ComplaintsforCareFirst, Inc.

• Initial Complaint

  10/30/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  My health insurance provider continues to tell me they have not received my requests to cancel my account. This has been going on since September. I called them on the phone and received verbal confirmation that my account would be closed within two weeks. It wasn't closed and my messages to customer service indicate there was no request to cancel my account. So I submitted a request online on October 11, with a request to cancel the following day since I was already well over the time I wanted the plan to end. This was recorded in their system with a confirmation number. I messaged them on October 18 because I hadn't received an update, and got a message saying no cancellation request had been received. I forwarded them a copy of the submitted termination form. But they keep ignoring my requests.

  Bureau response

  11/06/2023

  Kim *******
  CareFirst, Inc. 

  ***** **** *** *** ****** ****** ** *****
  
  
  Dear Kim *******:
  
  

  This is our second attempt regarding this complaint. For your reference, the complaint was submitted on 10/29/2023 and was assigned an ID of *********    

  BBB forwarded you a complaint filed by Sarah ****. We have not received your response in the time frame allotted. If you have responded directly to your consumer and reached a resolution, let us know so our records are current. If this was a simple oversight, please provide your response at this time. BBB understands that there are two sides to every story is interested in your perspective.

  
  In the interest of time and good customer relations, please provide BBB with written verification of your position in this matter within 7 calendar days.   
  
  We encourage you to use our ONLINE COMPLAINT system to respond to this complaint. If you received this complaint via email, the fastest and easiest way to view and respond is to the simply click on the “Respond to this Complaint”, link located on the left, when you are ready to answer. 
    
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code* **************

   

  Please understand that the consumer's complaint and your response may be posted on the BBB Website (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language. 

   

  We look forward to your prompt attention to this matter.
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

   

  CUSTOMER EXPERIENCE INFORMATION
  
  Customer Information:
  Sarah ****
  **** ****** ** *** ********** ** *****
  Daytime Phone: ###-###-####
  E-mail: ******************
  
  
  The details of this matter are as follows:

  Complaint Involves:
  Customer Services Issues
  
  Customer’s Statement of the Problem:
  My health insurance provider continues to tell me they have not received my requests to cancel my account. This has been going on since September. I called them on the phone and received verbal confirmation that my account would be closed within two weeks. It wasn't closed and my messages to customer service indicate there was no request to cancel my account. So I submitted a request online on October 11, with a request to cancel the following day since I was already well over the time I wanted the plan to end. This was recorded in their system with a confirmation number. I messaged them on October 18 because I hadn't received an update, and got a message saying no cancellation request had been received. I forwarded them a copy of the submitted termination form. But they keep ignoring my requests.

   

  
  
  
  
  Desired Settlement:
  Other (requires explanation)
  Cease billing me; Terminate my health insurance
   

  HIPAA: HIPAA Release was offered and accepted on 10/29/2023.

  
  Additional Comments from Consumer:
  

  Business response

  11/07/2023

  Good morning Heather, 

   

  Please note that an email was sent to you on November 2, 2023, to ************************* with the attached document.

  Also, the issue was resolved, and the member was contacted to advise on November 3, 2023.

   

  Regards

  Danielle

  Bureau response

  11/07/2023

  Sarah ****
  **** ****** ** ********* * *** ************ *****  
  
  Dear Sarah ****:
  
  This message is in regard to your complaint submitted on 10/29/2023 against CareFirst, Inc..  Your complaint was assigned ID *********  

   

  BBB has received a formal response from CareFirst, Inc.. We ask that you review the response and understand that BBB is here to assist both parties in reaching a fair and reasonable resolution.

  Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.

  Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  
  MESSAGE FROM BUSINESS:
  
  

  Good morning Heather, 

   

  Please note that an email was sent to you on November 2, 2023, to ************************* with the attached document.

  Also, the issue was resolved, and the member was contacted to advise on November 3, 2023.

   

  Regards

  Danielle

  Bureau response

  11/12/2023

  Kim *******
  CareFirst, Inc. ***** **** *** *** ****** ***** ** ***** 
  
  
  Re: ID * ******** - Sarah ****
  
  Dear Kim *******:
  
  Thank you for your recent response to Sarah ****. We have not yet heard from the consumer and are closing this case as answered.
  
  Following our usual procedure, BBB notified the consumer of your response and requested notification of whether or not a satisfactory resolution had been reached.  Unfortunately, the consumer has not notified our office if they are satisfied. BBB has determined that your company has addressed the issues within the complaint; therefore we have closed this case in our files. This matter will appear in your BBB Business Profile as: "Answered - The Business addressed the issues within the complaint, but the consumer did not accept the response, OR BBB has not heard back from the consumer as to their satisfaction."
  
  The text of your response may be publicly posted on BBB's website. BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language. 

   

  In the event the consumer contacts BBB again regarding this issue, we may reach out to you to review any new or additional information we've received from the consumer. 
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  Bureau response

  11/12/2023

  Sarah ****
  **** ****** ** ********* * *** ********* ** *****  
  
  
  Re: ID # ********- CareFirst, Inc.
  
  Dear Sarah ****,
  
  We have not received your response to confirm this complaint has been resolved. Therefore, this complaint has been closed and will appear in the company's BBB Business Profile as: “Answered- BBB has not heard back from the consumer as to their satisfaction with the business's response.” 
  
  Please know that BBB is always available to discuss your case and review additional information. Thank you for using BBB's Marketplace Services.
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####
  

• Initial Complaint

  10/25/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I am treating Carefirst patients in our medical practice. I wrote a prescription for a life and limb medication for a patient and the patient was unable to get the medication. I personally spent 4 hours on the phone to multiple representatives from this company and their behavior is awful. I was hung up on twice. The matter was subsequently resolved by one of the 14 reps that touched this case because she called back to the specialty pharmacy and the reason medication was being denied and I wasted 4 hours on the phone is because clerically the insurance was entered incorrectly on the pharmacy side of the same carefirst company. Why would anyone not recognize this issue from the beginning, is beyond me. The policy was read so many times, I have the patient's ID memorized at this point. They were provided all the information. This is more so for the reps who hung up on me and did not do their due diligence to support this patient in their treatment. It is disgusting that this took so much effort and that Carefirst is lying, cheating and stealing time from providers and care from their patients. They need to be held responsible for ridiculously long hold times and lack of initiative. This is the bare basics and this is not acceptable behavior on their behalf. I don't write complaint letters until I am so mad there is no other recourse. They need to be exposed. I recommended the patient contact 7 on your side so I feel they are getting off easy reading my complaint here.

