Complaints

This profile includes complaints for Blue Cross and Blue Shield of New Mexico's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Blue Cross and Blue Shield of New Mexico

  5701 Balloon Fiesta Pkwy NE Albuquerque, NM 87113-2447

• 

  Blue Cross and Blue Shield of New Mexico

  PO Box 27630 Albuquerque, NM 87125-7630

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:01/16/2025

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My minor daughter and I no longer have insurance after we sent in our tax paperwork for last year showing that she is my dependent and I did file taxes. She needs to go to the doctor and all of a sudden we have no insurance.. we need insurance ASAP. That is the whole reason why I sent in all the paperwork, even though I never received anything at the house I neverreceived any paperwork from these people I was told by my supervisor what to do and we all did it.

  Business Response

  Date: 02/10/2025

  No SaF on File, BCBSIL will respond to the member directly

• Initial Complaint

  Date:01/07/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Blue Cross Blue Shield sent us refund requests for some overpayments on claims. We have since submitted checks for the outstanding balance(s) and now they are recouping the money from claims that are due. The issue started in 2022 and we sent checks in 2023 for which we have copies of all of the checks. They insist that they do not owe us any money back and will not put us in touch with the accounting department that handles overpayments.

  Business Response

  Date: 01/14/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the provider directly with a resolution.

  Customer Answer

  Date: 01/15/2025

  Complaint: ********
  
  I am rejecting this response because:

  I have sent the HIPAA form to the patient for signature.  Without the involvement of BBB they will not assist and this wall fall through the cracks.  

  
  
  
  
  Regards,
  
  ******** ******

   

  [To assist us in bringing this matter to a close, the consumer must give a reason why they are rejecting the response. If the consumer does not provide a reason the complaint will be closed Answered]

• Initial Complaint

  Date:12/18/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Blue Cross Blue Shield of NM issued a check under my name which was never cashed out. Calls to them in attempts to get a new check remain unanswered for months. I have all supporting documentation ready.

  Customer Answer

  Date: 12/20/2024

  Good morning,

   

  Please find attached the information release form requested by BBB.

   

  Thank you!
  ****

  Business Response

  Date: 12/23/2024

  Please see the attached response for BBB# ********.

• Initial Complaint

  Date:07/24/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Got a letter from BCBS of NM stating I had $100 in rewards. Login and it says I only have $50. Tried contacting BCBS via the email link on website but just get error 404. Tried calling and get zero help. Here is the email I tried to send: Got a letter from BCBS that says, "Congratulations, you earned $100 in rewards for taking care of your health!" However, when I logged in I have $50. You can't tell me one thing and than do another. Tried calling about this and was treated horribly. Never got any rewards over the 2 years I've been with you, when I have completed items. So this incentive rewards is a total scam. I don't get rewards when I should, get told I have $100 in rewards but then only have $50. This needs to be fixed, you owe me $50 in rewards, plain and simple, based on the letter YOU SENT ME.

  Business Response

  Date: 07/31/2024

  Please find the attached response 

  Customer Answer

  Date: 08/13/2024

  BCBS's letter to you stated they sent me a letter since it is protected information.  I have not received any letter from BCBS regarding this nor a phone call.   They are just ducking and dodging. 

  
  

  Business Response

  Date: 08/19/2024

  Please see the attached letter in response to the members additional information request. 

• Initial Complaint

  Date:06/28/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I went to an ER (ER at the Lakes) for a health issue (short 15 minute exam). There is a dispute over which code to use between the ER and BCBS of New Mexico. BCBS refuses to pay for the ER visit, even though that is covered by the health insurance I pay for them to cover.

  Business Response

  Date: 07/09/2024

  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to ********* ****. 

• Initial Complaint

  Date:10/16/2023

  Type:Sales and Advertising Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Blue Cross Blue Shield of New Mexico refuses to opt me out of their marketing and extraneous communications. I have requested through chats, on the phone and now in writing by US mail - at least 8 times this year to stop sharing my address with third party affiliates. I do not wish to receive surveys and offers to particiapte in various programs. I have explained that I wish only to receive my program documents, explanation of benefits and anything that changes my plans or benefits. Their response is that I have to opt out each time someone new sends me something. Sometimes that is in the US mail and i don't even know how to do that. I've told them that they are the ones sharing my address and email and to stop it. They refuse.

  Business Response

  Date: 10/24/2023

  October 24, 2023
  
  *** **** ********* ****** ** ***** * ************ ** *****
  
  
  RE:      Record ID: *********
  Member/Provider/Inquirer: ****** ******
  File #: ********
  
  
  Dear Better Business Bureau:
  
  This letter is in response to Miriam Shanks’s inquiry, submitted to your office and received by Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, on October 17, 2023.
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to ****** ******.
  
  We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible. If you require additional information, please do not hesitate to contact us in the future.
  
  
  Sincerely,
  
  ***** ** *******
  
  Executive Inquiry Specialist
  Blue Cross and Blue Shield of New Mexico

• Initial Complaint

  Date:08/04/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Multiple healthcare providers who accept Blue Cross Blue Shield of New Mexico (BCBSNM) policies have informed me that they do not accept my specific BCBSNM policy. I am trying to find out from BCBSNM if they payout less to providers for my BCBSNM policy than for other BCBSNM policy types. If so, I'd like to know which BCBSNM policy types have higher payouts to providers so that I can factor that into my decision regarding policy selection for next year. To date, the BCBSNM member services organization has 100% refused to assist me. They state that they do not have the information, and they refuse to assist me in getting into contact with any person/organization within BCBSNM that may be able to assist me.

