ComplaintsforFEP BlueVision

• Initial Complaint

  01/24/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Re: FEP vision benefits 2024 Dear Mr. ****** I am having issues with receiving my entitled 2024 benefits for my contacts. I have contacted the supervisor Keira S**** for assistance. The issue remains unresolved and affects my vision health. I have been working on this issue for the entire month of January. I ask that the matter is escalated. Thank you, ***** ******

  Business response

  02/03/2024

  Member ****** was advised that there was some technical difficulties with member utilizing their benefit for the 2024 year. Since member was notified of the technical difficulties, the issue was escalated to our Tech Support team to research and resolve this internal issue.  We have remained in communication with member ****** by providing updates to the resolution to this issue. 
  As of 2/2/2024, all issues have been resolved. The member was contacted on 2/2/2024 to inform them that all issues surrounding their complaint has been fully resolved. Member has confirmed that they were successful at utilizing their 2024 benefit with no issues.
  We greatly apologize for the inconvenience in the delay in use of the 2024 Benefit as this was an one off and isolated incident. We appreciate Member ******'s patience and understanding as we worked to remedy this issue. 

• Initial Complaint

  12/08/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On December 1, 2023, I had an eye exam and purchased lenses through my **** ***** FEP Vision Benefits at ***** ****** (**). Prior to making my appointment, I did my due diligence and confirmed ** was one of the accepted providers. They are and in fact, they are a preferred provider. As an extra measure of precaution, I confirmed the Doctor of Optometry, Dr. Kristy W***** at ** was also an in-network provider. When I arrived at my appointment, I was advised by ** they could process my lenses under my insurance however I would have to directly submit a claim to **** ***** directly for the exam. My benefits cover a yearly exam, so I was not worried about getting reimbursement. However, once I contacted **** *****, I was told that I needed to seek reimbursement from **, and they needed to file the claim. I went back to **, and they advised that they could not process reimbursement because Dr. W***** is not credentialed with **** **** Again, I called **** ***** and they disagreed with **** assessment and again told me that if I wanted reimbursement, it would need to come from **. This back and forth went on a couple times (emails attached) and **** ***** finally landed on Dr. W***** needing to be removed from the website, but I was still out of luck for the cost of my exam. I was also told that if I wanted to file a claim with **** *****, it would have to be an out of network claim and I would only get a fraction of the exam cost. I’m at a loss for words. I did everything that I was supposed to do for **** *****, and I still was punished. I sought out the in-network provider; I sought out the in-network doctor and I’m still out of pocket because now to **** ***** says the doctor is out of network. While I will say that the representatives, I spoke with at **** ***** were incredibly kind, their hands were tied and couldn’t offer me anything more than an apology. I’m seeking a rightful reimbursement of $160 for an eye exam that is covered through my annual insurance.

  Business response

  01/23/2024

  We have carefully reviewed the member’s complaint. We found that the provider mentioned, Kristy W*****, OD, is a participating provider with **** ***** **** ****** FEP Vision. Accordingly, we have determined his benefits should have been applied at the time of service. Because of this determination, a check for $160 has been processed and was mailed to the address we have on file for the member on 1/22/2024. 

  Customer response

  01/29/2024

  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.   Regards, ******* *******

• Initial Complaint

  07/20/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I signed up with FEP vision in January and I checked to make sure my eye doctor was in network. I took my son to his appointment on July 11 and was told they were not in network. I paid for the visit and glasses. I went on the FEP website and it still showed my doctors office as in network. I called FEP and was told they hadn't been removed from the website. I asked if I had any recourse because I had done my due diligence in ensuring my eye doctor was in network by using their website and I was told I had no recourse. I have to pay out of pocket for my son's appointment and eyeglasses along with keeping an Insurance for the rest of the year that isn't any good for me to use with my doctor even though I did everything that I should have done before signing up.

  Business response

  07/28/2023

  This is in response to ******* ****’s complaint regarding the provider she took her son ****** to on July 11th, 2023. I will respond to the member’s points one by one:
  •The call that took place between member ******* **** and a BCBS FEP Vision representative on 7/20/23 was reviewed.
  •The member stated on the call, that she took her son ***** ****, to a provider that was listed on the BCBS FEP Vision in-network provider listing. 
  •The member stated on the call that the provider did inform her that their office is no longer in-network with BCBS FEP Vision.
  •Despite the provider confirming that they were not In-Network with BCBS FEP Vision, the member proceeded with the appointment. The member paid out-of-pocket and submitted an out-of-network claim to BCBS FEP Vision for reimbursement of *****’s eye exam. The member received the maximum $30 reimbursement for out-of-network eye exams.
  •Further research was performed to verify that the provider termed with BCBS FEP Vision as of 7/4/23 which was before ***** ****’s exam on 7/11/23. Please make note that when the member signed up for the BCBS FEP vision plan, the provider was In-Network.
  •A request to have the provider removed from the in-network listing has been submitted to the appropriate department. 
  •Currently, any further reimbursement for the remaining cost of ***** ****’s eye exam is denied.
  •The member may follow the appeal process if deemed necessary. 
  Thank you for your inquiry.
  Sincerely,
  Sarah B****
  
  

