ComplaintsforBlue Cross of Idaho Health Service, Inc.

• Initial Complaint

  06/20/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  As I stated below I went to the hospital via ambulance which is automatically under in network. Blue Cross refuses to acknowledge that and has not paid accordingly. We have made many many phone calls and sent two grievances and the first one they paid no attention to and the second they still want a month to resolve.....what.....it is black and white, it was an emergency! We have paid some of the bills and have asked for the differential to be put toward the $5,000 deducible.Thank you for your help!

  

  Business response

  07/01/2024

  Please see the attached document responding to Complaint Management: ID #********, submitted to Blue Cross of Idaho on June 21, 2024.

  If you have any questions, please let us know. 

  Thank you. 

  Customer response

  07/01/2024

   
  Complaint: 21879691
  
  I am rejecting this response because:  blue cross reviewed the in and out of network which most charges were out of network.  When I asked the supervisor about it she sent me the updated statement which still showed everything out of network.  All their paperwork states that if it is an emergency it is automatically in netowork.  The supervisor also stated that all the tests and scans were experimental and not covered, which is not the case!
  
  Sincerely,
  
  *************************

• Initial Complaint

  01/22/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I called 12/14/23 to cancel insurance starting 1/1/2024. I was told not to worry and they would NOT charge the new premium at the end of the month. Then, on 12/30/2023, my account was charged anyway. I called on 1/2/24 to request a refund and after 46 minutes on the phone was assured Id receive a check in ***** days. On 1/22/24 I have still not received a check. I spent an additional 39 minutes on the phone and was assured again that I would receive a check in ***** days. They stole my money and have not returned it. Based on the last time I canceled my husbands insurance when he got a new job last year, I think this is intentional fraud. How many people never catch the error and request the refund? This exact thing happened in April/May of last year. I did at least get the check after the first ***** days, even though I was assured when I canceled that the premium would automatically update and they would only charge for me (still on the policy). I sent the grievance department an invoice via email today for the refund plus 7.99% interest (compounded monthly) and $42.60 to pay me for my 1.42 hours of phone time trying to resolve this issue. A total of $359.21. If I had overdrafted due to their lies, that would have been worse. I cant afford TWO premiums (canceled plus the new other insurance I obtained)

  Customer response

  01/31/2024

  I finally received the original refund for the premium the company charged me for. I am not satisfied, because this is still a bad business practice. They had my money almost a month and I do not believe they would have refunded it without me chasing them down. I'm sending an updated invoice and letter to them tomorrow. (see attached). 

  

  Business response

  01/31/2024

  Please the attached response to Complaint ********

  Customer response

  01/31/2024

   
  Complaint: 21183224
  
  I am rejecting this response because this is a repeat situation and I was assured on December 14, that my cancellation request would go through in time and that I would not be charged the premium. I was assured that I did not need to log in and cancel autopay. All of those assurances turned out to be lies. I am convinced that if I had not called and spent the time on the phone, I would not have received a refund at all. I request the business reimburse me for my expenses and pay the additional amount requested, $44.49, as itemized on the invoice I sent. 

  I am hopeful that they will revise their business practices.

  Sincerely,
  
  ***********************

  Customer response

  01/31/2024

  Re: My Rejection

  In addition, the response from the business does not address why the check was not sent the first time I called on January 2, and was told that I would receive it in ***** days. 

  

  Business response

  02/13/2024

  Please see the attached response.

  Customer response

  02/13/2024

   
  Complaint: 21183224
  
  I am rejecting this response because:The response appears to just be a copy of the invoice I sent and originally attached. The reference number for my original call to the company was **********, and I talked with Destiny. Destiny assured me I would not be charged for the next month because I canceled in time. I am still requesting an additional refund of $43.69 as reasonable compensation for the involuntary loan of my money and the effort to get it back. In lieu of said compensation, I will accept evidence that the business has updated its policies and procedures regarding cancellations, so that this does not happen to other clients.   
  
