ComplaintsforAnthem Blue Cross And Blue Shield

• Initial Complaint

  01/10/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  We provided our elections and ********* premium to Anthem and still, on January 10th, do not have active health insurance.

  Business response

  01/21/2022

  Dear **************,
  
   
  
  Your recent correspondence sent to the Colorado Better Business Bureau, has been forwarded to me for research and response. 
  
   
  
  In researching your concerns with the information you provided, Anthem Blue Cross and Blue Shield of Colorado checked our online application system, paper applications, our Telesales, Health Plan Advisors records, and our group enrollment system.  We did not see anything that has been received for you.  However, the way you stated that you made your elections may indicate that you were electing coverage through an employer or possibly through Connect for Health Colorado (Exchange).  In which case, both of these entities would need to transmit your enrollment information to Anthem in order for Anthem to enroll you. 
  
   
  
  In addition, Anthem Blue Cross Blue Shield has offices is several different states.  If you enrolled in an Anthem Blue Cross Blue Shield plan through another state, you would need to contact that states Anthem Blue Cross Blue Shield office for further information on your enrollment.
  
   
  
  Thank you for bringing your issue to our attention. If you would like to provide additional information regarding this issue, we would be happy to do further research for you.
  
   
  
  Sincerely,
  
   
  
  **************
  
  Risk Analyst, Grievance and Appeals Risk Unit
  
  Regulatory Services  
  
   

• Initial Complaint

  10/04/2021

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I have a client with CIGNA and Blue Cross Blue Shield insurance. I am a BCBS provider but NOT a CIGNA provider. In order for BCBS to consider my claims, I have to send the denial from CIGNA attached to my claims. I have done this monthly since May 2021. Fewer than 1/4 of my submissions have been processed. The claims have to be sent to and inputted by Denver and then Mass BCBS pays them. Denver is not inputting my rejections from CIGNA, which means my claims cannot be processed by the Mass office. At this point I have called customer service for BCBS Denver multiple times, asked to be transferred to an on shore person; reached out to my provider relations person in Denver (he ignored my last three emails); called Mass BCBS multiple times; have called other branches of BCBS hoping to be transferred to a human in the US; my client has called multiple times. We have gotten nowhere. My claims keep going into a black hole. I want a human in Denver contact me and figure a solution.

  Business response

  11/09/2021

  Better Business Complaint #********

  
  Dear Ms. ***,

  
  I would like to apologize for the inconvenience and lack of response you have experienced previously in your efforts to resolve this matter. 

  
  Your issues have been reviewed by our Provider Contracting department, they are aware of this issue you have had in getting your claims processed in an expeditious manner, and will address your concerns appropriately.

  
  Upon receipt of your complaint, we were able to locate the information on the following claims, and they have been processed in our system.  You will be receiving Explanation of Benefits (EOB) notices within the next fourteen (14) business days on the following claims:

  
  Date of Service

  
  04/23/21
  12/08/20 – 12/16/20
  11/30/20
  11/03/20-11/24/20
  08/20/20-08/31/20

  
  The following claim paid on 09/27/21

  
  01/07/21-01/28/21

  
  The following claim is missing the EOB information from Cigna; please resubmit this claim with the Cigna information:

  
  12/30/20

  
  Thank you for bringing your concerns to our attention, it is through this type of input that we can accomplish Anthem’s mission, and improve the service levels for our members and providers.

  
  Sincerely,

  
  ***** ** **** Analyst, Grievances & Appeals Risk Unit
  Regulatory Services
  *** ******** ****** ** *****    
  

  
  

  Customer response

  11/11/2021

  
  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,
  
  ******* ***

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