  Business Response

  Date: 08/30/2023

  Please see the attached company's response

  This letter is in response to ****** *******’s inquiry, submitted to your office and
  received by Blue Cross and Blue Shield of New Mexico (BCBSNM), a Division of
  ****** **** ******* ***********, a Mutual Legal Reserve Company, an Independent
  Licensee of the Blue Cross and Blue Shield Association, on August 7, 2023
  
  Due to the Protected Health Information involved in the response of this inquiry a letter
  will be sent directly to ****** *******.
  
  We strive to deliver excellent service and appreciate being made aware of instances in
  which improvement is possible. If you require additional information please do not
  hesitate to contact us in the future.
  
  
  Sincerely,
  
  ******* ** ******
  Executive Inquiry Specialist
  Blue Cross and Blue Shield of New Mexico

  Customer Answer

  Date: 09/01/2023

  Complaint: ********
  
  I am rejecting this response because:
  
  BCBSNM has provided (via US mail) a form letter response that neither mentions nor addresses the issue.  The letter confirmed that I have coverage (something that I already knew and did not request confirmation thereof) and suggested the following resources for further assistance:

    -  Non BCBSNM entities (****************** and a related toll free phone number) that can't possibly address this issue which is BCBSNM specific.

    -  BCBSNM Member Services, which has previously refused to assist with this issue.

  At this point, I feel that BCBSNM has not actually examined in detail my original request.
  
  Regards,
  
  ****** *******

   

  [To assist us in bringing this matter to a close, the consumer must give a reason why they are rejecting the response. If the consumer does not provide a reason the complaint will be closed Answered]

  Business Response

  Date: 09/11/2023

  September 11, 2023
  RE: Record ID: *********
  Member Name: ****** *******
  File #: ********
  Dear BBB:
  This letter is in response to ****** *******’s inquiry, submitted to your office and
  received by Blue Cross and Blue Shield of New Mexico (BCBSNM), a Division of
  ****** **** ******* ***********, a Mutual Legal Reserve Company, an Independent
  Licensee of the Blue Cross and Blue Shield Association, on September 5, 2023.
  Due to the Protected Health Information involved in the response of this inquiry a letter
  will be sent directly to ****** *******.
  We strive to deliver excellent service and appreciate being made aware of instances in
  which improvement is possible. If you require additional information, please do not
  hesitate to contact us in the future.
  Sincerely,
  ***** ** *******
  Executive Inquiry Specialist
  Blue Cross and Blue Shield of New Mexico

• Initial Complaint

  Date:07/06/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In 2022 I tried numerous times to correct my address. Numerous places on APPS and on the WEB. I even was sent a letter. I never received my $100 from 2022 and now my doctor wants a wellness exam. Why? I'll never see my money because they never got a thing right. Beer yet I get a letter today for $50 incentive for home health assessment. Why? You got the letter to me bit ill never see a dime like last year.

  Business Response

  Date: 07/18/2023

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

• Initial Complaint

  Date:04/06/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Eight months ago we had procedures that were pre-authorized and paid in full by BCBS. In March of 2023 we received communications that BCBS made an accounting error and is now forcing the doctor's office to reimburse 100% of the pre-authorized and paid in full claims. In return, the doctor's office is now wanting us to pay for the procedures that BCBS reneged on. We have fought BCBS for weeks just to get them to sight the policy about their statute of limitations about going after $ for their accounting errors. They don’t have a limit for going back. Our doctor’s office and I both called BCBS multiple times asking about available benefits left on the plan. We were concerned with keeping a close record since it’s a once in a lifetime benefit. Since receiving the letters demanding payment from BCBS, we have been told that we have $12,000 left in lifetime benefits still available. We have been “family planning” for five years to avoid the financial stress that can be created by a baby. We have balanced our budget down to the penny to go through the IVF process without creating added stress to our lives in order to give ourselves the best chance for achieving the ideal outcome, a healthy baby. BCBS has added a tremendous amount of stress and financial hardship to our lives by reneging on their part.

  Business Response

  Date: 06/27/2023

  Please note, we mailed this response on April 27, 2023. We are attaching the letter mailed to your address. 

• Initial Complaint

  Date:01/26/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I've been working for months with this company seeking approval to purchase the necessary products. After months of negotiation, they provided me with the name and number of a supplier they directed me to use and then denied the claim.

  Business Response

  Date: 03/03/2023

  Please see the attached response. Thank you.

  This letter is in response to ****** ********’s inquiry, submitted to your office on January 26, 2023, and received by Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, on February 24, 2023. Due to the Protected Health Information involved in the response of this inquiry, a letter will be sent directly to Mr. ******** on or before March 17, 2023. Please allow adequate time for Mr. ******** to receive the letter as postal mail typically requires 7-10 business days for processing. We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible. If you require additional information, please do not hesitate to contact us in the future.