  Sincerely,
  
  ***********************

  

  Business response

  03/08/2024

  Attached a further response to the consumer's complaint.

• Initial Complaint

  01/16/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Regence Blue Cross Blue Shield sends out frequent emails regarding their ability to cover mental health related problems, saying to "Make the most of your 2023 Regence BlueShield of Idaho benefits". After seeing this and my basic EOB page only showing a $40 copay with the Medical Benefit Booklet page being not functional, I decided to start therapy. However, weeks later, ******* tells me now that they do not actually cover this service that they have been pushing and advertising the entire time and I now have to pay for these services primarily out of pocket. Given their broken website, I had no way of knowing this until I had already spent hundreds of dollars on therapy treatments.

  

  Business response

  01/23/2024

  Good Afternoon.

  It appears that this consumer is insured by Regence Blue Shield of Idaho. Blue Cross of Idaho has not had an active policy for this consumer since 2018.

  Regards,

  ********

  Customer response

  01/23/2024

   
  Better Business Bureau:
  
  It seems your system brought up the wrong business in my original complaint 
  
  Sincerely,
  
  *******************

• Initial Complaint

  09/09/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I went to the ******************** health insurance agency in *** idaho. I brought a rejection letter from department of health and welfare. The letter states that I didnt go forward with my ******** application so i was denied. I paid for health insurance on july 27. I got a letter from blue cross stating thank you for applying for health insurance. It listed the four of my family members. then I got a member welcome packet. then I got a letter mailed to me. I assumed it was a bill so i opened it at the end of the month which was the end of august. it stated that i had 15 days to send a denial letter from the department of health and welfare stating that I was denied for continous coverage because of their decision not me withdrawing my application. So I called and talked with 3 separate customer ********************** representatives. Long story short I got a call back from 1 of them on September 1 stating my insurance was finally "approved". So i just opened a letter for a September 1 bill of ****** . I called to pay it and the recording stated i owed *******. If my health insurance was granted September 1 the payment made july 27 should reflect for September. The going back and forth is starting to get old and im feeling like the situation is being used to exploit me for extra money. My hope is that i will pay ****** for this month and going forward.

  

  Business response

  09/18/2023

  Please see the attached response to complaint 20579061.

   

  Thank you

• Initial Complaint

  07/07/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I am locked out of my online account and Blue ********************** refuses to unlock my account so that I can find a doctor at bcidaho.com and check on statements and other health-related concerns.

  

  Business response

  07/18/2023

  Please see the attached response to BBB Complaint ID ********.

   

  Thank you,

  ********

  Customer response

  08/01/2023

   
  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,
  
  ***********************

• Initial Complaint

  03/02/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  The specialist I see at the *************************************** (****) in *******, requested I have a specialized procedure, positron emission tomography (PET) scheduled for Feb 7, 2023 as part of my on going medical care. On January 24, I contacted Blue Cross of Idaho (BCI) to find out if this **** procedure would be considered in-network (I've had previous BCI insurance which covered this in-network). The person (name unknown) could not even locate **** in the system. I then ended the call.On January 25, I called again and talked to *******. After explaining the situation, she told me it would be covered as in-network. She conference called someone (name unknown) from **** and they told me **** was a partner with BCI and indicated it would be in-network (I can't recall if she said for sure it was in-network).I then continued with the procedure under the knowledge provided by BCI ******* the out of pocket expense would be added to the in-network deductible / out of pocket maximum.Now BCI is telling me the procedure is out-of network and my only action is to appeal. I asked to speak to a manager, was put on hold, and the call was then ended with no attempt to reestablish the call. I then called back (call Reference **********) they checked as much as she could, requested a supervisor review the Jan 25 call and told me basically the same, I should file an appeal. She said she would email me the link but I have yet to receive it.I have funds budgeted for the in-network out-of pocket expenses. If I had been told the **** procedure was out of network, I would have made arrangements for the procedure to be done in ***** and the results sent to my specialist at ****. I was lied to and after paying **** for the procedure, I will only have a small amount of funds left for medical expenses for the rest of the year.The reason for the complaint is I was told the procedure was in-network and after now it is out-of-network

