ComplaintsforHMO Colorado, Inc. c/o Blue Cross Blue Shield

• Initial Complaint

  01/18/2024

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Unanswered

  More info

  In June 2023 I was seeking a Mental Health professional. I logged into my insurance portal, Anthem BCBS, and found someone that was in my network. Started seeing her till Nov 2023. I got a couple emails saying I had bills due from the therapist office so i logged into their portal to see all my claims were denied by my insurance. I tried contact Anthem several times to see what the problem was bc i was supposing be 100% covered. Once finally spoke to someone they said my provider was not actually in my network. I double checked the providers name and NPI with the *********** portal and it says she is in my network. I spoke with another person from BCBS who basically said oops, our bad that their website says my provider is in network bc shes really not. They said they will take her off the website which they havent and now i have a $1500 bill from therapy i cant afford. The whole reason. i got on their care portal was to find a provider who was in network bc my therapy is supposed to be 100% covered.

• Initial Complaint

  09/07/2022

  Complaint Type:

  Order Issues

  Status:

  Unanswered

  More info

  I am currently in the hospital and BCBS is refusing to provide me with services for a life-threatening medical conditionI have spoken to numerous managers, representatives and supervisorsthey continue to transfer me to different people with no results or care for the fact that I am in the hospitalI was told that someone named **************** would call me but I never heard back BCBS is paid $800 + per month for my policy but are refusing services requested by a MD and it has been deemed unsafe for me to return home.

• Initial Complaint

  06/30/2022

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  1) Date of the transaction: various dates 8/27/2021, 11/29/2021, 12/30/2021, 1/31/2022. 2) Amount dispute: $2,522.52 3) Nature of the dispute: I went to ****************** for prenatal visits on those various dates mentioned above for my pregnancy. My health insurance membership is with Anthem Blue Cross Blue Shield of Colorado ("BCBSCO"). The group number is 196037M001 and identification number FLW216A80128.BCBS terminated ****************** as an in-network provider for their PPO members in late November 2021. However, ****************** informed me that because I was already pregnant, I would be accepted by BCBSCO under the "Continuity of Care" to receive in-network services provided by ******************, based on their experience with similar patients who also have health insurance with BCBS and who were accepted under the "Continuity of Care" program which covers on-going treatment such as pregnancy or cancer treatment. ****************** gave me the "Continuity of Care" form to fill out with BCBS. I filled it out and submitted the form to BCBS in November 2021. At the end of February 2022 when I was about 36th week pregnant, I received a letter from BCBS denying my request for in-network service with ******************. As a result of this denial, BCBS didn't cover the **** from ******************. ****************** now asks me to pay this **** of $2,522.52. I spoke with ****************** about the situation. ****************** and I believed that because I was very far along with my pregnancy, my "Continuity of Care" request should have been accepted by BCBS, similar to other patients.As such, I am filing this complaint to request that this **** of $2,522.52 be treated as in-network patient and covered/paid by BCBS as in-network patient.

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