Complaints

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

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  Anthem Blue Cross and Blue Shield of Virginia

  2015 Staples Mill Rd Richmond, VA 23230-3108

  
• 

  Anthem Blue Cross and Blue Shield of Virginia

  PO Box 27401 Va 2002-n160 Richmond, VA 23279-7401

  

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:04/10/2025

  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.

  On December 18 of 2024 I had shoulder surgery with Tuckahoe orthopedics at the ********* orthopedic clinic. Prior to the surgery both the surgery center at *********** and my doctors office contacted anthem Blue Cross and Blue Shield. A prior authorization was requested and sent, as well as seeing what my out-of-pocket cost would be after using insurance. Anthem representatives advised both offices that I had met my out-of-pocket maximum for the year and I did not owe money for the surgery. I am now being billed by multiple different doctors saying that I have not met my out-of-pocket maximum. After speaking with anthem customer service I was advised that this was just a verbal agreement and was not correct. Advised I admit my out-of-pocket but on a phone call on todays date April 10, 2025. The customer service representative advised that I had notmet my out-of-pocket maximum which I had.

  

  Business Response

  Date: 04/11/2025

  Good morning, 

  We were unable to locate this member in our system. Please provide the member's identification number, including the three-character prefix. This information may be found on the member's health plan identification card.

  Thank you, 

  ******** *.

• Initial Complaint

  Date:02/06/2025

  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.

  On November 12, 2024 my office sent a request to Anthem Blue Cross and Blue Shield of Virginia to be removed as a in network provider. This request was sent to Anthem Blue Cross and Blue Shield of Virginia directly and submitted with EVERY dental claim from 11/12/2024 and AFTER. Anthem Blue Cross and Blue Shield of Virginia then stated that the request had to made through the Anthem webportal. The office sent the request through the portal. Anthem Blue Cross and Blue Shield of Virginia is ignoring the request from 11/12/2024.Anthem Blue Cross and Blue Shield of Virginia is forcing participation by not acknowledging the request made on November 12, 2024 to end in network participation. PLEASE HELP THE OFFICE OBTAIN A TERMINATION DATE FROM INTIAL REQUEST ON 11/12/2024.

  

  Business Response

  Date: 02/17/2025

  We are asking for an extension on this request due to the complaint was sent to the medical department in error and should have been sent to dental.  We are asking for the due date to be extended to 02/21/2024? 

  

  Business Response

  Date: 02/21/2025

  See attached response. 

• Initial Complaint

  Date:01/29/2025

  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.

  I lost my Anthem employer based coverage on November 30 2024 On December 14 2024 I received paperwork and instructions on electing a continuous of coverage through Cobra from my benefits administration ISolved Benefits Solutions On December 16 2025 I submitted paperwork and payment of $2314.34 to cover the months of December and January Anthem BCBS accepted payment for services on December 27 2024 As of today January 29, 2025 Anthem BCBS is refusing to honor the Cobra agreement and reinstate my coverage. According to Anthem BCBS it's not their problem. They gladly accepted payment for a service that they do not intend on honoring commiting insurance fraud solely so that if ever reinstated they can use the gap to deny all bills for this time period as untimely filing. They also feel that I should send them a third month premium yet they are not willing to honor the monies already received

  

  Business Response

  Date: 01/29/2025

  Good afternoon, 

  We were unable to locate this member in our system. Please provide the member's identification number, including the three-character prefix, for the plan that was cancelled. This information may be found on the member's health plan identification card. 

  Thank you, 

  ******** *.

  Customer Answer

  Date: 01/29/2025

  [A default letter is provided here which indicates your acceptance of the business's offer.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:

  Attached is a copy of my insurance card

   

  Id ************
  
  I have reviewed the offer made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. If the company does not perform as promised I can get back to you at: *********************************************************************************.
  
  Regards,
  
  ***** *******
  
  
  

  
  

  

  Business Response

  Date: 02/06/2025

  Good afternoon, 

  Member authorization is needed to address the member's concerns.  Please refer to the attached letter.

  Thank you, 

  ******** *.

• Initial Complaint

  Date:01/28/2025

  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.

