Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:12/14/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I switched Insurance due to new employer. I called the new insurer BCBS AZ and verified I would be covered for this specialty medication that I was already on. They confirmed I would be covered. Once I switched they denied my pre-auth saying I needed to take other meds first (this didn't make sense since my provider had already exhausted these options) Next, they denied due to needing additional testing which I had already had the testing done and provided. Next they denied due to needing additionally tests that were deemed irrelevant by the specialty practitioner (infectious disease dr) who was used to clear me for acceptable use. In a separate matter, BCBS AZ suddenly changed mental health benefits stating I can no longer see my therapist that took me a long time to find due to shortages, or use the service that helps me find therapists at all. It is clear the mission of this Insurer is to deny, prevent, and delay any and all claims at the expense of the patient.

  Business Response

  Date: 12/23/2024

  On behalf of Blue Cross Blue Shield of Arizona (AZ Blue), I am responding to Better Business Bureau (BBB) Complaint ID 22687723 initiated by Joshua Shockley.
  
  We have connected Mr. Shockley with a Care Manager to assist him with locating an in-network provider, and we have addressed his medication needs as well. We cannot provide additional details due to HIPAA privacy laws, however, we have resolved Mr. Shockley's concerns.
  
  If you require additional information, please contact me.
  
  Erin Entringer
  Manager, Corporate Ombudsman
  Blue Cross Blue Shield of Arizona
  602-864-4018
  [email protected]

• Initial Complaint

  Date:12/04/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Worst company on the planet. Despite selling me a more expensive plan to guarantee my medication would be covered- they keep denying it. I deal with this every 3 months. They claim a generic is available - it literally does not exist. Their own pharmacy dept tells you that. I jump thru hoops nonstop. And continue to be without by medication, and prior auths being denied because there is a generic version that is not being manufactured, nor on the market. Not a single person has been able to explain how this makes sense to me. Will be discontinuing my membership end of year and will never be back

  Business Response

  Date: 12/12/2024

  To Whom It May Concern: 
  
  On behalf of Blue Cross Blue Shield of Arizona (AZ Blue) I am providing a response to Better Business Bureau (BBB) complaint ID 22640430 initiated by Rhonda Hoffman concerning issues with her medication. 
  
  Our medication prior authorizations department has contacted Ms. Hoffman by phone to discuss her concerns. We were unable to get through, however, a voice message was left. A phone call was also placed to her prescribing physician, and our prior authorizations department was able to provide clarification directly to Ms. Hoffman's provider. We trust the BBB understands due to HIPAA privacy laws, we cannot share more details, however, we are addressing this matter directly with our member.

  Thank you,

  Erin Entringer 
  Corporate Ombudsman
  AZ Blue

• Initial Complaint

  Date:11/07/2024

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Blue Cross and Blue Shield of Arizona inexplicably cancelled my health insurance without informing me and without reason. I did not find out until I needed to see a doctor and they checked the insurance and told me it was cancelled. There was no reason for the cancellation. There is no information on my webpage account as to why the insurance was cancelled. I had paid all my premiums. I have tried to contact Blue Cross repeatedly but have not received any response.

  Business Response

  Date: 11/14/2024

  On behalf of Blue Cross Blue Shield of Arizona (AZ Blue), I am responding to Better Business Bureau (BBB) Complaint ID # 22524351 initiated by Tessa Szmania regarding the cancellation of her coverage.

  We confirmed that multiple notices were mailed to the member prior to termination, and we do not have record of the member contacting us prior to her submitting her complaint. We called the member on 11/08/2024 to explain the cancellation of her coverage and review her options for enrollment. The member had no further questions or issues for us to address.
  

  If you require any additional information, please contact me.
  
  Brittany Reyes
  Ombudsman Service Specialist
  Blue Cross Blue Shield of Arizona
  623-273-2101
  [email protected]

• Initial Complaint

  Date:07/17/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Claims for provider repeatedly denied. When i contact bcbs they give me different reasons why claims were denied. Agents have no idea. I am emailing an agent now who gives me an entirely different reason why the claims were denied. I sent my benefit book with areas highlighted refuting her reason. She cannot assist. Agents told me to find a new provider via the bcbs tool. I did so and the bcbs tool referred me to the VERY SAME PROVIDER that they are denying claims for. Cannot get anyone in phone who knows how to help. Email is useless. Agent gave me another new reason why claims were denied. Bcbs agents are literally just guessing. My medication cannot be stopped cold turkey and apparently i cannot find an in network provider to refill them because even the providers bcbs refers me to aren’t in network preferred.