  Bureau response

  11/01/2023

  Kim *******
  CareFirst, Inc. 

  ***** **** *** *** ****** ****** ** *****
  
  Dear Kim *******:
  
  

  This is our second attempt regarding this complaint. For your reference, the complaint was submitted on 10/24/2023 and was assigned an ID of *********  

   

  BBB forwarded you a complaint filed by Nancye ******. We have not received your response in the time frame allotted. If you have responded directly to your consumer and reached a resolution, let us know so our records are current. If this was a simple oversight, please provide your response at this time. BBB understands that there are two sides to every story is interested in your perspective.

  
  In the interest of time and good customer relations, please provide BBB with written verification of your position in this matter within 7 calendar days.   
  
  We encourage you to use our ONLINE COMPLAINT system to respond to this complaint. If you received this complaint via email, the fastest and easiest way to view and respond is to the simply click on the “Respond to this Complaint”, link located on the left, when you are ready to answer. 
    
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

   

  Please understand that the consumer's complaint and your response may be posted on the BBB Website (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language. 

   

  We look forward to your prompt attention to this matter.
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

   

  CUSTOMER EXPERIENCE INFORMATION
  
  Customer Information:
  Nancye ******
  **** ****** ** ********* ** *****
  Daytime Phone: ###-###-####
  E-mail: ************************************
  
  
  The details of this matter are as follows:

  Complaint Involves:
  Customer Services Issues
  
  Customer’s Statement of the Problem:
  I am treating Carefirst patients in our medical practice. I wrote a prescription for a life and limb medication for a patient and the patient was unable to get the medication. I personally spent 4 hours on the phone to multiple representatives from this company and their behavior is awful. I was hung up on twice. The matter was subsequently resolved by one of the 14 reps that touched this case because she called back to the specialty pharmacy and the reason medication was being denied and I wasted 4 hours on the phone is because clerically the insurance was entered incorrectly on the pharmacy side of the same carefirst company. Why would anyone not recognize this issue from the beginning, is beyond me. The policy was read so many times, I have the patient's ID memorized at this point. They were provided all the information. This is more so for the reps who hung up on me and did not do their due diligence to support this patient in their treatment. It is disgusting that this took so much effort and that Carefirst is lying, cheating and stealing time from providers and care from their patients. They need to be held responsible for ridiculously long hold times and lack of initiative. This is the bare basics and this is not acceptable behavior on their behalf. I don't write complaint letters until I am so mad there is no other recourse. They need to be exposed. I recommended the patient contact 7 on your side so I feel they are getting off easy reading my complaint here.

   

  
  
  
  
  Desired Settlement:
  Other (requires explanation)
  It would be nice if Carefirst reimbursed me for my 4 hours of time I spent on the phone trying to get their employees to do their job. I won't hold my breath but that is what it will take for me to retract my complaint.
   

  
  Additional Comments from Consumer:
  

  Business response

  11/02/2023

  Good Morning Heather:

  On 10/27/23 CareFirst telephoned the provider's office to discuss their concerns. Unfortunately, the provider was not in the office. Therefore, a message was left requesting they contact Rhonda Evans, Customer Service Advocate at ###-###-####. Ms. Evans attempted again, this morning, to contact the provider. She was advised theyt provider only comes in the office when they have appointments scheduled. Ms. Evans was instructed to try again tomorrow.

  If you have any questions, please don't hesitate to contact me at either ************************ or ###-###-####

  Bureau response

  11/02/2023

  Nancye ******
  **** ****** ** *** *** *********** *****
  
  
  Dear Nancye ******:
  
  This message is in regard to your complaint submitted on 10/24/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 

   

  BBB has received a formal response from CareFirst, Inc.. We ask that you review the response and understand that BBB is here to assist both parties in reaching a fair and reasonable resolution.

  Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.

  Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  
  MESSAGE FROM BUSINESS:
  
  

  Good Morning Heather:

  On 10/27/23 CareFirst telephoned the provider's office to discuss their concerns. Unfortunately, the provider was not in the office. Therefore, a message was left requesting they contact Rhonda Evans, Customer Service Advocate at ###-###-####. Ms. Evans attempted again, this morning, to contact the provider. She was advised theyt provider only comes in the office when they have appointments scheduled. Ms. Evans was instructed to try again tomorrow.

  If you have any questions, please don't hesitate to contact me at either [email protected] or ###-###-####

  Bureau response

  11/07/2023

  Kim *******
  CareFirst, Inc. ***** **** *** *** ****** ***** ** ***** 
  
  
  Re: ID * ******** * Nancye ******
  
  Dear Kim *******:
  
  Thank you for your recent response to Nancye ******. We have not yet heard from the consumer and are closing this case as answered.
  
  Following our usual procedure, BBB notified the consumer of your response and requested notification of whether or not a satisfactory resolution had been reached.  Unfortunately, the consumer has not notified our office if they are satisfied. BBB has determined that your company has addressed the issues within the complaint; therefore we have closed this case in our files. This matter will appear in your BBB Business Profile as: "Answered - The Business addressed the issues within the complaint, but the consumer did not accept the response, OR BBB has not heard back from the consumer as to their satisfaction."
  
  The text of your response may be publicly posted on BBB's website. BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language. 

   

  In the event the consumer contacts BBB again regarding this issue, we may reach out to you to review any new or additional information we've received from the consumer. 
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  Bureau response

  11/07/2023

  Nancye ******
  **** ****** ** *** *** ******** ** *****  
  
  
  Re: ID * ********- CareFirst, Inc.
  
  Dear Nancye ******,
  
  We have not received your response to confirm this complaint has been resolved. Therefore, this complaint has been closed and will appear in the company's BBB Business Profile as: “Answered- BBB has not heard back from the consumer as to their satisfaction with the business's response.” 
  
