ComplaintsforBlue Cross and Blue Shield of North Carolina
Health Insurance
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Complaint Details
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Initial Complaint
02/23/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
Im a provider for BCBS. Im a LCMHC. BCBS made an error on their side with my NPI and all my claims have been denied saying that Im out of network, when in fact Im not out of net work. This happened in December and to this date still has not been resolved. We filed a complaint with them in January and they told me 10 days until this was resolved. We call each Wednesday and each week they tell me its not resolved but will be in the next 10 days and each week its not resolved. When I ask to talk to a supervisor Im denied. Currently my family is hitting financial crisis but their lack of follow through. Im still providing services but they are not fixing the problem they continue to tell me will be fixed within 10 days. I will also be filing a complaint with *****. It really upsets be it takes going these routes to fins resolve.My reference number is 1-29185876721 Intake number-***** NPI number-**********Business response
02/24/2022
BlueCross ** will contact the complainant directly regarding their concerns.Customer response
02/28/2022
Today is day 5 since BCBS's response and I have not yet received a phone call from them nor has this issue been resolved. On Wednesday, which is in 2 days from now I will be calling BCBS again to check to see the status of this problem. This issue will not be considered resolved until BCBS calls me as they said they were going to do and fixes my NPI. Im hoping Wednesday morning when I call in that someone tells me this issue has been fixed.Business response
02/28/2022
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
02/02/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have applied for the BCBS health plan one month ago, and I have paid my first monthly premium online right away. I checked my credit card account, this transaction has been completed. But I kept receiving those emails to remind me to pay the due otherwise I may lose my coverage. I called their customer service of billing and payment department many times, every time the agent told me, "no worries, they have already received my payment, everything looks good, just disregard the emails I have received". I have received the last email on the date that two days before my policy should be effective, said " my policy has been finalized because I didn't pay the initial payment". What's wrong with that? I called them again, the agent asked me so many questions and didn't give any solution in the end. I have already scheduled an appointment with my doc, I need to fix this problem ASAP.Business response
02/23/2022
Business Response /* (1000, 7, 2022/02/14) */ Blue Cross NC has been in communication with Ms.***, and we confirmed for her on 02/03/2022 her individual policy became effective on 02/01/2022 per her request. Ms.*** was advised multiple applications were submitted, and multiple policies were assigned. The additional applications/policies have been voided, and Ms.*** has been advised the requests for payment were triggered from multiple applications.Initial Complaint
01/31/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have been denied 2022 health insurance. I was late paying my Dec 2021 bill. I paid it on the last day possible. I paid online where the system required me to pay Dec 2021 and Jan 2022 for a total of $2067. I called the Marketplace afterward to make sure I had coverage and was told I had a policy in place. I called Blue Cross three separate days to make sure the policy was in place for 2022. Each time I was told that it was re-enrollment time and that it was very busy and they were waiting for the money to clear. At no time was I told my policy had been terminated for late payment. I checked my bank next and found that the $2000.00 I paid had been transferred to Blue Cross on 1/6/22. Later that day I received my insurance card for 2022 in the mail. To the best of my knowledge, I was covered for 2022. This all occurred before the 1/15/22 deadline for open enrollment. If I had known BCBS was denying me coverage or had terminated my coverage I would have called the marketplace and bought coverage.I have taken this as far as I can with Blue Cross and admitting a computer error or malfunction is not within anyone's ability to admit and provide me coverage. I have terminal brain cancer and am currently being deprived of life-sustaining medication and treatments. This issue is of the utmost urgency to me. I believe my health status is an issue for the lack of reinstatement of my policy by BCBS. I am disgusted with my treatment and every BCBS employee I spoke to refused to identify any higher level of management I could speak to, write to or appeal my case. The last customer service supervisor even hung up on me when I asked about an appeal. In addition, BCBS has not made any attempt to return my $2000 which I could be using to purchase medication or pay for doctor's visits. My last 2 hour phone call (wait on-hold marathon) with the company had them stating that it could be up to 30 days from 1/27/22 until I saw a paper check.Business response
01/31/2022
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
01/27/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I am actually writing on behalf of my mother ***************************** who had a ******** supplement policy thru the **************** ID # **********. I paid her August premium. She died August 6, 2021. A refund was due of $260.69. I received check # ********** dated 10/14/21 issued to her estate. I did not establish an estate for her because she had nothing. I called BCBS on 10/29/21 to request that they reissue the check to the clerk of court here in Catawba County and gave them the address. I was told they could do nothing until the check was a month old. I called back on 11/15/21 and was told they would reissue and put a rush on it. To date the Clerk of Court has not received the check. I waited until January 25 to call them because I realize the process takes time and I had surgery in the meantime and was in recovery. I have spent an hour + on the phone with BCBS on January 25 being passed from number to number some of which only played music for an unbelievable amount of time each time being assured that I was being connected to the person that could help me. I feel that they are hoping I will give up and even though 3 different people have told me the issue would be resolved nothing is happening.Each time I have called, the person I talk to assured me the issue would be resolved. I have asked to speak to supervisors to no avail.I will appreciate any help you can give me. Thank you.************************* ************ *********************Business response