  Over the past year Anthem has repeatedly denied claims from in-network providers. The reasons are always insufficient info. But this simply isn't the case. They even denied a claim from my PCP which I've used for over 10 yrs. They said they weren't in network. Recently they denied radiation treatment. I'm asking for help with that immediately to be reprocessed. And overall, I want the training or whatever the issue is in the claims department to be addressed immediately. All of my providers have reported the same issues with Anthem.

  

  Business Response

  Date: 01/28/2025

  Good morning, 

  We were unable to locate this member in our system. Please provide the member's identification number, including the three-character prefix. This information may be found on the member's health plan identification card.

  Thank you, 

  ******** *.

  Customer Answer

  Date: 01/28/2025

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  [Dear ********-

  Here is my account info: Member id: ************, dob: ******.  I called today and was told there was a peer to peer review needed for the brachytherapy treatment.  But, I'm wondering why no one contacted my doctor but instead denied the radiation.  I was supposed to have treatment today and have taken off from work.  This has been happening to many of my claims. Please call me at ************]

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

  
  

  

  Business Response

  Date: 01/31/2025

  Good afternoon, 

  Member authorization is required to address the member's concerns.  Please refer to the attached letter.

  Thank you, 

  ******** *.

• Initial Complaint

  Date:01/24/2025

  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.

  BCBS Federal Health Insurance denial of claims in bad faith. I am a federal employee enrolled in the ************ Employee Program. In December 2016, my 15-year-old son required emergency surgery for appendicitis, which resulted in multiple surgeries and an extended hospital stay at ********************************* in *******, operated under the Defense Health Agency (DHA). The treatment occurred from December 21, 2016, through January 20, 2017.Both the hospital and I submitted three medical claims to **** in 2017, but claims were denied for reasons that were not consist with their policies and a meet the legal definition of bad faith. The intent of the denials was to create delays and allow for BCBS to "run out the clock". My claim remains that **** violated the minimal contractual obligations under our insurance plan. We are currently being required to pay $71,062 to the **** Treasury for a medical debt that, under normal circumstances, should have been processed by **** following the initial claim submission to DHA in February 2017.BCBS misrepresented facts in its efforts to continue denying the claim. Despite the financial and psychological hardship **** has caused my family, these actions were deceitful or, at best, the result of unintended/clerical errorserrors for which the member cannot reasonably be held at fault.There is sufficient evidence to indicate that errors and mismanagement occurred on BCBSs part. I respectfully request that **** correct this tort of bad faith, process the claims appropriately, and provide OPM with the accurate documentation that has been selectively omitted. This will enable *** to reverse its decision and restore integrity to the process.

  

  Business Response

  Date: 01/27/2025

  The claim in question was denied for Timely Filing back in 2019. Until February 2024,there were no inquiries to the Plan regarding this claim and the denial. Upon receipt of the members inquiry, it was discovered that the members wages were garnished starting in May of 2022; therefore, as the deadline for appealing was exhausted, and there were no documentation indicating that the member was prevented from filing the request within the timeline due to circumstances beyond their control, the appeal was not reviewed under the Disputed Claims Process. Letters were sent to the member several times advising past time to appeal starting in February 2024 and most recently on January *******.   Therefore, the claim will not be reprocessed.  If the member has further questions regarding the claim they can contact the CareFirst Plan at ************.

  Thank you

  Customer Answer

  Date: 01/28/2025

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  

  The intent of BCBS health coverage is to provide minimum essential coverage and meet the minimum value standard for the benefits it provides, as stated in our plan. **** failed to meet its most basic requirements, specifically those outlined on page 83 of the 2017 Service Benefit Plan (Plan) as it pertains to Medical Emergencies.  This is not a dispute, **** breached their contract and only recently decided to deny responsibility in Bad Faith ******************************* and its members are obligated to comply with the plan. If legitimate disputes arise, the plan outlines the appropriate dispute process. However, this process is not intended to correct bad faith actions by an insurance company. My claim remains that **** violated the minimal contractual obligations under our insurance plan and only recently decidedly convert their position to deceive and misrepresent facts to falsely blame members.   

  I assert that BCBS misrepresented facts in its efforts to continue denying the claim. **** stated that the denial is not eligible for the Disputed Claims Process but also implied that it successfully delayed the matter through repeated denials.  Due to BCBS recent actions and continual behavior to assume this is a dispute is an action of bad faith.   The reasons for BCBS denials are in direct and specific conflict with the plan and meet the legal definition of bad faith. Despite the financial and psychological hardship BCBS has caused my family, these actions were deceitful or, at best, the result of unintended/clerical errorserrors for which the member cannot reasonably be held at fault.