  Please know that BBB is always available to discuss your case and review additional information. Thank you for using BBB's Marketplace Services.
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####
  

  Customer response

  11/07/2023

  I was out of town last week. My staff has no recorded message from any of the people listed above. I specifically asked them if they spoke to either Rhonda ***** or Dee ****** and they responded no. I am not sure why you would close my complaint when I clearly listed what happened, just because you documented 2 days of attempted calls does not mean this should be closed. You are doing a horrible disservice to the community by closing this case. I will continue to go public about how BBB is not appropriately addressing my complaint also, not a good position for your company. I am in town. My cell phone number is ###-###-####. Feel free to call that anytime, I answer the phone myself so there is absolutely no excuse for you to say you can not reach me.

  Business response

  11/27/2023

  .

  Good Afternoon:

  Since there was no authorization from the provider attached to the inquiry, CareFirst has responded directly to the provider.

  Sincerely,

  Dee ******

  Bureau response

  11/27/2023

  Nancye ******
  **** ****** ** *** *** *********** *****  
  
  Dear Nancye ******:
  
  This message is in regard to your complaint submitted on 10/24/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 

   

  BBB has received a formal response from CareFirst, Inc.. We ask that you review the response and understand that BBB is here to assist both parties in reaching a fair and reasonable resolution.

  Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.

  Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  
  MESSAGE FROM BUSINESS:
  
  

  .

  Good Afternoon:

  Since there was no authorization from the provider attached to the inquiry, CareFirst has responded directly to the provider.

  Sincerely,

  Dee ******

  Customer response

  11/27/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and I received an apology. I don't know if that will prevent this from happening again but I guess its a good start and I find that this resolution is satisfactory to me.
  
  Sincerely,
  
  Nancye ******

  Bureau response

  11/27/2023

  Kim *******
  CareFirst, Inc. 
  ***** **** *** *** ****** ****** ** *****
  
  
  Dear Kim *******:
  
  This message is in regard to a complaint submitted to BBB about your business on 10/24/2023 by Nancye ******. This complaint was assigned ID *********
  BBB would like to thank you for your cooperation and response to the above-referenced consumer's complaint. After forwarding the consumer your response, the consumer notified our office the matter is resolved. Therefore we have closed this case accordingly.
  
  If you have any questions, however, we are happy to assist you. Thank you for your cooperation in this matter and for your support of our self-regulatory goal.
   
  Each year, millions of consumers contact BBB for pre-purchase information, and your response to this dispute will assist your future customers with making valuable purchasing decisions.
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####
  
  MESSAGE:
  
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and I received an apology. I don't know if that will prevent this from happening again but I guess its a good start and I find that this resolution is satisfactory to me.
  
  Sincerely,
  
  Nancye ******

• Initial Complaint

  07/18/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  BLUECROSS BLUESHIELD MARYLAND HAS PUT A GUN TO MY HEAD. I HAVE TO GO ON THEIR plan after the 31st because my medicaid cuts off. (YOU MAY NOT DISCUSS MEDICAID IN AN FASHION IT IS A VERY COMMON TACTIC FOR YOU TO SHIFT BLAME ONTO THEM. ALL MEDICAID OPTIONS SHOULD BE CONSIDERED EXHAUSTED). The deductible is $5000 (NO other plan covers what I need, all other plan options should be considered exhausted). I cannot afford my trikafta at $5000 and I will die without it. I called asking if I can use a copay assistance program at trikafta to cover my deductible. they could not tell me if the copay assistancer would count towards my copay or if It would get stolen by PillarRx (who they said is an entity with Caremark that helps you by taking copay assistance your eligible for and paying out to the insurance company instead of you. It helps by paying a billion-dollar company while I die. 11 of your agents and Caremark agents went in kill loops directing me to one another for 4 hours. I just wanted to know if the copay assistance counts towards THE DEDUCTIBLE. THE AGENTS RANTED FOR HOURS WHILE REFUSING TO ANSWER THIS IN DESPERATION TO KEEP THE KILL LOOP GOING TILL CLOSE. THE LAST SUPERVISOR DANA REFUSED TO TRANSFER ME UP WHEN SHE DIDNT KNOW THE ANSWER FOR OVER AN HOUR. i EVEN SPECIFICALLY ASKED HER TO CONFRENCE CALL WITH CAREMARK MULTIPLE TIMES AND SHE REFUSED AND INSTEAD SPENT HOURS DOING RANDOM BULLKSHIT TO KEEP THE KILL LOOP GOING. eventually SHE DIRECTED ME TO THE COPAY ASSISTANCE i FOUND ORIGINALLY. She DID NOT HELP. THIS WAS THE ASSISTANCE i WAS ASKING ABOUT. THEY HAVE SUCEEDED IN THE KILL LOOP. 4 HOURS AND i FAILED. I WANT TO SMASH MY TEETH IN NOW, I hate myself for being used by your agents. I even told dana I was thinking about hurting myself and she did not transfer up. I REALLY THINK IM DEAD AFTER THAT, THERES NO WAY TO GET MY MEDS. I will sue if you use PillarRx to steal my assistance. I also want credit on my premium for this awful treatment.

  Bureau response

  07/18/2023

  Kim *******
  CareFirst, Inc. 
  ***** **** *** *** ****** ***** ** *****
  
  
  Dear Kim *******: 
    
  Better Business Bureau (BBB) received a complaint about your business. BBB understands that there are two sides to every dispute, and we have not pre-judged the validity of this claim. This is your opportunity to address the concerns of your consumer and to rebuild the trust that first brought you together. BBB seeks to help businesses resolve their disputes, whether or not they are accredited with BBB.  The complaint was submitted on 7/17/2023 and was assigned an ID of *********   
  
  How do I take care of this?
  Your BBB is requesting a written response to this complaint within the next 7 calendar days.  Your prompt and professional response greatly enhances the chance for a successful resolution and will further your reputation as a BBB Accredited Business.  If you received this complaint via email, the fastest and easiest way to view and respond is to the simply click on the “Respond to this Complaint”, link located on the left.  All responses will be copied to the complainant. 
  
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  What should I include in my response?
  Please provide an explanation of the events from your perspective and/or a concrete plan for how to work toward a resolution. Remember that the more factual information we have about the case, the easier it is for all parties to develop a full understanding of the situation. 
   
  Please understand that the complaint content and your response may be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.
  
  What will happen if I do not submit a response and what can I expect to happen next?
  If you do not respond promptly to this complaint, it may be closed as Unanswered.  This may result in a substantially lower rating with BBB, which could adversely influence potential customers. Once we receive your response, we will forward it to your customer and ask them to tell us in writing whether your response resolves their concerns.  If they continue to express dissatisfaction, the case will be reviewed by BBB staff to determine if the remaining concerns warrant an additional response.  The overall standard applied in the review process is: Did the company act in good faith, and do everything that could be reasonably expected, or is responsible for, to resolve the issue?
  
