ComplaintsforBlue Cross and Blue Shield of North Carolina
Health Insurance
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Complaint Details
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Initial Complaint
02/12/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
2/2/24. I went to fill my medicine and found out my health insurance was canceled. I called bcbsnc ************ was on phone for 2 hours. Got disconnected. All these calls I can prove on my phone bill. Called back that night, the ** rep put my issue as ***** for some reason. Didnt make since. The switched me to another ** rep for him to tell me the previous person shouldnt have done that. The issue is bcbs cashed my money. They said I never paid it which makes no since cause I added dental insurance and that was paid the exact same time and posted to my bank. . So bcbs cancel my policy for no reason. I called back 2/5 2/7 2/9. Each time 2+ hours. I sent them an email of my bank where both health and dental posted. Mean time I have canceled 2 doctors appointments and am now 7 days out of my medication. Just was on hold for 37 minutes when ** rep hung up. Called back got a nice lady that put me through to a supervisor **** ***. She said she waiting on whoever to ok that they did take my money. Which I wont hear anything til Monday 2/13 and that is if someone has looked at the bank statement. I have another doc appointment Tuesday 2/14. If they are not gonna reinstate my policy I want my 100.14$ back and cancel my dental. I will never ever have bcbs againBusiness response
02/12/2024
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
02/05/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
In October 2023 I submitted a claim for multiple chiropractic visits and was told I needed a different diagnostic code. I resubmitted the claim in December 2023 and called to follow up today, February 5th and the representative first told me that she could see my claim had been processed, but could not see for what amount or when/if my refund had/would be sent. She recommended I call back in a few days. I asked to speak to a supervisor and she placed me on hold for 20 minutes and then asked me to hold longer. When I asked why she said she was checking my refund amount. I inquired why she could all of a sudden check that, but couldn't before and she had no answer. I continued holding and she came back again to tell me that I needed to resubmit my claim for each individual visit. I asked her why she said it had been processed and she just repeated that I needed to resubmit the claim. I asked again to speak with a supervisor and was put on hold again. After holding for an hour I asked her to have someone return my call and her response was to take my number and tell me MAYBE someone would call me back lol. She told me her name was: *********Business response
02/06/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
01/17/2024
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
I had a baby on 02Nov23. I made a change of life event request to add the newborn to the policy. Once my employer confirmed this was processed on their end to BCBS I contacted them due to an upcoming doctors appt. They confirmed he had not been added and recommended I talk to employer. After the two parties spoke and resolved the issue, a new card was to be created confirming 2023 newborn coverage. After multiple attempts via chat and phone I have had no 2023 coverage for my child. I do however have **** coverage. I now have out of pocket expenses and denied insurance claims. As a resolution I am being told "just resubmit the claims and you might get a refund". There has been no escalation allowed and I haven't been able to speak to a supervisor. I am now requesting the BBBs support in obtaining a resolution.Business response
01/17/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
01/12/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
Message: I have gone NUEROUS rounds with BCBS North Carolina Experience Health. I have been waiting for an almost $700 reimbursement since September 12, 2023 (with an expected up to 45-day process) and it is now Jan. 10, 2023.The last excessive wait time was for $900.00.I have talked to Senator ******** office I have filed a grievance with Medicare.I was in need of that reimbursement before Christmas and it is accruing interest on a credit card.I WANT REIMBURSE FOR CREDIT CARD INTEREST THEY CONSISTENTLY HAVE NOT RECORDED MY NEW ADDRESS There are no less than 30 phone calls, all documented by BCBS This, for seniors, is negligent customer service. There are oh so many adjectives that can be added to this, but the service I have had has caused excessive anxiety. Think about it: someone has your money and doesn't pay you. They have more excuses than you can count and the company, with I think genuinely good people...can't seem to get you your check ether. ...This was sent to the Senator:Sent grievance Jan. 5th to Senator ****** Service was 9/12/23 - it is now Jan. 10th. Amount ****** of dental service. Mailed: ******* the dental receipt 9/12/2023. 11:00 a.m.BCBS insurance reimbursement # SF20230809271021572 Supervisor's # - ************************* ************** Experience *********************** ************ ---Good luck ANYBODY...and if anyone can get me my money. Great....Iet is now Jan. 12 and no check. They said there was a reissue...AND I FIND OUT IT WAS SENT TO THE OLD ADDRESS. THIS IS UNCONSCIONABLE CUSTOMER SERVICE.But this company needs to be called on the carpet for the most ineffectual customer. This time frame is negligent to receive a reimbursement. NO SENIOR NEEDS THIS RUN AROUND.I have all receipts....BCBS cannot provide a mailing receipt to me....however they did tell me they sent the new refund check to the old address. There is no excuse whatsoever for any of this.Business response