02/01/2022
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
01/26/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I spoke to them about a rebate check issued for North Carolina. They told me they would mail me the check to my Virginia address. I still have not received the rebate check.Business response
01/26/2022
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
01/21/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My name is **************************** Blue Cross Blueshield ID# **************. I need to cancel my BCBSNC policy. I have been unable to do so. They will not let me cancel on line. Although I have attempted to call many many times no one ever picks up the phone. Two years ago this month my previous employer placed me on an Aetna PPO plan. My plan with BCBSNC PPO should have been immediately canceled but BCBSNC continues to extract $232.50 from my checking account for the past two years. Obviously I am retired and on a fixed income and this money is important to me. Can you please help me to cancel my plan and attempt to obtain reimbursement for the money they continue to take from my checking account. Since they will not allow me to cancel my policy on line and tell me to call a number where no one ever picks up I am in a real dilemma. Please do not tell me to keep calling because this does not work and I need to change this situation immediately. Thank you.Business response
01/24/2022
Blue Cross ** will contact the complainant directly regarding their concerns.Customer response
01/28/2022
Please do not close this case yet since the issue remains unresolved and I feel I am facing the same problems that I have continually had with this provider. A representative from Blue Cross Blue Shield called and left a message saying that it may takes "months" to close my case. Also an Email asking when was the best time to call. Which I responded to. She has not called and my attempts to call her only gets her voice mail. I really do not know why what was once a reputable company responds in this manner. I feel that as a senior citizen BCBS should act more responsibly in helping me with this problem since they are accessing money that I require for other bills.Business response
02/01/2022
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
01/18/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
They owe me refund checks for dental service I've already paid for. I've contacted them to change my mailing address, which they say they changed. The checks never arrive, so I've call back to inquire and the address was never changed. This ongoing cycle has repeated itself since 2019. However, the bills arrive so their mailing system does work, just not when they owe me money!Business response
01/18/2022
Business Response /* (1000, 5, 2022/01/18) */ Thank you for the referral. We will reach out to our member and address any questions or concerns. Consumer Response /* (3000, 12, 2022/02/11) */ Hi, BCBS representative ***************** has emailed me about this and I have responded to her, but now she is unresponsive and the issue has not been resolved. Can you please assist? Thank you! Business Response /* (4000, 14, 2022/02/11) */ Thank you for the referral. We will reach out to our member and address any questions or concerns. I have Left Multiple VMs for Mr. ********** to contact me back.Initial Complaint
01/16/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
We have been paying premiums for Health Care Coverage via Blue Cross Blue Shield of North Carolina since December of this year. The payments go to the ***** Provider Flores 24/7 to a representative named ***** ***** who can be reached at ************. My husband is to have Health, Dental and Vision Coverage and I am to have Dental coverage. The company has messed up the coverage and as a result we only have Vision coverage for my husband. The company will not respond to emergency reinstatement requests sent by ***** *****, they will not respond to our emails and there is no one on their help desk that I can directly contact to get this matter fixed. This has been going on since the 20th of December, my husband needs to go to the doctor and despite paying over $800 for coverage we have none. If necessary I can send copies of emails sent. I will just now send a copy of my husbands current coverage.Business response
01/20/2022
Blue Cross NC has been in contact with our member. We have identified the error made by an external vendor, and the issue has been corrected and resolved.Customer response
01/21/2022
I am so thankful for your resolution of this issue. The BBB is such a wonderful resource. Prior to your involvement I spent weeks trying to contact them and the ***** vendor to fix the issue to no avail. The BBB is wonderful! Thank you so much!Customer response
08/03/2022
Complaint: ********
I am rejecting this response because:My husband had ***** Coverage that was managed by Flores 24*7 through Blue Cross Blue Shield. He got a job with insurance in April so we cancelled the coverage for our family. I just received a letter than our coverage was cancelled as of July due to non-payment. We cancelled it in April, I have the evidence of the cancellation and I am afraid we will be turned over to a collection agency due to their incompetence. This is the second time I have reached out to BBB with the same two companies as we spent the first two months of our insurance paying for health, dental and vision and only receiving vision until you resolved this. I reached out to a contact at BCBS on Monday and did not hear back.