  We look forward to helping you and your customer work toward an amicable resolution. 
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####
  

   

  CUSTOMER EXPERIENCE INFORMATION

   

  Customer Information:

  William **************

  **** ********** *** *** * ************ ** *****

  Daytime Phone: ###-###-####
  E-mail: ******************
  

   

  The details of this matter are as follows:

   

  Complaint Involves:
  Billing or Collection Issues 

   

  Customer’s Statement of the Problem:
  
  BLUECROSS BLUESHIELD MARYLAND HAS PUT A GUN TO MY HEAD. I HAVE TO GO ON THEIR plan after the 31st because my medicaid cuts off. (YOU MAY NOT DISCUSS MEDICAID IN AN FASHION IT IS A VERY COMMON TACTIC FOR YOU TO SHIFT BLAME ONTO THEM. ALL MEDICAID OPTIONS SHOULD BE CONSIDERED EXHAUSTED). The deductible is $5000 (NO other plan covers what I need, all other plan options should be considered exhausted). I cannot afford my trikafta at $5000 and I will die without it. I called asking if I can use a copay assistance program at trikafta to cover my deductible. they could not tell me if the copay assistancer would count towards my copay or if It would get stolen by PillarRx (who they said is an entity with caremark that helps you by taking copay assistance your eligible for and paying out to the insurance comapny instead of you. It helps by paying a billion dollar company while I die. 11 of your agents and caremark agents went in kill loops directing me to one another for 4 hhours. I just wanted to know if the copay assistance counts towaRDS THE DEDUCTIBLE. THE AGENTS RANTED FOR HOURS WHILE REFUSING TO ANSWER THIS IN DESPERATION TO KEEP THE KILL LOOP GOING TILL CLOSE. THE LAST SUPERVISOR DANA REFUSED TO TRANSFER ME UP WHEN SHE DIDNT KNOW THE ANSWER FOR OVER AN HOUR. i EVEN SPECIFICALLY ASKED HER TO CONFRENCE CALL WITH CAREMARK MULTIPLE TIMES AND SHE REFUSED AND INSTEAD SPENT HOURS DOING RANDOM BULLKSHIT TO KEEP THE KILL LOOP GOING. eVENTUALLY SHE DIRECTED ME TO THE COPAY ASSISTANCE i FOUND ORIGINALLY. sHE DID NOT HELP. THIS WAS THE ASSISTANCE i WAS ASKING ABOUT. THEY HAVE SUCEEDED IN THE KILL LOOP. 4 HOURS AND i FAILED. I WANT TO SMASH MY TEETH IN NOW, I hate myself for being used by your agents. I even told dana I was thinking about hurting myself and she did not transfer up. I REALLY THINK IM DEAD AFTER THAT, THERES NO WAY TO GET MY MEDS. I will sue if you use PillarRx to steal my assistance. I also want credit on my premium for this awful treatment.
  
  
  
  
  
  Desired Settlement:
  Store Credit
  
   

  HIPAA: HIPAA Release was offered and accepted on 7/17/2023.

  Bureau response

  07/18/2023

  William **************
  **** ********** *** *** * ************ *** *****
  
  
  Dear William **************:
  
  Thank you for contacting the Better Business Bureau. This message is in regard to your complaint submitted on 7/17/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 
  
  Now that I have filed, what is the next step?
  We have forwarded your complaint to the business for their response. We have asked the business to reply promptly, but some disputes may take longer than others to conclude.  Please be patient as we work to ensure that your concerns are addressed. 
  
  What if I do not agree with the response from the business?
  It is important for both parties to maintain realistic expectations and respond in a professional, fair and courteous manner.  Our goal is for you and the business to be able to work towards an amicable solution. Should this prove difficult, we may offer you and the business the opportunity to participate in binding arbitration.  More information about these options can be found at www.bbb.org
  
  What happens if a business does not respond?
  BBB will make every effort to obtain a response from the business, but some businesses simply do not ever contact us.  BBB is not an enforcement agency. We cannot force a business to respond. However, failure to do so may result in a negative impact on their BBB rating, which may drive away future customers. BBB can also refer you to other agencies that may be able to assist you, depending on the specific nature of your complaint. 
  
  Feedback from consumers is vital to BBB. We appreciate your willingness to report this information to us. We look forward to helping you and the business work toward a resolution. Please do not hesitate to contact us with any additional questions or concerns.  
  
  Sincerely,
  
  

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  Business response

  07/20/2023

  Tell us why here...July 20,2023 
  
  
  Better Business Bureau of Greater Maryland Attention: Heather ****** 
  Dispute Resolution & Trade Practices Specialist 
  *** ** ***** **** ***** ****  ********** ** ***** 
  
  
  RE: BBB File Number* ******** * William **************  
   
  
  Dear Heather ******: 
  
  This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  
  
  CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.  
  
  
  Sincerely, 
  
  Danielle ******* 
  
  Danielle ******** *** ******* 
  CareFirst Executive Inquiry Department 

  Bureau response

  07/20/2023

  William **************
  **** ********** *** *** * ************** *****
  
  
  Dear William **************:
  
  This message is in regard to your complaint submitted on 7/17/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 

   

  BBB has received a formal response from CareFirst, Inc.. We ask that you review the response and understand that BBB is here to assist both parties in reaching a fair and reasonable resolution.

  Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.

  Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  
  MESSAGE FROM BUSINESS:
  
  Tell us why here...July 20,2023 
  
  
  Better Business Bureau of Greater Maryland Attention: Heather ****** 
  Dispute Resolution & Trade Practices Specialist 
  *** ** ***** **** ***** ****  ********** ** ***** 
  
  
  RE: BBB File Number: ******** – William **************  
   
  
  Dear Heather ******: 
  
  This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  
  
  CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.  
  
  
  Sincerely, 
  
  Danielle ******* 
  
  Danielle ******** *** ******* 
  CareFirst Executive Inquiry Department 

  Bureau response

  07/25/2023

  Kim *******
  CareFirst, Inc. ***** **** *** *** ****** ***** ** *****
  
  
  Re: ID * ******** * William **************
  
  Dear Kim *******:
  
  Thank you for your recent response to William **************. We have not yet heard from the consumer and are closing this case as answered.
  