  Business Response

  Date: 07/25/2024

  On behalf of Blue Cross Blue Shield of Arizona (AZ Blue), I am responding to Better Business Bureau (BBB) Complaint ID #22002389 initiated by Janetta King concerning the difficulty she experienced when trying to locate an in-network provider and denied claims.

  Upon receipt of her complaint, we assigned this to a care manager for immediate outreach. We have made two attempts to call the member, but we have been unable to reach her. We will continue to try to get in touch with Ms. King, and we will be happy to assist with resolution once we are able to speak with her. 

  If you require any additional information, please contact me.
  
  Brittany Reyes
  Ombudsman Service Specialist
  Blue Cross Blue Shield of Arizona
  623-273-2101
  [email protected]

  
  

  Customer Answer

  Date: 07/29/2024

  I have never received any calls from the claims department. I have received calls from Danielle R in membership services and also 2 BCBS nurses.  
  

  My last communication with Danielle R was when she offered to refill my prescriptions through the BCBS pharmacy and connected me with Quartet to find a provider. Quartet matched me with THREE providers that did not accept my BCBS plan. Three.  Quartet’s entire purpose is to match patients with providers and insurance plan and they failed.  
  

  When I told Danielle R this she replied that my plan did not offer many providers of this speciality. She apparently phoned Quartet and made sure they had a provider match for me.  She assured me that the next match was in my plan. Nope. In fact the next TWO matches were not in my plan network. 
  

  Quartet had now failed five times.  I phoned each provider matched with me and they all said they were not in my plan’s network. 

  If I had not called the providers’ offices, I would currently be building up out of pocket expenses again. I day again because I have $2400 out of pocket expenses with the first doctor. 
  

  back to the claims department, my last contact with Danielle R in membership services was 7/17 and she would no longer respond to my emails. I did not have a phone number for her.   I continued to email. No reply. 
  

  Eight days later a BCBS person named Douglas W emailed me and said they forwarded my issues to the claims department. I have heard nothing else despite sending ANOTHER email to Douglas W., who also did not provide a contact number to himself  

   

  Douglas W attached a list of mental health providers in my area to that email.  That email sent on 7/24.  As you know, psychiatric meds cannot be stopped in one day  i had already informed Danielle R that I could not wait for prescriptions and that the provider whose claims were denied was slowly adjusting the meds so she was only giving me two weeks of meds at a time with no refills  So since I had not heard anything from BCBS Danielle after 7/17, I had to get with a nurse friend to help me find a provider.  By the time the email with the list of providers was sent to me, I already had found my own provider after much stress.  The fact that BCBS ignored me for eight days is unacceptable for a person in these middle of a new psychiatric diagnosis and medicine treatment that was changing every two weeks  

  BCBS still has not offered any resolutions to the denied claims from the provider that had the six claims denied.  I did not receive an EOB from BCBS for these six claims until after the fifth visit.  I decided I had to stop seeing that provider due to the cost of $355 each appointment being denied by BCBS for a total of over $2400 that I must now pay on my own after being told by BCBS that the provider was in my plan. 
  

  I do not accept BCBS’s answer and have also sent an appeal regarding the denied claims. 
  

  I am also sending a complaint regarding their partner Quartet. 

