Complaints

This profile includes complaints for BlueCross BlueShield of South Carolina's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  BlueCross BlueShield of South Carolina

  8733 Highway 17 Byp S Myrtle Beach, SC 29575-7711

• 

  BlueCross BlueShield of South Carolina

  PO Box 100300 Columbia, SC 29202-3300

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:02/13/2025

  Type:Product 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 had a confirmed appointment with BCBS of South Carolina in their **************, ********* on Friday, Dec 13. it was confirmed when i booked it for 2pm EST on that date. i followed up with my contact ******** ******** via phone three (3) times and numerous times via email to confirm. she never got back to me. the deadline for open enrollment was that following day so it HAD to be done that day and i was told that was the only day and time she could do it. i was flying home from *** and my flight was going to be at the same time as the meeting, so i paid $135 (see receipts) to ***** to fly home for the confirmed appointment. she never showed. i have copies of the emails i sent to her. i ended up having to take three hours that afternoon and evening to call and get coverage. about 6 weeks of calls to the manager ****** ******** were never returned. finally spoke with his asst ********* and he finally called me back a week later. there was just excuses that they were "really busy" and knew they would be missing appointments but admitted they did nothing to follow up with anyone if they had an appt. i spoke with someone in corporate about this ***** ******* and today i find out that **** is refusing to credit me any money for the flight i had to take. this may seem ***** but after them s******* up and not responding to an existing customer is not okay. their "values" of Integrity, Respect, Commitment, Excellence and Caring are poorly represented by them and their staff. i was asking for a minuscule amount to account for the *** expense I had to incur because of their lack of customer care, staffing and follow up. its gross how much time i had to spend to even get a call back from them and then it was endless excuses. i can tell so many people have filed complaints with the BBB about them (and the other bad things i read online) so am now not surprised about this issue. OH they also never processed my Dental plan so i had no coverage for Jan 2025. another issue....

  Business Response

  Date: 02/25/2025

  We have reviewed the details of this matter and are satisfied that it has been addressed appropriately. We consider this matter to be closed.

  Customer Answer

  Date: 02/25/2025

   
  Complaint: 22934291
  
  I am rejecting this response because:

  for the many reasons i listed in my complaint -- the fact that my emails and calls to the person i had the appointment with never ONCE responded to me and the countless calls to the manager of that office (where this staffer worked) were never returned. countless hours of follow up with no response is unacceptable and unsatisfactory. of course BCBS does not care as i am now stuck with insurance with them for the next year -- so what do they care? i was asking for a measly amount to cover the cost of the airfare for the flight i took to come back for the **** confirmed and scheduled appointment so i am frankly not surprised at their lack of care since their staff and management can't be bothered to follow up with clients.

  
  Sincerely,
  
  ****** ********

• Initial Complaint

  Date:06/13/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore 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.

  Since April 18, my dentist has been attempting to obtain an auth for a crown. To date, June 13, it has still not been approved, and each time I call BCBS I am told it is being worked on and then the next time I call, I am told that nothing has been done with it. The dentist advised me in April that it needed to be done quickly. This is my second complaint with BBB about BCBS and their untimely managing of prior authorizations for dental work. I have been a BCBS client for almost 50 years, am a state retiree, and should not have to go through this to get a crown approved. My dentist has sent needed records to BCBS so I don't know what the issue is and BCBS can't elaborate.

  Business Response

  Date: 06/19/2024

  Our member services team successfully investigated the denial, made adjustments to resolve the issue, and has notified the member directly.

  Customer Answer

  Date: 06/20/2024

   
  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,
  
  ***********************

  I would hope to receive this approval in writing since I was told on Thursday the crown was approved and then told again on Friday that it kicked out again but would get resolved.  Thank you sincerely for your help.

   

• Initial Complaint

  Date:05/20/2024

  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 am having billing issues with my ********** Blue Shield Account and have had them since I started my account this year. This started with the healthcare exchange telling me that they needed payment I have the Marketplace telling me that they do not accept payments but I had to make a payment to start the process so the first payment was made, then there were attempts on my checking account for BCBS Premium Draft andI called BCBS and they don't know I called the Government and they say they do not collect premiums, so now I am confused if this is Silver or bronze and have to make a decision and rates because I am starting a new job, so I am very confused and need answers

  Business Response

  Date: 05/24/2024

  Our member services team has reached out to the member to address their concerns regarding the mailing address and policy changes or renewals. The member has expressed satisfaction with the resolution, and we consider this issue resolved.