  Following our usual procedure, BBB notified the consumer of your response and requested notification of whether or not a satisfactory resolution had been reached.  Unfortunately, the consumer has not notified our office if they are satisfied. BBB has determined that your company has addressed the issues within the complaint; therefore we have closed this case in our files. This matter will appear in your BBB Business Profile as: "Answered - The Business addressed the issues within the complaint, but the consumer did not accept the response, OR BBB has not heard back from the consumer as to their satisfaction."
  
  The text of your response may be publicly posted on BBB's website. BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language. 

   

  In the event the consumer contacts BBB again regarding this issue, we may reach out to you to review any new or additional information we've received from the consumer. 
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  Bureau response

  07/25/2023

  William **************
  **** ********** *** *** * *********** ** *****  
  
  
  Re: ID * ********* CareFirst, Inc.
  
  Dear William **************,
  
  We have not received your response to confirm this complaint has been resolved. Therefore, this complaint has been closed and will appear in the company's BBB Business Profile as: “Answered- BBB has not heard back from the consumer as to their satisfaction with the business's response.” 
  
  Please know that BBB is always available to discuss your case and review additional information. Thank you for using BBB's Marketplace Services.
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####
  

• Initial Complaint

  06/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  One of my claims (E*********00) was erroneously denied by CareFirst. The reason for denial was a required 12 month waiting period (that does not apply to me.) When I call in and message within the portal, CareFirst agrees that the waiting period does not apply to me and submitted this claim to be reprocessed. However, it has been over 90 days since my original request via phone for reprocessing (call made on 3/31/2023) and over 30 days since my follow up request via messaging in the online portal (made on 5/26/2023). I've messaged them and called them multiple times and each time, they said it will take another "XX" number of business days with no resolution in sight. CareFirst member ID: ********* Date of service: 1/5/2023 Claim number: E*********00 Erroneous Reason for denial: "This service is subject to the member's 12 month Benefit Waiting Period." The 12-month Class 3 & 4 waiting period does not apply to existing members with no lapse in coverage prior to 1/1/23. My coverage began 8/2022 and I do not have a lapse in coverage therefore I do not have a waiting period. CareFirst agrees that I do not have a waiting period and the claim should be reprocessed however, reprocessing is not taking place.

  Business response

  07/03/2023

  In absence of authorization and order to safeguard protected health information, CareFirst will be responding directly to the complainant.

  Customer response

  07/09/2023

  
  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.

  I am however, dismayed that it took me writing to the BBB to finally get the business to respond and resolve my longstanding issue. 
  
  Sincerely,
  
  Meiping ****

• Initial Complaint

  06/07/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had Carefirst insurance with a previous employer that would not expire until the end of May 2023. I started working at a new employer and signed up for a new policy since the old one was to expire on May 31st 2023 from the previous employer. On May 22nd 2023 i signed up for my new policy that would begin on June 1st 2023. On June 5th i found out that my new policy was voided because a payment was never made. So instead of having some type of grace period to make a payment, they voided my new policy immediately. I did not receive and emails, texts or phone calls from anyone that a payment was due immediately. I was waiting for some form of billing documentation to come in the mail from Carefirst and nothing ever came. If i did not call Carefirst on June 5th 2023, i would never have known my insurance was voided. I made a payment over the phone on June 5th 2023 to activate this account. I had to take my daughter to the doctor's on June 6th for an ear and eye infection. The doctor's office informed me today that my insurance was not currently active and i would have to pay out of pocket. I contacted Carefirst and they told me it would be possibly up to 48 hours for my policy to be activated while the payment was still processing. This doesn't work for me. If I was notified that the payment was due before June 1st, I would have paid it and none of this would have happened. Also, not activating the account immediately after I paid on the phone, doesn't work for me. I was a 7 year long member and only switched to a different group number. My member ID is exactly the same. I should have had a 90 day grace period to make payment instead of them voiding my new policy immediately.

  Business response

  06/08/2023

  From:              Donna ***************
  To:                   BBB of Greater Maryland
  Subject:           Respond to Complaint
  Date:                6/8/23
  
  RE:                   BBB File Number:  ********
  Consumer:       *******, Kenneth
  
  Dear: Ms. ******,
  
  This letter is to acknowledge the receipt of your correspondence. 
  
  CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau. We will reply directly to the complainant. 
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.
  
  Sincerely,

  
  Donna ***************
  Senior Analyst, Executive Inquiry
  CareFirst BlueCross BlueShield
  **** ** ******* ****** ********** ******** *****
  W ###-###-#### | F ###-###-####
  carefirst.com

• Initial Complaint

  06/06/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My office provides outpatient physical therapy in Baltimore, MD. We hired a new therapist over a year ago and filed for credentialing as soon as she was hired. We also credentialed with many other insurance companies and have gotten credentialing in a timely manner. Carefirst has not issued my therapist credentialing but shows on their website that she is apart of Carefirst. Our claims have been denied and I have been cosigning all of her notes which is taking up a significant part of my time. My complaint is that we have numerously tried to contact carefirst via phone, email and online portal and have received absolutely nothing. We have not been able to contact a live person on the phone for the past 6 months. We had a previous complaint over a year ago with a different issue and needed to file a complaint, in which at that time, Carefirst contacted us, gave us a liason to get in touch with and as soon as our issue was resolved, that individual's number stopped working. I have a small office so I understand I don't affect carefirst too much but I am still trying to run my business efficiently and should get help with this issue in a timely manner. My office has been trying to get in touch with Carefirst for over 3 months. I would like Carefirst to contact my office and resolve this issue immediately and give us a liason with a direct number that will work for future problems.

  Bureau response

  06/06/2023

  Kim *******
  CareFirst, Inc. 
  ***** **** *** *** ****** ***** ** *****  
  
  Dear Kim *******: 
    
  Better Business Bureau (BBB) received a complaint about your business. BBB understands that there are two sides to every dispute, and we have not pre-judged the validity of this claim. This is your opportunity to address the concerns of your consumer and to rebuild the trust that first brought you together. BBB seeks to help businesses resolve their disputes, whether or not they are accredited with BBB.  The complaint was submitted on 6/5/2023 and was assigned an ID of *********   
  
  How do I take care of this?
  Your BBB is requesting a written response to this complaint within the next 7 calendar days.  Your prompt and professional response greatly enhances the chance for a successful resolution and will further your reputation as a BBB Accredited Business.  If you received this complaint via email, the fastest and easiest way to view and respond is to the simply click on the “Respond to this Complaint”, link located on the left.  All responses will be copied to the complainant. 
  