• Initial Complaint

  Date:05/01/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  The Maximum Out of Pocket I was supposed to pay last year according to my benefit plan was $3,000 and they let me over-pay $67.95 without any notification that I was owed a refund. I did not notice until I checked my account online and it showed I was owed that amount for 2023. Their system should have caught this and not allowed the claims to go over the threshold of my OOP maximum since that it was it promises via benefits contract and I should have been issued a refund check immediately once their system caught it. I am the one who had to call customer service to notify them which they agreed that I was owed a refund and said they mailed my check April 3rd (I have proof via email) which I have yet to receive. I called back today and was notified that no effort was made to actually mail my refund check. This company tried to scam me! It's almost half a year later and no refund check has been issued to me. For this I deserve interest or a refund on my premium I paid this year because this is not the service I paid for. Now, they want me to contact the provider myself for a refund once they send them a letter even after I've done all the work. It is their fault their system didn't catch it and if I wouldn't have said anything they would have stolen my money without any consequences for who knows how long. They should pay me for doing their work. 5 months later and still no refund or representative from the company reaching out regarding my refund. This company needs to be held responsible for stealing their members money and making no effort to let their customer know they are owed a refund or providing the refund in a timely manner. This company will scam you unless you are careful

  Business Response

  Date: 05/10/2024

  On behalf of Blue Cross Blue Shield of Arizona (AZ Blue), I am responding to Better Business Bureau (BBB) Complaint ID # 21654293 initiated by Brittnie Franco concerning her reimbursement check.  

  We reviewed our records and determined the cause of these issues. On 05/10/2024, an AZ Blue representative called Ms. Franco to advise on our findings and confirm check #1124878 for $64.93 was issued on 05/06/2024, and it should be received in 7-10 business days. We advised Ms. Franco no further action is needed from her and provided her a direct point of contact for any issues in the future.

  Ms. Franco indicated she was pleased with the results of our review, and upon her receipt of the reimbursement check, we will consider this matter resolved. If you require any additional information, please contact me.
  
  Brittany Reyes
  Ombudsman Service Specialist
  Blue Cross Blue Shield of Arizona
  623-273-2101
  [email protected]

  Customer Answer

  Date: 05/13/2024

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID 21654293, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
  
  Regards,
  
  Brittnie Franco
  
   
  

• Initial Complaint

  Date:01/30/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I applied for a reimbursement benefit for hearing aids on 10/26/2023 the unit price was $1599.99 which was covered under the benefits provided by my medical plan (they cover up to $2500 every 5 yrs). I received no reimbursement, contacted them in December, they said they pushed it through "expedited" and issue has not been resolved as of 01/03/2024 when claims are advertised to be done within 30 days. Member ID: R61545718 Message ID: A79BA311E2A0

  Customer Answer

  Date: 02/05/2024

  Regarding: Complaint ID: 21222466 Date Filed: 1/30/2024 I received a phone call from a representative at BCBS and they said the reimbursement will be paid in the mail 5-7 business days. I would like to close this complaint 21222466 at this time and mark it as completed satisfactorily.

• Initial Complaint

  Date:10/22/2023

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My husband and I have both elected Blue Cross Blue Shield COBRA with our former employers plans (separate employers). I elected September 8, 2023 and my husband elected on October 3, 2023. I have paid $1,541.01 (3 months of premiums) for a medical and dental plan and my husband has paid $803.53 (1.5 months) for a medical plan. To date we have not been added back to the plans by Blue Cross Blue Shield of AZ. The COBRA administrators for both plans have notified Blue Cross Blue Shield, but we have not been added. We have tried to deal with customer service but they don’t seem to understand the issue (and there is a complication of the fact I was on my husband's BCBS plan, but then sought COBRA with my former employer's plan, also a BCBS plan) and tell us that we need to have our former employers add us back to the plans. This is not our former employer’s issue. The common denominator here is Blue Cross Blue Shield. And one of the individuals I spoke with could pull me up by the group number, but then the next I talked with could not. My husband has also spoke to customer service to no avail. We still don’t have coverage and we have had to pay out of pocket for medication. My husband and I want to be added to the plans that we have paid for and get reimbursed for the prescriptions we have had to pay for out-of-pocket.

  Customer Answer

  Date: 10/30/2023

  In regards to my complaint (#20767526), it has been resolved with BCBS of AZ.

• Initial Complaint

  Date:06/26/2023

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My deductible is $7000.00l I met it a little before May 1 2023. Once it's met BCBS is suppose to cover all health care and pharmacy. I have called BCBS numerous times and they keep saying give us 48 hours to fix it. That's 2 months ago still not fixed They have not covered any of my medication. They say to pay they will reimburse me. I don't have 1200.00 for 1 med. (Yupelri) That's why I pay for insurance. So in the mean time I do without or if I'm lucky my dr gives me samples.