  

  Business response

  03/09/2023

  Response for Complaint

  Customer response

  03/09/2023

   
  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,
  
  ***********************

• Initial Complaint

  01/13/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I had knee surgery in 2021. Some of the medical bills were never paid. I had to pay them to a debt collection agency. I have a $4500 max out of pocket on my policy. I met my $2500 deductible plus have paid $3,597. I have paid $6,097. I have called multiple times, been put on hold, transferred to multiple people, with no resolution. I want to be reimbursed for the $1,597 I paid above my max out of pocket.

  Customer response

  01/18/2023

  This is the settlement paperwork I turned in to the collection company, which included the attorneys fees of $1,000. Also the balance of the account after I had made the payments included in the other photo attached. This was after meeting & paying my $2,500 deductible. They already have that on file because they sent me a letter stating I had met it. 

  Customer response

  01/23/2023

  See attached

  

  Business response

  02/06/2023

  Please see the attached response to Complaint ID ********.

  Customer response

  02/06/2023

   
  Complaint: 18810713
  
  I am rejecting this response because: I have provided dates of service multiple times over the phone and in photos provided. As you can see in their response, I met my $2500 deductible, then I provided proof of payment of an additional $4000. I am not even asking for the attorney fees that I had to pay to the collection agency as well. I have provided proof I have paid more than my $4500 max out of pocket. I want to be reimbursed the amount of $1500 that I paid above my $4500 max out of pocket stated in my policy. It is unfortunate as a consumer I have to go through this with an entity that has unlimited resources to dispute my claim. They have taken advantage of me and this is my only recourse. Regardless of dates of service or any other way they have continued to deny responsibility, I have shown how much money I have had to pay, which exceeds the amount on my policy. That amount is for a calendar year, regardless of services I needed. I want them held accountable. They have unlimited funds, and couldn't pay another $1500 on the bills that were owed. I had to pay that. 
  
  Sincerely,
  
  *********************

• Initial Complaint

  10/26/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Blue Cross is supposed to put in a walkin tub/bath tub. They currently tell me that all the paperwork has been burned up and they don&#**;t have it. The people that were going to do it was Custom Home Bath & Refurbishing. The person they were using did not have any contractors license or any license. This business would not take out any permits for this job.

  

  Business response

  11/03/2022

  Please see the attached response to Complaint ********. Thank you.

• Initial Complaint

  08/31/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I got a letter from Blue Cross of ************************* had a policy with them for several years. I'm turning 65 soon and will get ******** & going to switch to a supplement plan from BC Idaho. After this letter I'm planning on another company. I have never used them for medications, nor plan to. I was shocked that I got a letter from BC Idaho that basically said I should consider not taking this antidepressent, consider taking something else, or try therapy. I should even take this letter and show it to my doctor. "This important info can help you get better results from your new medicine." All in hopes that I will use their Rx plan. While at first I just ignored it as more "turning 65" junk mail. But, after reading fully I'm angry that they had access to my meds *********** would use it in such a deceving manner. To me this is as bad as all the other scammers that prey on seniors.

  

  Business response

  09/26/2022

  Please see the attached response.

• Initial Complaint

  11/21/2021

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Blue cross of Idaho claims to be a good insurance not true can't get a hold of a live person when needed the web site is impossible to use they can't even answer questions about doctors are in network or how much a ** pay will be I called 8 different numbers and no one **uld answer any of this or the offices were closed so no way to find out and also have to switch pharmacy

  

  Business response

  12/01/2021

  Good morning, 

  
  

  Attached is our response to consumer complaint # *******. 

  
  

  Thank you,

  Grievances and Appeals Specialist 

*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. ↩