• Initial Complaint

  01/09/2023

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  I am a federal employee and customer of ***** Vision under FEP BlueVision PPO standard (FEDVIP). During open season for benefits (Nov 14-Dec 12, 22) I reviewed my current plan including the approved providers list via the BENEFEDS portal. Once I confirmed my optometrist was still listed as in-network, I decided to keep FEP BlueVision/***** Vision standard as my elected vision insurance as I have been satisfied with their coverage to this point. On 3 Jan 23, I contacted my optometrist' office (***** *** ****, Chardon, OH) to schedule an eye exam for my wife and I at which time the provider advised they were no longer in network with *****, they knew they were still showing up on the approved provider list and I was one of multiple customers they have had to advise of this erroneous listing. NOTE: as a standard plan customer there is zero out of network coverage. If I want to see my preferred optometrist any longer I must either change my plan or pay 100% out of pocket. I called BENEFEDS and was told there is no exception (OPM policy) to allow an out of open season switch for such an issue. Furthermore, the BENEFEDS rep advised they publish the provider list exactly as furnished to them by ***** Vision. If a provider was no longer covered, ***** should have updated the listing. This brings the following questions to mind: Why has ***** Vision not provided an updated listing to BENEFEDS? When did ***** *** **** cease to be a newtork provider? How long does it take for ***** Vision to update their provder list? Some lag in processing such an update is understandable, but given the timing of the year, this delay has now locked me in to a plan I do not want and forced me to find another optometrist which I have no desire to do, otherwise spend quite a bit out of pocket while still paying for insurance I will not utilize for the entire year. Effectively, ***** VIsion has fraudulently represented themselves to lock in guaranteed revenue for the next year

  Business response

  01/27/2023

  Dear ******* ********,This is regarding your recent inquiry to the Better Business Bureau (BBB). Since **** ***** **** ****** FEP Vision is not the organization responsible for receiving premium payments for **** ***** **** ****** FEP Vision members, we are not able to offer any reimbursement of the premiums you have paid thus far. However, due to the circumstances surrounding your inquiry, we would like to offer you a reimbursement of your next visit at the in-network rate for services received at a visit to ***** * ******* Eye Care LLC this benefit year. When you visit this provider, please have them prepare an itemized receipt and email this receipt to *****************************. Please include your name and **** FEP Vision ID number in the subject line as well as “ATTENTION: Barbara A****”. When I receive this documentation, I will have it processed so that your out-of-pocket amount is equal to that of a member receiving the same services at an in-network provider.I have also contacted our Provider Relations team to further investigate the Provider’s In-Network termination. We apologize for the inconvenience that this matter has caused and are willing to do whatever in our power to make this right.  Please contact me directly at ###-###-#### if you have any questions. I am typically available between 8:00 AM and 4:30 PM Eastern Time on weekdays.Sincerely,Barbara A****, FEP PCSA###-###-####8** ******** ******* ***** ***** ************* ** *****

• Initial Complaint

  01/06/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  10/16/2021 - IS DATE OF SERVICE My EOB states I am responsible for 60.80 yet I was charged nearly 90 dollars by Lenscrafters. I would like BCBS assistance in obtaining my refund from Lenscrfters. Lenscrafters over charged me.

  Business response

  01/10/2022

  Dear Ms. *******,

  
  This is regarding your complaint to the Better Business Bureau.  Your complaint has been forwarded to Blue Cross Blue Shield FEP Vision.  I am happy to assist you with resolving this issue.

  
  I had your inquiry reviewed by a member of our management team with the request that we issue you a payment for $26.65 to reimburse you for the expense in question.  The management team member concurred with me. She has agreed to allow this payment as a one-time courtesy. Consequently, a check for $26.65 will be processed this week and mailed to the address we have on file for you on 1/17/2021.

  
  If you have any further questions or concerns about this situation, please feel free to telephone me directly at (508) 591-5359.  I am available between 8:00 AM and 4:30 PM Eastern Time on weekdays.   I would be delighted to speak with you!
  
  Thank you for being a Blue Cross Blue Shield FEP Vision member.
  
  Sincerely,
  Barb A****
  BCBS FEP Vision

• Initial Complaint

  12/31/2021

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On 10/13 I had an eye appt for medically necessary contact lenses. Upon my initial visit the provider sent fep a pre auth for my contact lenses. The total cost is in the neighborhood of $650. Generally a pre auth takes 24-72 hrs. After nearly 3 wks of waiting for the pre auth to clear without avail, I paid everything out of pocket with the understanding I would be reimbursed once I had submitted all proper paperwork. All paperwork was submitted in a timely fashion. After numerous phone calls and emails back and forth a resolution still has not been made and I still am without my $650 that was supposed to be reimbursed. It has now been a little over two and a half months and the issue still has not been resolved. Please help!!!

  Business response

  01/05/2022

  This is in regard to your recent complaint to the Better Business Bureau (BBB).A check for $255 was processed on 1/3/2022, and the check was forwarded to the address we have on file for you on that same day.  A member of our supervisory staff attempted to telephone you on 1/4/2022 to discuss this inquiry and left a message for you to return her call.  As of yet, she has not received a callback.If you have any questions, please feel free to contact us.  Sincerely,Barbara A****Blue Cross Blue Shield FEP Vision    

  Business response

  01/07/2022

  Dear Mr. *******:We apologize for the ongoing inconvenience this has caused. We seek to provide a satisfactory resolution and have further reviewed the details of this challenge. We will have an additional check issued to you for $375.88.  When added to the $255 we issued previously, it will reimburse you in full ($630.88) for the expenses you incurred for your medically necessary contact lenses.  This check will be available next week and will be overnighted to you.If you have any further questions or concerns about this situation, please feel free to telephone me directly at ###-###-####.  I am available between 8:00 AM and 4:30 PM Eastern Time on weekdays.   I would be delighted to speak with you.Thank you for being a Blue Cross Blue Shield FEP Vision member.Sincerely,Barb A****BCBS FEP Vision

  Customer response

  01/07/2022

  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.  Regards, ***** ******* Thank you very much.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