  Business Response

  Date: 07/07/2023

  On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to Better Business Bureau (BBB) Complaint ID # 20235417 initiated by Kandace Bortz concerning her deductible and reimbursement for medications. 

  During our review, we identified the issue with her deductible and corrected it on July 6, 2023. A BCBSAZ representative also left Ms. Bortz a voicemail to explain the issue and confirm that her deductible has been met and she has been reimbursed.

  BCBSAZ considers this matter resolved. If you have any questions, please feel free to contact me.

  Brittany Reyes
  Ombudsman Service Specialist
  Blue Cross Blue Shield of Arizona
  623-273-2101
  [email protected]

  Customer Answer

  Date: 07/10/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID 20235417, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
  
  Regards,
  
  Kandace Bortz
  
   
  

• Initial Complaint

  Date:05/08/2023

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  BCBS of Arizona is the worst company to work with. They are constantly throwing EOBS out when received with claim forms stating the EOB was never sent. When you call they say the same thing then will look back and see the EOB. Next, they either don’t forward medical claims to sub insurance companies such as ameriben then say it’s up to us when they’re the middle man. Don’t be the middle man if you’re going to let claims go unpaid for months. They ask for a call back number but hang up and then never call back. This company is absolutely horrible and is the worst insurance plan a person could have! Nothing is ever routed to high ups either!

  Business Response

  Date: 05/15/2023

  On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to Better Business Bureau (BBB) Complaint ID # 20034023 initiated by ******** ****** concerning various service concerns she has experienced.
  
  A BCBSAZ representative reached out to Ms. ****** directly on May 10, 2023 to discuss her concerns and provide information on how to bill certain types of claims. Ms. ****** was provided with the contact information for her assigned BCBSAZ Provider Liaison, as well as the phone number to our ESolutions department for assistance with the web portal.
  
  We consider this matter resolved. If you require any additional information, please contact me.
  
  **** *********
  Manager, Corporate Ombudsman
  602-864-4018
  [email protected]
  
  (Please note, we received this complaint on May 9, 2023 indicating a due date of 10 calendar days from receipt. We understood the due date for our response to be May 19, 2023, however, we received a “past-due” notice on May 14, 2023.)
  

• Initial Complaint

  Date:02/21/2023

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In December 2022, I logged on to the BCBS site to pay my monthly bill. For some reason the Pay option was not available. After numerous attempts of phoning them, finally was told my policy had been cancelled. To find out why they transferred me to another number which the wait time was 79 minutes. Leaving my phone number for a call back, they never called me back. Tried the same thing the following day, but they never called me back. Therefore, I got a new Dental policy from another company and gave up on BCBS. This month I received a statement from them. Tried calling them back to explain that I wanted to cancel this policy and why. Several times, I was transferred until finally, "We are experiencing technical difficulties, try again later." Then they hung up. This type of service is not acceptable.

  Business Response

  Date: 02/28/2023

  To Whom It May Concern:
  
  On behalf of Blue Cross Blue Shield of Arizona, Inc. (BCBSAZ), I am responding to Better Business Bureau (BBB) Complaint ID 19441161 initiated by Sid McClellan concerning the difficulty he experienced with his dental policy.
  
  We regret the frustration Mr. McClelland experienced, and we understand Mr. McClelland intends to terminate his dental policy. We have terminated Mr. McClelland’s policy as requested, and we consider this matter to be resolved. If you require any additional information, please contact me.
  
  Thank you,
  **** *********
  Corporate Ombudsman
  Blue Cross Blue Shield of Arizona, Inc.
  (602) 864-4018
  [email protected]
  
  P.S. - Please note – we received this inquiry on February 21, 2023 indicating a response due within 10 calendar days. We understood our response to be due by March 3, 2023, however, we received a past-due notice on Sunday, February 26, 2023. We trust the BBB will consider our response to be timely, as indicated by the initial response due date. Thank you.