01/12/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
01/03/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
In an effort to have a new OTC card issued, Ive been on hold with your customer service department for well over one hour. Each message repeats that the hold time hasnt changed. *** placed several calls and have been unable to have anyone answer the phone. This may be one of the worst customer service experiences ever. Its very disappointing to have such a simple request to be unable to be resolved with this amount of effort. Its amazing that youBusiness response
01/03/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
12/27/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
BC/BS of ** incorrectly entered information from an Employee election form, and has refused for over 90 days to correct it and update the information.Business response
12/27/2023
BlueCross ** will contact the complainant directly regarding their concerns.Customer response
12/28/2023
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
12/15/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
My healthybluenc.com account cannot be accessed since Dec 1, 2023. My ******** started on Dec. 1. I created an account but could never login.I made 2 support tickets but tech. support isn't doing anything to help.Both my account and my moms accounts are broken and will not let us past using the 2FA. I've tried multiple devices, cleared browser caches, and even the ****** Health App.When both me and my mom have asked for supervisors (as advised by ncmedicaidplans.gov) we were met with "you don't need to speak to a supervisor".I need access to my account so I can check the information and everything is correct or I will switch ******** providers.Business response
12/15/2023
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
11/08/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
I am writing to file a formal complaint against Credence Blue Cross Blue Shield (BCBS). As of September 21, 2023, my employer facilitated a health insurance transition from Aetna to Credence BCBS due to my relocation. Prior to this switch, I had fully paid my annual deductible and out-of-pocket maximum with Aetna.Despite multiple communications and providing a copy of my Explanation of Benefits (EOB) from Aetna as proof of meeting my financial responsibilities, Credence BCBS has not updated my account. This oversight has persisted for two months, despite assurances received during a three-way call with my employer, Aetna and Credence BCBS that the matter would be resolved within a month.This inaction has adversely affected my access to necessary healthcare services, as I am being erroneously charged for services that should be covered. The failure of Credence BCBS to address this issue promptly is unacceptable and unprofessional, warranting immediate attention and resolution.Business response
11/09/2023
Blue Cross ** will contact the complainant directly regarding their concerns.Initial Complaint
10/09/2023
- Complaint Type:
- Product Issues
- Status:
- Answered
BCBS sent me a check to pay a doctor that I signed over to the doctor directly. Months later BCBS contacted me saying that I owed then $179.87 for overpayment to the doctors. I called them and spoke to them 5 times and explained all five times t hat I never deposited the money and signed it over to the doctor and they should contact the doctor to get the overpayment back. That is their job not mine. The last person I spoke to said to me that they would take care of it and I was not responsible for it. However, instead I was sent to collections. BCBS needs to remove me from collections and if they want the money that they overpaid the doctor then need to collect the money themselves. I and not a BCBS employee and its not my responsibility.Business response
10/09/2023
BlueCross ** will contact the complainant directly regarding their concerns.Customer response
10/09/2023
I will not accept this solution until they remove me from collections and fix this issue on their side.
Complaint: 20711949
I am rejecting this response because:
Sincerely,
*******************************Initial Complaint
10/06/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
Was scheduled for a partial knee replacement surgery on the 6th October 2023. At 4:30pm on the 5th October ********************************************************** they denied my surgery as not medical needed. I believe BCBSNC is in breech of contract for denying me this medical needed service. Not to mention the pain and therapy and injections this is the next steps medically. I have had this scheduled for week causes me major inconvenience. I also have an appeal for a ** they wouldn't pay for. Sorry I choose BCBCNC.Business response
10/06/2023
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.