Sincerely,
******* ******Business response
08/05/2022
Thank you for the referral. We have made outreach to our member to address all questions and concerns. We are providing our member with support and assistance with the resolution of their concerns as it relates to the reasoning for the end of coverage on their certificate of credible coverage.Customer response
08/05/2022
Complaint: 1*******
I am rejecting this response because:
Other than getting an email on Wednesday that they would look into it I have not been told that they resolved my issue. The issue is that I am afraid they will harm our credit rating claiming that our policy was cancelled due to non-payment when in fact we voluntarily cancelled it in April when my husband got a new job. That is on the records that I sent to BBB>
Sincerely,
******* ******Initial Complaint
01/13/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My ******** doctor ordered hormonal testing which was conducted by ******************, Inc. in **************, on September 28, 2021. Blue Cross requested additional documentation from my doctor and subsequently acknowledged receipt of it. At the time of service, I had paid met my maximum payments for 2021 and was not responsible for any further medical payments of any type for the remainder of 2021. I have spoken with a number of Blue Cross reps regarding my claim for reimbursement for my payment to ****** in the amount of $165, and an additional $175 that ****** is requesting. Each of these reps tells me a different story each time, even acknowledging their errors in date and claims processing. I am now being ignored, and am requesting assistance in receiving my reimbursement and payment to ******, as described above. Thank you.Business response
01/14/2022
Business Response /* (1000, 5, 2022/01/14) */ BlueCross NC will contact the complainant directly regarding their concerns. Consumer Response /* (3000, 7, 2022/01/21) */ I was thankful to have finally received communication from Blue Cross Blue Shield of North Carolina, but the complaint is still not resolved. Their requirements and responses are moving targets. I hope that with this communication, it will be resolved without further unnecessary delay. Their antiquated processing and communication systems are unacceptable. Business Response /* (4000, 9, 2022/01/21) */ We have made contact with the member and presently working on a resolution. More Information from Consumer:I do not know why you chose to close this as "assumed satisfied." It is still outstanding. I understand that you cannot/will not take any further action, but I do not agree with this closed status. We cannot assume that it will be satisfied or resolved.Initial Complaint
12/28/2021
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
I have been a Blue Cross Blue Shield of ** personal (family) policy holder since 2012 with auto draft premium payments and multiple rate increases (over 300% of original cost since inception). I received a letter dated 11/30/21 saying that my coverage "ended or was canceled as of 11/30/2021 due to subscriber moving out of the area". We have not moved. We did change our mailing address back in spring of 2021. We as a family of four have had no insurance coverage since 11/30/21 and have had to pay out of pocket and / or postpone health care and prescriptions while we await resolution. We have called three times attempting to resolve this issue. Once on 12/15/21; once on 12/21/21 and once on 12/27/21. During the first two inquiries we were told this was an internal error and the case (original BCBSNC Case **********) would be marked urgent and resolved with coverage reinstated within 24-28 hours. This did not occur. On 12/27/21, I have been told that the previous customer service rep had entered a request to cancel the policy inadvertently on 12/15/21 - not sure how this could have been done as the policy had already been canceled on 11/30/21 according to the letter. I was given a new case number (********) and was told that reinstatement would now take 7-10 business days. I asked repeatedly for an explanation as to why it was actually canceled (still no reason given) and why it would now take 7-10 additional business days when we were told 24-48 hours twice before. I was told this was communicated by supervisor. I asked repeatedly to speak with said supervisor and / or to be given their name and employee ID. I was refused this information and was told at one point that to get the supervisor name, I would need to hang up, call back the same number, provide the same reference number and someone would give me that information. I asked why they couldn't give it to me on the existing call and was then placed on eternal hold (2hours +)Business response
01/07/2022
Business Response /* (1000, 5, 2021/12/28) */ BlueCross NC will contact the complainant directly regarding their concerns. Consumer Response /* (3000, 7, 2021/12/28) */ I have been contacted by BCBS directly and the matter has been resolved satisfactorily. Thank you
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Contact Information
Customer Complaints Summary
107 total complaints in the last 3 years.
24 complaints closed in the last 12 months.