  We have learned that our overseas claims were handled by your contractor, ***. We have learned that **** do not have access to their paperwork. This is not our problem. Members do not have access to that information. Members follow the instructions on ***********. We do not know if we are dealing with BCBS-******, BCBS-AXA, BCBS-Virginia, or BCBS-**************. We work with ***********.  Since 2014, our family has moved from ************** to ****** to ************************ to ***** to Virginia to ******* and back to the **. We have updated our information EVERY TIME.   Both my son and I had other significant procedures that were covered, no questions, do disputes, BCBS paid and processed per their plan.  BCBS made a mistake, but instead of correcting, they have chosen to divert a breach in contract to a dispute, acting in bad faith.  

  BCBS decision in 9/17/2019 and repeatedly denying and delaying this claim, **** has demonstrated an intent to avoid its contractual obligations.  The plan clearly states BCBS responsibility for medical emergencies.   To site paragraphs as BCBS did in prior letters avoids that you failed to act on all the relevant pages and text regarding medical emergencies.   Again, the intent of your referenced pages should not be to allow BCBS to intentional misrepresentation of material fact (page 6) and subsequently convert a likely clerical error into a clear definition of an insurance company denying service in bad faith.  

  My only oversights is in assuming that **** processed the claim per their plan, as they had done every single time.  Particularly, during an emergency, life saving surgeries, on a minor.   It is not my responsibility to tell **** how to do their job, but I will call out lies and deceitful actions as have been recently exposed.   

  We do not argue this is a dispute as defined in the member plan but expose that **** has recently converted action to deny coverage in legal definition of bad faith/fraud as of February of 2024.  True, we had no idea that **** did not comply with their contract until investigating, but it was **** who has, plausibly, knowingly intended to convert contract violations to claim dispute.  We prove that there is absolutely no dispute in our claims that is compliant with the Plan.   

  There is a contract violation that was exposed last year and continues to demonstrate **** intent to deny this claim until all available deadlines had passed.   

  There is sufficient evidence to indicate that errors and mismanagement occurred on ***** part. I respectfully request that BCBS correct this tort of bad faith, process the claims appropriately.   All claims were submitted within the time limit and in accordance with BCBS policy and plans.   There is no public document or plan that allows BCBS to deny and delay claims for no reason but to delay.   BCBS plans gave all permissions and instruction for **** to process the claim and recently has decidedly to deny this on bad faith.  

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

  
  

  

  Business Response

  Date: 01/29/2025

  We understand that the member is not happy with our response. Unfortunately, the member did not appeal within 6 months of the denial issued in 2019, nor did they provide documentation of what prevented they from appealing in a timely manner.  Therefore, we are unable to waive timely appeal on this claim and reprocess. If the member has further questions regarding the claim they can contact the CareFirst Plan at ************.

  Thank you, 

  Customer Answer

  Date: 02/03/2025

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  

  BCBS behavior, and continual denial is unethical.  BCBS is not denying that they committed the crime, acted in bad faith or unethical.  **** understands that they failed a member, breached their contract by choosing to take a clerical mistake and use timelines as a way to push blame.   BCBS also choose to mislead the *** in providing sufficient documents and investigations to allow *** to reverse BCBS decision as permited under the Section 980.105(e)(5) Title 5 of the Code Federal Regulations.   

  The hospital and I complied to the denial in 2017.  **** denied the claim because they wanted to know if there is any other insurance responsible.  This is not a policy or plan requirement and is not a valid excuse for denial per their plan in 2017 nor in 2025.   How ever we confirmed that we don't have any other insurance in 2017; at least 5x a year we comply with this non policy request.   After 2017, we did not hear from **** nor the hospital and is very typically when a claim is resolved.   We assumed that BCBS complied with their policy and plan and resolved the medical claim.   

  It was not until May 2022, when the US Treasury started collections, that we found out that **** didn't pay.  It wasn't until 2024 that we found out that it was a result of *************** and clerical mistakes.   2024 is also the year **** decided that they aren't responsible for breach in contracts or any ethical responsibilities and aggressively to mislead *** in efforts that the member is responsible to find **** mistakes, and we should have known that **** makes mistakes that they hide behind for profit.    