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  What should I include in my response?
  Please provide an explanation of the events from your perspective and/or a concrete plan for how to work toward a resolution. Remember that the more factual information we have about the case, the easier it is for all parties to develop a full understanding of the situation. 
   
  Please understand that the complaint content and your response may be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.
  
  What will happen if I do not submit a response and what can I expect to happen next?
  If you do not respond promptly to this complaint, it may be closed as Unanswered.  This may result in a substantially lower rating with BBB, which could adversely influence potential customers. Once we receive your response, we will forward it to your customer and ask them to tell us in writing whether your response resolves their concerns.  If they continue to express dissatisfaction, the case will be reviewed by BBB staff to determine if the remaining concerns warrant an additional response.  The overall standard applied in the review process is: Did the company act in good faith, and do everything that could be reasonably expected, or is responsible for, to resolve the issue?
  
  We look forward to helping you and your customer work toward an amicable resolution. 
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####
  

   

  CUSTOMER EXPERIENCE INFORMATION

   

  Customer Information:

  Marina *****

  *** ************ **** ********** ** *****

  Daytime Phone: ###-###-####
  E-mail: ************************
  

   

  The details of this matter are as follows:

   

  Complaint Involves:
  Service Issues 

   

  Customer’s Statement of the Problem:
  
  My office provides outpatient physical therapy in Baltimore, MD. We hired a new therapist over a year ago and filed for credentialing as soon as she was hired. We also credentialed with many other insurance companies and have gotten credentialing in a timely manner. Carefirst has not issued my therapist credentialing but shows on their website that she is apart of Carefirst. Our claims have been denied and I have been cosigning all of her notes which is taking up a significant part of my time. My complaint is that we have numerously tried to contact carefirst via phone, email and online portal and have received absolutely nothing. We have not been able to contact a live person on the phone for the past 6 months. We had a previous complaint over a year ago with a different issue and needed to file a complaint, in which at that time, Carefirst contacted us, gave us a liason to get in touch with and as soon as our issue was resolved, that individual's number stopped working. I have a small office so I understand I don't affect carefirst too much but I am still trying to run my business efficiently and should get help with this issue in a timely manner. My office has been trying to get in touch with Carefirst for over 3 months. I would like Carefirst to contact my office and resolve this issue immediately and give us a liason with a direct number that will work for future problems.
  
  
  
  
  
  Desired Settlement:
  Contact by the business
  
   

  Bureau response

  06/06/2023

  Marina *****
  *** ************ **** ********** *** *****
  
  
  Dear Marina *****:
  
  Thank you for contacting the Better Business Bureau. This message is in regard to your complaint submitted on 6/5/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 
  
  Now that I have filed, what is the next step?
  We have forwarded your complaint to the business for their response. We have asked the business to reply promptly, but some disputes may take longer than others to conclude.  Please be patient as we work to ensure that your concerns are addressed. 
  
  What if I do not agree with the response from the business?
  It is important for both parties to maintain realistic expectations and respond in a professional, fair and courteous manner.  Our goal is for you and the business to be able to work towards an amicable solution. Should this prove difficult, we may offer you and the business the opportunity to participate in binding arbitration.  More information about these options can be found at www.bbb.org
  
  What happens if a business does not respond?
  BBB will make every effort to obtain a response from the business, but some businesses simply do not ever contact us.  BBB is not an enforcement agency. We cannot force a business to respond. However, failure to do so may result in a negative impact on their BBB rating, which may drive away future customers. BBB can also refer you to other agencies that may be able to assist you, depending on the specific nature of your complaint. 
  
  Feedback from consumers is vital to BBB. We appreciate your willingness to report this information to us. We look forward to helping you and the business work toward a resolution. Please do not hesitate to contact us with any additional questions or concerns.  
  
  Sincerely,
  
  

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  Business response

  06/07/2023

  June 7, 2023 
  
  
  Better Business Bureau of Greater Maryland Attention: Heather ****** 
  Dispute Resolution & Trade Practices Specialist 
  *** ** ***** **** ***** ****  ********** ** ***** 
  
  
  RE: BBB File Number: ******** – Marina *****  
   
  
  Dear Heather ******: 
  
  This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  
  
  CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.  
  
  
  Sincerely, 
  
  Danielle ******* 
  Danielle *******, Sr. Analyst 
  CareFirst Executive Inquiry Department 

  Bureau response

  06/07/2023

  Marina *****
  *** ************ **** ************ *****  
  
  Dear Marina *****:
  
  This message is in regard to your complaint submitted on 6/5/2023 against CareFirst, Inc..  Your complaint was assigned ID *********  

   

  BBB has received a formal response from CareFirst, Inc.. We ask that you review the response and understand that BBB is here to assist both parties in reaching a fair and reasonable resolution.

  Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.

  Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  
  MESSAGE FROM BUSINESS:
  
  June 7, 2023 
  
  
  Better Business Bureau of Greater Maryland Attention: Heather ****** 
  Dispute Resolution & Trade Practices Specialist 
  *** ** ***** **** ***** ****  ********** ** ***** 
  
  RE: BBB File Number: ******** – Marina *****  
   
  
  Dear Heather ******: 
  
  This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  
  
  CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.  
  
  
  Sincerely, 
  
  Danielle ******* 
  
  Danielle ******** Sr. Analyst 
  CareFirst Executive Inquiry Department 

  Customer response

  06/07/2023

  
  Complaint: ********
  
  I am rejecting this response because:
  
  Sincerely,
  
  Marina *****

  Bureau response

  06/13/2023

  Kim *******
  CareFirst, Inc. 

  ***** **** *** *** ****** ***** ** *****
  
  Dear Kim *******:
  
  This message is in regard to a complaint submitted to the BBB about your business on 6/5/2023 by Marina *****.  This complaint was assigned ID *********
  
  Why am I receiving another letter regarding this complaint?
  We recently received additional correspondence from the consumer in the above-referenced case.  The information has been reviewed by your consultant and we believe this information warrants some additional remarks from your company.
  
