ComplaintsforBlue Cross and Blue Shield of North Carolina
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Complaint Details
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Initial Complaint
09/20/2021
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
BCBS sent me an email that they sent me a check that hasn't been cashed in April ** may. I have called the number multiple times and either get a message that they are having technical difficulties, or I get through the the person tells me their systems are downBusiness response
09/21/2021
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
09/09/2021
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
I am seeking payment for a $238 health claim that SHOULD be covered by BCBS. It is a covered expense and I have sent all of the requested paperwork multiple times to them, but they continue to deny this claim. They say I need to "submit the original receipt" which I HAVE DONE. They have this receipt! They are literally just doing paperwork fatigue and continuing to ask me to fill out more forms and each time they ask me to submit the original receipt. I have given them all that they requested and they still deny this claim!I am requesting a refund paid directly to me in the amount of $238.Blue Cross Claim # = *********** Charge for a required blood test. I have provided doctor name, diagnosis code, procedure code, NPI/tax number for doctor, and ALL ELSE that they have requested. Every time I call them, they say they have everything they need, and then another letter arrives in the mail asking for more info that I have already given them!Business response
09/10/2021
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
09/07/2021
- Complaint Type:
- Product Issues
- Status:
- Answered
On March 20, 2020, my wife received medical treatment for which she paid $510.00 upfront. On March 21, 2020, she submitted a **************** Claim Form (****). Blue Cross Blue Shield (BCBS). BCBS ***************** has denied to assign a claim number 6 times for various reasons that include but are not limited to, they lost the form, a NPI number, missing patient information (that was listed on paper), and legibility, The **** was faxed back to BCBS on 7/8/2020, 7/16/2020, 8/17/2020, 5/12/2021, 8/2/2021, and 8/24/2021. Our Dr ******** us of the 8/24/2021 denial with the reason being legibility. The Dr ****** representative stated everything is clearly written and they have no idea what could be considered illegible. I called BCBS on 9/3/2021 and spoke to ******* in customer service who said they would not be able to assist since the form is considered in "processing." ******* further stated while there are employees, they do not speak to customers. He suggested to fax again.Business response
09/08/2021
BlueCross ** will contact the complainant directly regarding their concerns.Customer response
09/09/2021
"BlueCross ** will contact the complainant directly regarding their concerns" seems like a whole lot of nothing as far as resolving this issue.Business response
09/09/2021
Blue Cross ** will contact the complainant directly regarding their concerns.Initial Complaint
08/12/2021
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
BCBS filed my medical bill **** of Network" and should have been filed *************************** ****** has called their customer service line 4 diffent times and I have called 1 time myself. Everytime they just say it's under review. This procedure was done back in March 2021. Now the *************** sending me a bill for something that should be covered.Business response
08/12/2021
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
08/02/2021
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
Unfortunately my family has had a difficult year medically. We have a high deductible plan through BCBSNC. In April I noticed we paid over my out-of-pocket limit by about $734. I called and was told it would be reviewed and that would take 30 days. Thirty days later there was no resolution and I was told "there is no 30 day limit we can take as long as we want." That issue is STILL not resolved but they have reviewed my account, reprocessed many of my claims, and now I am supposed to ask for refunds from several offices and pay more money elsewhere. Unfortunately it isn't clear how much refund and from whom because no EOBs are available online. I have wasted an incredible amount of time on the phone and each time I get someone knowledgeable they offer to call weekly with updates and then they never call. At this point we have paid a total of $15,175.07 in healthcare expense despite having a $14,000 out-of-pocket limit. I would like answers to my questions and resolutions.Business response
08/02/2021
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
07/29/2021
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I booked a Covid antibody test in Jan through CVS. While there, I was offered a flu shot. I knew that it's free under my insurance and the location was in-network, so I received it. I received a bill for $50 from ************** claiming that they are separate pharmacy from CVS and not in my network. It has always been marketed as CVS MINUTE CLINIC to me--as a consumer, how am I to know that it is not part of CVS? I have called BCBS FOUR TIMES now, each time they say they will escalate and someone will call me back. BCBS has NEVER called back. I called ************** and in their notes (BCBS claim # *******V1656, TCN Internal Control # *****G663000), the reason BCBS did not cover it is that it applies toward my deductible, which is incorrect as my plan covers it. The $50 bill is now in collections; I have called to have that paused while in dispute. But I cannot get BCBS to resolve this! 6 hours on the phone now. It's despicable and inhumane and I know so many who experience the same.Business response
07/29/2021
BlueCross ** will contact the complainant directly regarding their concerns.
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Contact Information
Customer Complaints Summary
111 total complaints in the last 3 years.
27 complaints closed in the last 12 months.