  How will any member know that BCBS made a clerical mistake and didn't pay?  (We are also pursing action against the hospital for not informing us that BCBS failed to pay).  The Hospital informed us that they received denials with NO explanation of why.   

  To be fair with BCBS-Virginia, we were under BCBS-****** at the time were overseas.   This is how BCBS manages its program and increases the likelihood of coordination issues.  BCBS Virginia is only involved, because we have been living in Virginia for several years now.   BCBS Virginia is a victim of corporate policy to mislead thru coordination.   

  There is no history of a denial in 2019. In 2019, I was deployed to ***********************, and later that year moved from *** to DHS. In 2019, BCBS did not renew its contract with their overseas partner, *****************, and is when **** found out/exposed that there was an open unresolved claim.  We proved that both the hospital and I submitted all required documents on time, and within less than 1 year of discharge from the hospital.  **** chose to remain silent and ignore their responsibility. We assumed to have continual health care coverage, but apparently there are holes in BCBS when employees move and transfer.   BCBS needs to corrects clerical mistakes, honor their plan and policy agreements, and make right their wrongs.  Instead, BCBS choose to deceive, and I don't think it was BCBS-Virginia to fix, but BCBS-Federal Employee Program to fix.   

  These documents proves that BCBS behavior (in this case) is unethical, and BCBS is not denying that they kept quiet, delayed and misleading ***>  The attempt to mislead *** is done in Bad Faith and attempt to deceive the federal government.    *** is poorly staffed and easily intimidated by BCBS.  BSBS has more lawyers, more time and more money and can make decision based on profit rather than ethics.    Had BCBS provided *** with all the data, I assure you *** would allow **** to correct and waive any time limitations.  Rather to have a clerical mistake than an act of Bad Faith.     

  BCBS made $1.3B in net profit (record setting 2nd highest), almost twice that of 2017 pt 2018, so there was incentive and intent.  

  That's just 30 minutes in a whole year time, that **** made in profits by denying responsibility for clerical mistakes and then choosing to mislead ***.   I know BCBS knows the correct history and actions.   BCBS chooses to conceal.  

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

  
  

• Initial Complaint

  Date:01/06/2025

  Type:Customer Service 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 have called anthem multiple times and no one will resolve my issue. Someone is fraudently using my insurance. I want a new card with a new number and these claims removed from my acct

  

  Business Response

  Date: 01/07/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card. Also, can you provide the dates of service in question that you think are fraudulent?

  Thanks,

  *****

• Initial Complaint

  Date:01/03/2025

  Type:Delivery 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.

  The Pharmacy that they are associated with is CarelonRX... I placed an order for a drug to prevent rejection of my transplanted heart. 2 orders in a row, they have screwed up the process in every way. I ordered on a Friday, told the following Wednesday that the order was cancelled with no reason. 1.5hr phone call later, they need a new script from doctor. I have Doctor send it over, they process the order, I call to say I need the Drug ASAP. They said, "because the order was processed already, we cannot overnight it" . . . . seriously that was there response. It's now Friday, my last day I have that medication. The order is paid and the status is "The pharmacy is checking to make sure the medication is in stock" I have been on the phone for an hour now and no resolution. Anthem says is not their problem. It will be when I need a new heart transplant.

  

  Business Response

  Date: 01/06/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three letter prefix. This can be located on the member's identification card. 

  Thanks,

  Paige 

• Initial Complaint

  Date:12/19/2024

  Type:Customer Service 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.

  We are a medical provider who has continuously experiences issues with our credentialing contract and fee schedule. We are not being paid at our properly contracted rate. We are also still being listed as an *** provider when we have been an INN provider for over 10 years. We have been trying to contact our local POC, but they will not ***ly back to our emails to assist us. When we reach the credentialing line no one will assist us because they state that our local *** has to. This has been an ongoing issue where no one will follow through with the assistance.

  

  Business Response

  Date: 12/20/2024

  Please be advised we need the providers tax Id # and NPI # and any claim information that they may have that are effected by this in order to address there concerns. 