  How do I see the new information?
  If received via email the fastest and easiest way to view and respond to the complaint is to use the link on the left.
  
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  What should I include in my response to the consumers rebuttal?
  Please respond to the additional information that has been provided by the consumer.  If you have not already done so, please submit copies of supporting documents to your BBB using the contact information at the bottom of this correspondence.  Please understand that the complaint content and your response will be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.
  
  In the interest of time and good customer relations, please respond within 5 calendar days.
  
  How many more times will I have to respond to this complaint?
  We appreciate the response you have already provided and our goal is to minimize back-and-forth communication.  The new information provided by the consumer may have brought up new concerns that your BBB consultant felt needed some clarification.  By providing this information, you are allowing BBB to develop a more complete picture of the situation and how to move forward. 
  
  Generally, resolving a complaint requires both parties to move from their current position to a middle ground. In your response, please state your position and if possible indicate what steps can be taken by both parties to resolve this matter. If necessary, the BBB will offer its mediation and/or arbitration services to bring a close to this matter.
  
  We look forward to your prompt attention to this matter.
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  MESSAGE FROM CONSUMER:
  
  
  Complaint: ********
  
  I am rejecting this response because:
  
  Sincerely,
  
  Marina *****

  Bureau response

  06/26/2023

  Kim *******
  CareFirst, Inc. 

  ***** **** *** *** ****** ***** ** *****
  
  
  Dear Kim *******:
  
  This message is in regard to a complaint submitted to the BBB about your business on 6/5/2023 by Marina *****.  This complaint was assigned ID *********
  
  Why am I receiving another letter regarding this complaint?

  This is a reminder that you have not responded to the consumersadditional correspondence in the above-referenced case.  The information has been reviewed by your consultant and we believe this information warrants some additional remarks from your company.
  
  How do I see the new information?
  If received via email the fastest and easiest way to view and respond to the complaint is to use the link on the left.
  
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  What should I include in my response to the consumers rebuttal?
  Please respond to the additional information that has been provided by the consumer.  If you have not already done so, please submit copies of supporting documents to your BBB using the contact information at the bottom of this correspondence.  Please understand that the complaint content and your response will be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.
  
  In the interest of time and good customer relations, please respond within 5 calendar days.
  
  How many more times will I have to respond to this complaint?
  We appreciate the response you have already provided and our goal is to minimize back-and-forth communication.  The new information provided by the consumer may have brought up new concerns that your BBB consultant felt needed some clarification.  By providing this information, you are allowing BBB to develop a more complete picture of the situation and how to move forward. 
  
  Generally, resolving a complaint requires both parties to move from their current position to a middle ground. In your response, please state your position and if possible indicate what steps can be taken by both parties to resolve this matter. If necessary, the BBB will offer its mediation and/or arbitration services to bring a close to this matter.
  
  We look forward to your prompt attention to this matter.
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  MESSAGE FROM CONSUMER:
  
  
  Complaint: ********
  
  I am rejecting this response because: see attached
  
  Sincerely,
  
  Marina *****

  Bureau response

  07/10/2023

  Kim *******
  CareFirst, Inc. 

  ***** **** *** *** ****** ***** ** *****
  
  Dear Kim *******:
  
  This message is in regard to a complaint submitted to the BBB about your business on 6/5/2023 by Marina *****.  This complaint was assigned ID *********
  
  Why am I receiving another letter regarding this complaint?
  We recently received additional correspondence from the consumer in the above-referenced case.  The information has been reviewed by your consultant and we believe this information warrants some additional remarks from your company.
  
  How do I see the new information?
  If received via email the fastest and easiest way to view and respond to the complaint is to use the link on the left.
  
  

  If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.
  To access/respond to this complaint online:
  Go to: ****************
  Enter the following code: **************

  What should I include in my response to the consumers rebuttal?
  Please respond to the additional information that has been provided by the consumer.  If you have not already done so, please submit copies of supporting documents to your BBB using the contact information at the bottom of this correspondence.  Please understand that the complaint content and your response will be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.
  
  In the interest of time and good customer relations, please respond within 5 calendar days.
  
  How many more times will I have to respond to this complaint?
  We appreciate the response you have already provided and our goal is to minimize back-and-forth communication.  The new information provided by the consumer may have brought up new concerns that your BBB consultant felt needed some clarification.  By providing this information, you are allowing BBB to develop a more complete picture of the situation and how to move forward. 
  
  Generally, resolving a complaint requires both parties to move from their current position to a middle ground. In your response, please state your position and if possible indicate what steps can be taken by both parties to resolve this matter. If necessary, the BBB will offer its mediation and/or arbitration services to bring a close to this matter.
  
  We look forward to your prompt attention to this matter.
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  MESSAGE FROM CONSUMER:
  
  
  Complaint: ********
  
  I am rejecting this response because: Attached is the HIPPA release form.
  
  Sincerely,
  
  Marina *****

  Bureau response

  07/18/2023

  Kim *******
  CareFirst, Inc.
  ***** **** *** *** ****** ***** ** ***** 
  
  
  Re: ID # ******** - Marina *****
  
  Dear Kim *******:
  
  Thank you for your cooperation in responding to the above consumer's complaint.
  
  We forwarded your response to Marina *****. The consumer notified our office that they are not satisfied. BBB has determined your company has addressed the issues within the complaint; therefore we have closed this case in our files. This matter will appear in your BBB Business Profile as: “Answered - The Business addressed the issues within the complaint, but the consumer did not accept the response, OR BBB has not heard back from the consumer as to their satisfaction.”
  
  The text of your response may be publicly posted on BBB’s website. BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language. In the event the consumer contacts BBB again regarding this issue, we may reach out to you to review any new or additional information we've received from the consumer.
  
  We appreciate your cooperation in addressing this matter and hope we can be of service to you in the future.
  
  Sincerely,
  
  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-####

  Bureau response

  07/18/2023

  Marina *****
  *** ************ **** ********* ** *****  
  
  Dear Marina *****,
  
  This message is regarding Complaint ID # ********- CareFirst, Inc.
  
  Your complaint is closed for one of the following reasons:
  
  We understand you are NOT satisfied with the business's response, and have noted your dissatisfaction in our files.  While we were unable to reach your desired resolution, the business has provided your Better Business Bureau (BBB) with its position.  This matter is now closed in BBB files, and will appear in the company's BBB Business Profile as: "Answered - the business addressed the issues within the complaint, but the consumer remains dissatisfied."
  
