ComplaintsforRegence Blue Shield of Idaho

• Initial Complaint

  07/09/2024

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  Good day,My daughter, was taken to the **** emergency department last March 15, 2024. It was a very stressful period for our family. My daughter ******************** is covered under my health insurance with Regence under policy ID # **********. I coordinated with Regence right after I got the bill from **** with guarantor ID:4328333 in the amount of $9,880.04 regarding payment to the hospital. I told the representative from Regence that my daughter and all of my children do not have medical coverage from Aetna anymore. According to Regence, they will coordinate benefit coverage with Aetna since my children were previously covered under my husband's medical insurance. There is another claim from **** under my son's name *************************** with guarantor ID:4329351 in the amount of $1,032.30 and this bill has not been paid either. I gave Regence more than three months for them to process these two claims and yet no payment has been done. I have called Regence @ PEBB member line # ************** on several occasions but until now this issue has not been resolved. These two above mentioned claims have been past due and I am so worried that **** will send these to a collection agency which in turn will ruin my credit. Regence has been my medical insurance for several years and I have been paying my monthly premiums which is deducted automatically from my salary. This is not fair to me and my children that we have insurance coverage and yet Regence is not taking responsibility for it. Regence has to pay all these claims as my children are covered under my insurance. Kindly help me resolve this issue as soon as possible before my account goes to collection.Thank you very much.Sincerely,*****************************

• Initial Complaint

  04/28/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I was told by my healthcare provider (Regence Blue Shield) that preventative care and screening were covered before the deductible for my plan, and that I would merely have to pay a small percentage of coinsurance (rather than the whole sum). This is specified in the documentation attached. I have gone to a doctor one time in the last twelve months for a routine screening (screening is listed as a form of preventative care section in the attached document) and to discuss treatment for my allergies. They charged me in full for the visit, claiming it was an 'outpatient consultation'.Two years of having this plan and they have not helped me with *any* bills, preventative screening or otherwise. I filed an appeal with them and am filing a complaint with you as I am fairly certain this is blatant abuse and a widespread practice where they advertise and contractually promise to cover "preventative care", but in practice they do not. Have half a mind to investigate further and stage a class action lawsuit. *************************** once said *************** companies believe that they are solely in the business of collecting premiums, and forget that they are in the business of providing insurance." This seems precisely true of Regence.When I see a doctor for routine preventative care or a general physical exam they ignore their contractual obligation and bill me in full. Listing 'Finish the Job' as desired settlement as it is their job to pay their contractually obligated portion of the bill.

• Initial Complaint

  03/20/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  ON 01/25/24 I purchased my second pair of hearing aids from ******. As I did 5/6 years ago I sent my claim to my Blue Cross Blue Shield Ins. This is my second pair which my insurance paid for before. I did not hear for some times, I went on their website and learned my clam had been denied because it had been sent to the wrong office. No mention was made of PRE-AUTHORIZATION. I have a hearing loss, I waited the 5 year requirement between hearing aids, the policy covers hearing aid up to $2200, I was not notified of the pre-authorization, in fact I have not received one letter for ** BS since I bought my aids. ****** was not aware of the need of pre-authorization. I called ** BS in early March and learned this time my claim was denied since I did not get pre-authorization. I also heard this new requirement just went into effect recently. I'm out $ *******, and I pay about $800 a month for my insurance, it's just not right.

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