• Initial Complaint

  Date:04/09/2024

  Type:Product 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 Shield of South Carolina contracts with OptumRX to handle their prescriptions. On February 9, they overcharged me on a copay by $291.08. Neither ********** nor Optum disagrees that they made this mistake and owe me this money. After 4 phone calls and no results, I filed a complaint with the Centers for ******************* Services. A couple of days later, ****** from **/BS of SC called me. She said that ***** told her the payment would be processed on March 16, and I should get it in 7 to 10 days. There was a long story about the claim for a refund having been approved on March 1, and that the processing would be March 16 (which is a Saturday, by the way). I forget the exact words she used, but I inferred that refunds are processed in groups. More than 10 days passed, and no payment. I called ****** again. She called Optum again and called me back. Now the story was that a check was mailed "yesterday," which was March 29. Now it is 12 days later and no check. It really sounds like Optum is telling stories, and I don't know when/how/if I can ever get my refund.I called ********* and ***** told me that she could file a complaint, but that the Centers for ******************* Services was over them. I told her that I already filed a complaint with them. I asked her what would happen. She said they would have 30 days to resolve it. When I asked what would happen if they didn't resolve it by then, she had no answer. It doesn't look like OptumRX is going to pay. I think BC/BS should pay me, and withhold that money from Optum. Barring that, ******** should refund me, and withhold that money from BC/BS. That's not going to happen, of course.So, I'm talking to people who have no power to do anything, other then file complaints, but with no teeth. There is no incentive for Optum or ********** to pay me. So, I'm reaching out to you to be another entity to complain, put pressure on them, etc. I am owed $291.08. Please help, thanks.

  Business Response

  Date: 04/18/2024

  Our member services team has confirmed with the member that the issue ******* raised has been resolved. Therefore, we consider this issue closed on our end.

  Customer Answer

  Date: 04/22/2024

   
  Complaint: 21550374
  
  I am rejecting this response because:
  
  Sincerely,
  
  *****************************

• Initial Complaint

  Date:03/18/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore 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 the ***************** car insurance gives you the option to get a personal injury protection letter from your healthcare provider so I contact ********** Blue shield of South Carolina my provider through work I was awarded a letter to give to my insurance company for my car and it's been over a month and a half I still haven't gotten a letter I've contact them for additional times had to go over the problem three more times about this is what I need the second third and fourth time they all claim they understand and are going to send it out they never do the last time the fourth time I asked for an actual piece of letter in the mail because they cannot seem to email me what I need now it's been more than 14 days since that time and I still haven't received what I need their service is already subpar for the healthcare they do provide and all I'm trying to do is get a piece of paper and they seem to not be able to do that even though they say they will and they say over and over they're going to do it they're going to send it out they're going to email it over I have yet to receive anything.

  Business Response

  Date: 03/19/2024

  Our member services team was able to contact ******* and answer the questions presented, as well as send documentation as a follow-up. We feel this issue has been closed. 

  Customer Answer

  Date: 03/19/2024

   
  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

  Date:03/07/2024

  Type:Service or Repair Issues
  Status:

  UnansweredMore 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.

  1/19/2024-filed an out of network health claim with BCBS of South Carolina. Date of service - 1/18/2024. Claim filed through their digital Health Claim portal using my BCBS "My Health Toolkit" account. After uploading, Given a "confirmation code" and message, "Please allow for the review process to be completed. Once the review is finalized, the status and details of your claim will be updated in your claims list." No confirmation email sent. No record of it anywhere else on file. Additional out of network claim filed with same provider 11 days later-date of service of 1/29/24. Same ambiguous confirmation code, no follow up communication.Did search in "claims list" for record 1/19/2024 claim. Records did not reflect claim being submitted-not listed under "pending", "processing" or "denied" was not shown processed claims list. became concerned that claim was not being reviewed. Called BCBS, was told, claim was being escalated would be about 2 weeks. No status change in online claims list. Called week later, told it was being escalated would be 2 weeks. Called today, 6 weeks from the initial filing date, was told it is being escalated and it will be two weeks. I said I was told that 4 weeks ago (really 5 weeks ago). Representative stated, online claims filing is "working out the kinks". Since filing the claims, 3 other claims sent directly from providers were processed and paid before these claims were even reviewed. After my call with BCBS today, the claims are now showing to be "processed" as of today. Not able to view the Explanation of Benefits for these claims. Link is there, nothing loads. Loads for other claims.BCBS notes on list - pay the full amount of 150$. Checked benefits guide: out of network states: Outpatient Psychiatry: $15/visit or 40% coinsurance. I have also nearly met my deductible.Claim#: C4053N9190000 Claim#: C4054N1330000

• Initial Complaint

  Date:12/27/2023

  Type:Product 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.

