC will contact the complainant directly regarding their concerns.Customer response
06/20/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
*******************Initial Complaint
05/28/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
On 4/29/24 I signed up for insurance with BCBS of NC to start in May using the government ************ I was approved, issued an account at ********************** NC, sent medical cards via mail, made my initial premium payment, signed up for their online platform called Blue Connect. Received a bill for ***** Logged on to Blue Connect on 5/23 to pay but there was no option on my online account. Called customer service for Blue Connect and spoke to *******. She said they would fix this plus email me a link to make the payment. Never received the email. The next morning 5/24, I tried to log onto Blue Connect but couldn't. Called Blue Connect, they were baffled but my acct was inactive. Called BCBS of NC ***************** The female sounding rep mumbled a name. First she said that my account was past due and that my first paymt was applied to April. impossible because, I was covered by different insurance company as I only moved to ** at the very end of April. I couldn't be double covered in April. Correspondence from BCBS NC shows that my coverage began in May. BCBS patched me to gov ************ Gov determined that 2 acts were opened in error, told BCBS how to fix immediately but BSBC rep was non responsive even when she was instructed exactly how to fix. *** forced to escalate the issue. *** rep asked BCBS to email.me a card NOW to the active acct, then left call. The email contained the old inactive card. When I asked BCBS why they sent me that and why she didn't comply with Gov instructions to fix my issue immediately, she said that I "needed to be nice to her." At no time was I rude to her. She could have fixed my issue but instead allowed the problem to persist and Gov forced to file an escalation. After 2hrs, 8 min, still have an inactive acct, no access to my paid insurance and a rep who did nothing for me, refused to follow the Gov *********** reps instructions to immediately correct the error or even allow me to pay my June premium.Business response
05/28/2024
BlueCross NC will contact the complainant directly regarding their concerns.Customer response
05/31/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
***********************Initial Complaint
05/16/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
Enrolled in ********* Was approved. Tried for 2 months to get ******************** card sent To local DSS. Could never get anybody on the phone.Business response
05/16/2024
BlueCross NC will contact the complainant directly regarding their concerns.Initial Complaint
04/26/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
My mom (*************************) passed away August 10, 2023. She had a supplemental health insurance policy with BCBC of NC. Her estate is due a refund check (approximately $225) for the month of August after she passed. I have contacted customer service at ********************** 7 times (10/5/23, 12/13/23, 2/1/24, 2/22/24, 2/27/24, 3/22/24, 4/26/24) since my mom passed asking about the status of the check. Every time I am told that the request is being sent over to be processed. When I asked if there is a manger/supervisor I can talk to about it I am told no. Can the BBB please help me with this issue?Business response
04/26/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
04/09/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I am a retired Federal employee and have health insurance through the Blue Cross/BS insurance company of North Carolina Federal employee program. At the end of Dec 2023 I filed a claim for a hearing aid replacement which is covered by my policy. BC/BS processed that claim in early Jan 2024, approved it and listed on line my Explanation of Benefits that at charge of $1499.99 was paid on Jan 19, 2024. But I never received an EOB in the mail or a check for that amount' After a near month delay I phoned BC/BS and told them no check . They said they would investigate that but no check ever came. After numerous calls every week or two I kept getting told that they would cancel the lost check and send me a new one. But one never came. I talked with BC/BS personnel for more than 15 times and each time told its being processed , or the check is in the mail. After contacting the ************** of OPM that agency contacted BC/BS about this and a new insurance employee contacted me- from an ****** of ******** Satisfaction- and said the issue was being resolved and I would soon have a check. That was near the end of March. After more than 2 weeks of that I was told yesterday that they are still working the problem but replacing a lost check is very difficult and time consuming. Now it is nearly 90 days since they had approved my claim and nearly 60 days since I first reported it but this "difficult " problem of a lost check seems to be impossible by BC/BS to resolve. They seem to be the most incompetent, uncoordinated company with a minimal amount of concern for their customers when problems occur. For weeks and weeks and by numerous employees I have been told that the problem is being resolved and my check is on the way- but to date- April 9, 2024 I have yet to receive it or told when to expect it. Pure management incompetence at the highest level.Business response
04/09/2024
Thank you for the referral. Since 3/26/24, we have been in communication with this member regarding this issue. We will reach out to our
member and continue to address any questions or concerns.Customer response
04/10/2024
Complaint: 21552033
I am rejecting this response because: The issue has NOT been resolved. The claim has not been paid yet. This is the same response I have been getting for weeks that "the problem is being handled and the check is in the mail. "
When I receive a check for the approved claim then I would consider this issue resolved but that is NOT YET the case.
Sincerely,
***********************Business response
04/10/2024
Thank you for the referral. We will reach out to our member and address any questions
or concerns.
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Customer Complaints Summary
107 total complaints in the last 3 years.
24 complaints closed in the last 12 months.