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Review from MARYJO T
1 star08/02/2024
I PAID MY MONTHLY PREMIUMS FEES ON THEIR WEBSITE LIKE I ALWAYS DO EVERY MONTH. THIS MONTH I MADE MY PAYMENT BUT INSTEAD OF ME GETTING A CONFIRMATION ABOUT PAYMENT BEING MADE I WAS BROUGHT BACK TO THE BILL LIKE IT WAS NEVER PAID. I SEARCHED THE WEBSITE TO SEE IF THE PAYMENT WAS PENDING, THERE WAS NOTHING. I THOUGHT THERE WAS A HICCUP WITH THE SYSTEM AND MADE IT AGAIN THIS TIME I WAS GIVEN A RECEIPT WAS PAID AND BILL IT SHOWED 0.00 DUE. IN A FEW MINUTES I RECEIVED 2 EMAILS FROM BCBS SAYING THEY RECEIVED MY PAYMENT. I AGAIN LOOKED AND ONLY SAW THE SECOND PAYMENT THAT I MADE BUT TO BE SURE I CALLED THEIR CUSTOMER SERVICE DEPARTMENT. THE GIRL I SPOKE TO ASSURED ME THERE WAS ONLY ONE PAYMENT COMING OUT AND IT WAS THE SECOND PAYMENT I MADE, I KNOW THIS BECAUSE THE FIRST PAYMENT I MADE I PUT PAYMENT DATE AS 8/1/2024 WHICH IS THE DUE DATE, THE SECOND PAYMENT I FORGOT TO CHANGE THE PAYMENT DATE SO IT WAS FOR 7/31/2024. WELL ON 8/1/2024 I SAW ON MY BANK ACCOUNT THE ONE PAYMENT COMING OUT, BUT THEN ON 8/2/2024 I SAW A SECOND PAYMENT COMING OUT. I CAN'T AFFORD TO PAY 926.00 TWICE I HAVE OTHER BILLS COMING OUT AND THAT SECOND PAYMENT WOULD OVERDRAFT MY ACCOUNT. THE ONLY OPTION I HAD WAS TO BUT A STOP PAYMENT ON THE SECOND PAYMENT AND PAY $32.00 FEE FOR THE STOP PAYMENT. THE ONLY THING I WANTED FROM BCBS WAS TO PAY ME BACK THE $32.00 SINCE IT WAS THEIR WEBSITE THAT DID NOT FUNCTION CORRECTLY AND THEIR CUSTOMER SERVICE REP SAID THERE WAS ONLY ON PAYMENT. WELL THEY WILL NOT REIMBURSE ME, WHAT A SHADY COMPANY THEY ARE RUNNING. I DID NOTHING WRONG IN FACT I DID EVERYTHING RIGHT BY CALLING THE SAME DAY I SAW THE 2 EMAIL TO CANCEL ONE PAYMENT. I WAS GIVEN AN EXCUSE THAT THE BANK WAS HOLDING THE FIRST PAYMENT, BUT THE SECOND PAYMENT DID NOT HAVE THAT ISSUE. THEIR SYSTEM SOULD NOT ALLOW SOMEONE TO MAKE THE SAME PAYMET TWICE, THIS IS THEIR ISSUE, EVEN THE CSR I SPOKE TO TODAY TOLD ME SHE HAS MANY CALLS WITH ISSUES WITH THEIR WEBSITE THE LAST FEW DAYS,BUT DON'T CAREReview from Elisabeth C
1 star02/28/2024
Terrible dental service. My dentist referred me to a specialist for a root canal and there is noone in my area who accepts this insurance. The company is taking forever to give a pre approval so that I can try to find someone to take care of my tooth. In the meantime they say that if I get it taken care of before the pre approval I might have to just pay for it myself because they didn't approve the procedure. So I am stuck in pain with my tooth getting worse and worse while they do nothing. I have spent countless hours on the phone asking if there is anything that can be done so that I can get my tooth taken care of and they continue to talk in circles about needing the pre approval to go through before any other steps can be taken. Better off with no insurance at all that with this insurance.
Excellus Blue Cross Blue Shield Response
05/07/2024
Upon receipt of your complaint, we requested and received input from **********. The input was provided by Mr. M*****, Sr. Grievance and Appeal Specialist. ********** Member Services outreached to your general dentist and requested they submit a prior authorization for the root canal to determine if the procedure would be covered under the dental plan. Their records indicate the prior authorization was received on March 18, 2024. The root canal on tooth #15 was approved on March 20, 2024, under predetermination of benefits # ************. ********** was able to locate the following participating provider: ******* Dental, *** ******* Avenue, Rochester, NY *****, ###-###-#### (Specialty Dental Care), ###-###-#### (General Dentist) ********** Member Services Department tried contacting you on March 27, 2024, and April 8, 2024, to provide you with the dental clinic information; however, there was no answer. The representative did leave a voicemail advising you to contact our Member Services Department at ###-###-#### regarding the provider listing.Customer Response
06/11/2024
Unfortunately this was done after I had to have and pay for the root canal out of pocket. The participating provider that you "approved" was also not accepting new patients. I had previously contacted them when forced to try to find a provider for myself and I informed the staff at Excellus of this fact during one of my many phone calls. I spent hours on the phone with Excellus trying to explain to them that I could not wait to have the root canal done and they just continued to tell me that there was nothing they could do. Coming back after the root canal was already performed to say that they would have covered it does not change the fact that they DID NOT COVER the root canal when it needed to be done. Dental work can not always wait and refusing to pay for it at the time it is needed or at lease reimburse after the fact is negligent and defeats the purpose of having insurance. In order to make this right Excellus needs to reimburse me for the dental work that I had to pay for out of pocket as a result of their stall tactics and negligence.
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