Complaints

This profile includes complaints for Blue Cross and Blue Shield of Vermont'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 Vermont

  445 Industrial Ln Barre, VT 05641

• 

  Blue Cross and Blue Shield of Vermont

  PO Box 186 Montpelier, VT 05601-0186

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:09/26/2024

  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.

  I have called customer service and sent multiple letters with my bills. My bill continues to show a past due amount. **************** told me my account is up to date no past due amount but my bill continues to show a balance forward. I have sent letters showing my payments and that my account should not have a balance forward however these letters and calls seem to be getting ignored because I continue to get bills with a balance forward. I have now gotten letter that says I must pay entire balance on bill or they will cancel my insurance. Please help me get this corrected thanks *****

  Business Response

  Date: 10/03/2024

  Hello Kevin,
  
  Thank you for taking the time to share your concerns and issues with us. Our premium billing team outreached to you by phone on September 27 and September 30 to discuss your concerns. They were not able to reach you and left voicemails with their contact information and we have not heard back from you.
  
  To resolve this matter, you will need to contact the premium billing team at (888) 320-9798, option 4. Their office hours are Monday through Friday, 8:00 a.m. to 4:30 p.m., excluding holidays. Please note, we will be closed on October 14, 2024, in observance of Indigenous Peoples' Day.

  Sincerely,
  
  Customer Service
  Blue Cross® and Blue Shield® of Vermont
  www.bluecrossvt.org

• Initial Complaint

  Date:03/12/2024

  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.

  I called on 03/12/2024 for claims inquiry from a providers office. I was in the queue for 1 hour and 40 minutes before a representative answered. When they did, they told me I needed to contact the Vermont Blue Card Line and I was transferred where I was in the queue for another 1.5 hours before it just disconnected.

  Business Response

  Date: 03/14/2024

  Hello,
  
  Weve reviewed the information provided in this complain and do not believe this was a customer of ours for this type of inquiry. Weve reviewed our records and see the phone number ************** is associated with a billing company for a providers practice that is not contracted with Blue Cross Blue Shield of Vermont.
  
  The phone number that was contacted in the complaint documents, **************, is for our Provider ******************** and it is only appropriate for Blue Cross Blue Shield of Vermont contracted providers to call this number.
  

  Providers who are not contracted with Blue Cross Blue Shield of Vermont and are located outside the Vermont service area file claims to their local Blue Cross Blue Shield plan and would need to contact their local Blue Cross Blue Shield plan for questions on claims theyve submitted. The exception to this rule is if the member is our insured and the claim was processed by ******** as primary, and the claim crossed over from ******** to Blue Cross Blue Shield of Vermont directly. Based on contact history from the phone number provided, this exception is not the nature of the complainants inquiries.
  
  If the complainant needs assistance with claims theyve submitted to their local Blue Cross Blue Shield plan, such as claim status, payment, processing, and denials, they need to contact their local Blue Cross Blue Shield plan to resolve.
  If the complainant needs assistance with ******** crossover claims, benefits, eligibility, and prior authorization requirements, they may contact our ****************s line ************** or by email at *************************** However, if their inquiry ultimately is related to how a claim has processed through their local Blue Cross Blue Shield plan, they will still need to contact their local plan for claims assistance.
  
  Based on the information provided and, in our records, the complainant is not a Blue Cross Blue Shield of Vermont customer and contacted an inappropriate phone number for claims assistance, which resulted in them being routed and on hold with the wrong company and departments.
  
  If the complainant attests to be a contracted Blue Cross Blue Shield of Vermont provider, wed be happy to confirm if they provide us their National Provider Identifier (NPI) number, and we could provide additional options for them to review claims status.
  Otherwise, should they need further assistance from our company for inquires that would be appropriate for us to handle, they may contact our **************** team at ************** or by email at ***************************
  
  Sincerely,
  
  Customer Service
  **********************
  **********************************
  Case# ********

  Customer Answer

  Date: 03/14/2024

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  [We ARE the billing company for a Physical Therapy Practice in Morristown, Vermont who is in network and BCBSVT is the local plan. Your answer doesn't really excuse why your hold times are 1.5 hours long, whether or not a provider is contracted or why it disconnected from the waiting queue after an hour and a half. ]
  
  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  *****

   

   

  Business Response

  Date: 03/21/2024

  Hello,
  
  Thank you for providing additional information. We are aware there are increased hold times due to volume of calls and apologize for any inconvenience.We did investigate our call records with the information you provided and do not see any calls were being dropped. If you are impacted by a long hold time for your inquiry, we have other ways you can get in touch with us in a timely manner:

  
  For out of area (Blue Card) claims: *******************
  For ****** member claims: **************************
  For Federal Employee Program (FEP) claims: *****************************
  Our ************************ (PRC) for ****** contracted providers: www.bluecrossvt.org/provider-login

  
  Our PRC and emails are sent via a secure messaging service to protect your health information.

  
  If you prefer to call:
  For ****** member claims: **************
  For out of area (Blue Card) claims: **************

  
  When contacting ****** by email or phone, please have the following information available:

  
  Provider NPI
  Members First and Last Name, Date of Birth, and ID Number
  Date of service and total charge amount (For claims inquiries)

  
  Please also keep in mind, ****** contracted providers are required to provide ****** with written notice of the existence of any agreement with a Business Associate, including, but not limited to, a billing service to which a provider discloses Protected Health Information for the purposes of obtaining payment from Blue Cross ** and/or TVHP.  If you are contacting ****** on behalf of a ****** contracted provider, please be sure the practice has notified ****** prior to contacting us to ensure we can assist you with your inquiry.

  
  Sincerely,
  
  Customer Service
  **********************
  **********************************
  Case# ********

• Initial Complaint

  Date:08/26/2023

  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.

  My wife, ******************************* who is now deceased went to **** emergency room on July 17, 2022. She was told that she needed to be transferred to ***** because of potential internal bleeding. She was transported to ***** by ********** EMS. The billing was not submitted properly or on time to BCBSVT by Barre EMS. I paid the ambulance bill out of my own pocket for $1649.34. When I realized that the claim should have been paid, I contacted Barre EMS and BCBSVT in April 2023. BCBSVT has denied the claim because it was too long ago and wasn't submitted properly. The claim should have been paid through my CVMC Employee Blue Cross.

  Business Response

  Date: 08/31/2023

  Hello, 

  This matter has been resolved.

  Customer Service
  

  Blue Cross and Blue Shield of Vermont

  www.bluecrossvt.org

• Initial Complaint

  Date:02/22/2023

  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 filled out information seeking basic information on insurance opportunities. I then proceeded to get an unruly amount of calls. In spite of me asking them to stop calling, using forceful language, demanding they stop calling, indicating that I would be reporting my complaints, they continued to call, as the screenshot indicates, 10 times over 1 hour. When I asked them to stop calling they just hang up on me. I Don't know any other solution at this point to get them to stop calling me.

  Business Response

  Date: 02/24/2023

  Hello,
  
  Weve verified the phone number that this customer is receiving calls from is not a Blue Cross Blue Shield of Vermont phone number and is not used by anyone legitimately representing our business. When weve called the phone number to verify who may be fraudulently representing our business, the representatives refuse to identify who they work for and disconnect our calls. These phone calls are rom persons fraudulently representing our business and we encourage the customer to report the phone number as fraud, and to not provide the callers any information.

  Sincerely,
  
  Customer Service
  Blue ************************* Blue ********************** of **********************
  **********************************

  (