  BCBS has not properly accounted for the out of pocket costs I have paid to date in 2023. Specifically, I paid $2,000 in out of pocket costs between January 1 and June 30 which have not been applied to my account for my member spouse. As a result, I have overpaid out of pocket costs and am due a refund. I have been trying to get the issue resolved through BCBS since August 3, 2023. I have been told the issue was escalated on August 10, 2023. I have been told for months that the issue is valid. As of December 22, I am told the resolution is still being worked on. I am requesting that BCBS resolve this matter promptly and apply to my account all out of pocket costs I have paid and also refund to me all resulting overpayments of out of pocket costs.

  Business Response

  Date: 01/04/2024

  We have received and reviewed the complaint and our member services team has contacted the member to better understand the issue. Our team is committed to and are currently working on a resolution.  

  Customer Answer

  Date: 01/04/2024

   
  Complaint: 21060029
  
  I am rejecting this response because:
  BCBS has had over 5 months to resolve this issue. Continued delay is not a satisfactory resolution. The problem needs to be resolved immediately to avoid further complications related to my overpayment of out of pocket costs. 
  ************************************************

• Initial Complaint

  Date:05/15/2023

  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.

  Hello, I hope this reaches you well, I have questions about the billing on claims DOS: 03/21/23 Claim 308700BHB000, Claim 308302QND0000 3/15/2023 Claim Number 307507F2H000 I believe all of these involve a company by the name of Doctor's **** located on East Main Street, ***********, ** . I had to visit multiple times because of severe brochitus, or chest infection. and it took two visits to diagnose and then 1 to get proper medicine at CVS across the street. This is on top of the visits I had to make to CVS where the care started and CVS could not identify the root cause of the illness. So this was first treated with cough drops, vitimine C, oral temperature termonitor, tylenol which do nothing for an infection. So while I lost my job because of this, I am constantly paying co-pays at CVS and Doctor's **** and I may have gotten a break on the meds, am I supposed to get billed like this for this kind of keep coming back we aren't shure what you have service? Then I get shuffled across the street, then back over to CVS for the prescription?It was my understanding physician's offices are not supposed to charge patients for copays or billing for the same thing within so many days like 30 or 60. I appreciate what they did, but I was in severe pain dna it did me to facors to be out of work and then have to give up my job to get better. Please get back to me on this because I am not sure about this billing and would like to file for or ask for a refund if I am supposed to have not had to pay for the additional service visit.

  Business Response

  Date: 05/18/2023

  Upon review, we have determined the claims were processed correctly. We have been in touch with the member.

• Initial Complaint

  Date:04/07/2023

  Type:Service or Repair Issues
  Status:

  ResolvedMore 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 have health insurance not dental insurance with another carrier and BCBS is not paying the dental even though I dont have dental insurance and never had dental insurance with another carrier since having BCBS

  Business Response

  Date: 04/10/2023

  The member's policy was updated to reflect no other dental insurance coverage. The member's claims were adjusted to allow benefits. The member will receive adjusted Explanation of Benefits (EOBs) to show the claims were reprocessed to allow benefits.

  Customer Answer

  Date: 04/11/2023

   
  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

  Date:02/07/2023

  Type:Customer Service Issues
  Status:

  ResolvedMore 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 the ambulaory center to have outpatient procedure done and it was.My insurance paid agreed upon services of $2,297.51. Insurance paid ******* of that request.that left ****** owed. I paid pre ******. That meant they owed me a refund of $324.89.I called insurance and both of us talked on phone with billing center of ambulatory center and they said it was processing and i would be refunded. That was in August, I've called every month since asking about my refund and again today their reply is it is being processed. It's been 1 year this month.

  Business Response

  Date: 03/01/2023

  We are working with the provider regarding the member's refund, and we have been in contact with the member to update her on the process. We will maintain regular contact with the member until the issue is fully resolved.

  Customer Answer

  Date: 03/02/2023

   
  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. But they must do as they said and help get my refund.
  
  Sincerely,
  
  *************************