  Customer Answer

  Date: 01/02/2025

  Our NPI is ********** and Tax ID is *********. Our provider is Moonhee ** and we are at the 4495  ****************************************** address.

  We appreciate you looking into our contract.

  Thank you.

  

  Business Response

  Date: 01/16/2025

  Please see attached decision letter. 

  Thanks,

  *****

  Customer Answer

  Date: 02/21/2025

  This is our 2nd attempt to get assistance. We initially sent our first complaint to BBB back in December to make a formal complaint about our contract with Anthem BCBS of Virginia where we are being incorrectly paid for medical claims and our provider is being listed as out of network. Our local POC never replies to our emails. She replied back after the BBB report was filed, we had a very brief contact with her where she asked us to sent supporting documents for our claims and network status and said she would do research and get back to us. After NUMEROUS unanswered emails since december we are back to square one. This is the most unprofessional service and this is supposed to be the ONLY person who can help us. A medical provider should not have to endure such a long process to be paid correctly at their legally binding contract agreement and should not be represented incorrectly on the network websites as out of network. We have been practically begging her to reply to us and our emails still go unanswered. We would truly rather not deal with our local POC because obviously they do not represent the local area properly and professionally. We ask for their supervisor or someone else to reach out to us.

  

  Business Response

  Date: 02/24/2025

  Date Sent: 2/24/2025 10:19:26 AM
  Good morning, 
  
  Please provide the name and address of the provider, the Tax ID number, and the *** number.
  
  Thank you, 
  
  ******** *.

  Customer Answer

  Date: 02/24/2025

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and responding the following questions. 
  
  "Please provide the name and address of the provider, the Tax ID number, and the *** number."
  
  -> BMH PT P.C,  ***********************************************, Tax ID **********, *** **********. 
  
  ******* **
  

  

  Business Response

  Date: 02/27/2025

  Please see enclosed letter.

  Thanks,

  Paige 

  Customer Answer

  Date: 02/27/2025

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  Per the resolution message it stated that someone had contacted us but that was indeed NOT the case. We have NOT been contacted by anyone at all during this new complaint. This is the exact reason why we have to file these complaints because no one will follow up with the proper communication and assist they just want to pass it on to someone who won't reply to us. The contact information for ******* ** is : ************ Please contact to discuss as this is not resolved. 
  
  Regards,
  
  Moonhee Jo
  
  
  
  
  

  

  Business Response

  Date: 03/06/2025

  Refer to attached decision letter.

  Thanks,

  Paige 

• Initial Complaint

  Date:12/18/2024

  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.

  The insurance company Anthem erroneously stopped paying us for our legitimate pathology services in April 2024. We became aware of this in June 2024 and have worked extensively with them via ****, our billing company, since June 2024 to remedy the issue but they keep giving us the run around. We took certain steps as recommended by the Anthem Rep ******** which only led to more problems. Anthem is now saying that they don't have to pay us retrospectively for any of our pathology services for Anthem Federal Patients. We were advised by an anthem rep ********** to make certain changes to our account which resulted in this problem in June 2024. We have a whole string of emails to document this occurrence. Since then we have tried to work with them to remedy the issue but nothing has worked. We are now submitting a THIRD application to try to remedy the issue. However, the anthem rep ***** ***** states that Anthem won't pay us anything retrospectively. This is dishonest and unethical. Another example of a large insurance company hurting physicians and patients. Just outrageous and a disgrace. My name is **** ******** MD. ********** name is ******** ******** Gastroenterologist PC. The complaint is against the all powerful ***************** ANTHEM.

  

  Business Response

  Date: 12/26/2024

  Please see attached decision letter.

  Thanks,

  *****

• Initial Complaint

  Date:12/05/2024

  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.

  I am a health care provider with public Partnership I have been caring for a very critical patient since early November and received no payment. Anthem has to give the approval to pay. All paperwork has been done and submitted.I also made numerous phone calls with still no response. I understand a approval can take up to 14 days but 2months ?? Someone please help me to get this issue resolved. NettieMeade .************. Patient ********* ****** ID number for ***********************************

  

  Business Response

  Date: 12/06/2024

  Good morning, 

  We were unable to locate the member in our system using the identification number provided.  Please submit copies of the front and back of the member's health plan identification card.   

  Thank you, 

  ******** *.