  OR
  
  We have not received your response to confirm this complaint has been resolved. Therefore, this complaint has been closed and will appear in the company's BBB Business Profile as: “Answered- BBB has not heard back from the consumer as to their satisfaction with the business's response.”

  
  If this is the case, please reply to this email and for the complaint to be reopened so you can submit a response to the business. After your request is processed, you will receive an email asking for your response with a link to the complaint.
  
  Please note, the text of your response may be publicly posted on BBB's website.  BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language.
  
  We appreciate the opportunity to be of service, and sincerely hope you will contact us for future pre-purchase information. 
  

  Sincerely,

  Heather ******
  Dispute Resolution Specialist
  *************************
  Phone: ###-###-#### MESSAGE FROM BUSINESS:
  
  June 7, 2023 
  
  
  Better Business Bureau of Greater Maryland Attention: Heather ****** 
  Dispute Resolution & Trade Practices Specialist 
  *** ** ***** **** ***** ****  ********** ** ***** 
  
  
  RE: BBB File Number: ******** – Marina *****  
   
  
  Dear Heather ******: 
  
  This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  
  
  CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.  
  
  
  Sincerely, 
  
  Danielle ******* 
  
  Danielle *******, Sr. Analyst 
  CareFirst Executive Inquiry Department 

• Initial Complaint

  04/12/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I recently reinstated my insurance with BlueChoice, because my new employer’s health plans are through them. But because I had BlueChoice several years ago with a previous employer, all my information is tied to my old company email address. That means I can’t login to my portal, because the password reset function doesn’t work, as the reset links are sent to an email I can’t access. I called BlueChoice over a month ago (~March 9th) to speak with someone about resolving this. They said due to a technical issue on their side, they couldn’t reset my password, so I should wait for them to resolve it. I waited about two weeks before calling back, and I got the same reply- they were still having technical issues. I called a third time, asked to speak to a manager and was told I could not, so my information was taken down and was supposed to have been sent to a manager. It wasn’t. My medical plan has been active for two months now, and I can’t do anything I should easily be able to do- check information about network providers, see my account balance, change my personal information, etc. I’m locked out of everything, and BlueChoice hasn’t done anything to fix this problem. I’m sure I’m not the only person experiencing this, so I would like them to fix their technical issues so I can reset my password and mailing address, so I can actually use my health services.

  Business response

  04/19/2023

  This letter is to acknowledge the receipt of your correspondence.  Thank you for allowing us the opportunity to further review your concerns.
  
  Your letter has been forwarded to a CareFirst staff member to investigate and we have been in contact with the complainant.  Please be assured that we are working as quickly as possible to provide an equitable resolution. 

• Initial Complaint

  04/12/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I received out of network services upon approval of those services. I filed the claims to care first blue choice for $6580.00in September 2022. They send me a check of $2654.52 and $2526.98 to my provider. First of all they made a mistake of sending it to provider where I paid her in full and according to their guide lines I am responsible to file and receive payment. When I enquire about it than I came to know that they send part of the payment to her. I contacted my provider and asked her if she received the check. She said she never received any check. I went after CFBC to issue me the payment which they did but they send me the payment in my provider's name so I can not cash it. This check was issued on 01/26/2023. Since then I have been calling them but they never gave me an answer when I will receive the check. I am retired person and I have mortgage to pay. I am tired of calling them to get my money. Please help me to get my money. They should also compensate me for stress, tension, lies and misleading.

  Business response

  04/19/2023

  Good Evening Heather:

   

  The inquiry is currently being reviewed, and the claim adjustment should be completed this evening. I will provide a detailed response tomorrow to include either a copy of the Explanation of Benefits or a screen print of the adjusted claim. Your patient is appreciated

  Customer response

  04/27/2023

  
  Complaint: ********
  
  I am rejecting this response because in Dec 2022 care first claims they sent the check to the provider. I complained to care first that provider never got it and I paid her in full so that check should come to me. In Jan 2023 care first sent me the check of $2526.98 in the provider's name which I could not encash (copy of the check attached). After bringing this error to Care first attention nothing has been done since January after numerous calls forcing me to go to BBB.
  
  Sincerely,
  
  ***** ********

• Initial Complaint

  03/30/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  My COBRA dental and vision coverage through previous employer is not ineffective (TASC is my COBRA servicer). I have been paying COBRA premium monthly and I confirmed with TASC that my dental and vision coverage through COBRA is still effective and should be effective until 8/31/2023. They sent CareFirst proof of payment/ coverage on 2/21/23. Carefirst website shows that my coverage was terminated on 11/30/22. I have been trying to resolve this issue since. I tried calling CareFirst multiple times and kept getting transferred to different departments who were not helpful. Average hold time on the phone is at least 45 minutes. I sent a message via Carefirst portal 2 weeks ago but I did not get any response. My recent dental claims were denied. I need to go back to see my dentist ASAP due to emergency. But because my coverage is showing as inactive, I cannot afford to go now and pay upfront. I only have 4 months of coverage to get my oral health taken care of. Member ID ********** group number 0H3C. I will be filing a complaint with Maryland Insurance Administration if the issue does not get resolved within 2 weeks.

  Business response

  03/31/2023

  Good afternoon Heather, please see attached in response to BBB ********* Thank you

• Initial Complaint

  03/23/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Since December 2022, CareFirst ********** has been applying the incorrect subsidy amount, having the incorrect policy information on my account, and charging me random amounts that are higher than I'm supposed to be paying. I have called them at least 5 times, sent them 6 emails, and contacted ** ****** **** without a proper resolution. Every time I call they tell me they are escalating the problem but if I don't pay the premium as it's shown, my policy will be canceled--but I shouldn't worry because they'll credit me the difference. That has yet to happen. The latest bill is 3x the amount I'm supposed to be paying and I have no idea why. And if I don't pay that my policy will lapse.

  Business response

  03/24/2023

  March 24, 2023
  
  Reference: Consumer Info: ********
  
  Dear Dispute Resolution Team:
  
  This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.
  
  CareFirst requires a valid "Authorization Form" in order for us to release specific details regarding customers' complaints. Because we do not have that authorization on file, we will reply directly to the complainant.
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.
  
  
  Sincerely,
  
  Terea ********
  
  

*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. ↩