Reviews

I had a medication that I had been on for 6 months that needed a new PA. Fine. I met all requirements for approval, no big deal. PA submitted, denied. Provider's office calls to find out why. Person on # on denial to call couldn't answer, they "weren't clinical." Fine. They gave them a # for the provider to call pharmacist for a peer-to-peer. Pharmacist says yeah, it shouldn't have been denied, fax us a letter with all the things that apply to patient that make her meet requirement for med. Provider does this. Almost a week later, no updates. I get on to check status of my PA. Still says denied. After being on hold for over 30 min, I finally get a real person. They say, "sorry, ma'am, your provider never submitted a PA" - so they are unfortunately unable to give me an appeal update. Only thing is, I work at said doctor's office. So I know for a fact PA was submitted. Even give them the reference #. They still say no such claim exists. I get off the phone, go back to the PA status page, wouldn't you know? Entire thing no longer exists. It was deleted. New PA submitted with exact same info as first that was wrongfully denied, and boom, approved within 20 minutes. Tried to blame it on the doctor's office and lie to me, the consumer. DO BETTER, STOP LYING TO COVER YOUR MISTAKES (deny, deny, deny, hope the consumer doesn't question it), AND STOP SCREWING PEOPLE OVER!!!!! Zero stars, but that isn't an option.

On serval occasions I have received emails from them telling me that I have a new bill on my portal that I need to review. When I click on the URL it takes me to my portal and the fails to load and I receive a notice that I need to call service. When I called their customer service and after a transfer The customer service agent suggested that I reset my computer. She did not know how to do that and I found that resting to computer factory settings will result in a loss of all my data and installed programs. They failed to correct the problem and wasted my time.

I had a procedure on 5/31/24 which is a service covered under ACA guidelines (sterilization). I did a considerable amount of research prior to the procedure to confirm that it would be covered. I now have 2 EOBs for 2 different anesthesia charges and providers - basically, my insurance is trying to say that anything outside the procedure itself is only covered under my benefits guide. However, this is incorrect. *************************************************** Page 4, Q1 specifically mentions the procedure and confirms that anesthesia should be included as part of the covered procedure, as well as basically everyone else. h**************************************************************************************************** Confirms this. Page 19 of my benefits guide indicates that the plan is ACA compliant. Something can’t be “covered at 100%” if I am paying for any part of it out of pocket. The company is requiring me to file an appeal when this is violating government guidelines and compliance for it to even be billed against my plan coverages.

There customer service is a joke. And there app and web site is the worst i have encountered. Will not stay with them next round for sure.

Ditto the experience of the person who left a comment 10-04-2022. This may well have been the very worst telephone "customer support" call I've ever had. 45 minutes on the phone--for nothing. Two persons I talked to were practically unintelligible, none of the four seemed interested in why I was calling (to switch Part D plans). The last person worked for another firm and brokered ******** Advantage plans. When I asked to talk to someone from BCBS of KS, the phone went dead. :-/

BLUE CROSS AND BLUE SHIELD DOES NOT PAY CLAIMS. THEY HAVE HIRED OVERSEAS CUSTOMER SERVICE REPS WHO BARELY SPEAK ENGLISH AND TELL YOU THE SAME THING WORD FOR WORD, SCRIPTED EVERY TIME. AMERICANS NEED TO ASK THEMSELVES THIS. THE RISE IN OUR PREMIUMS AND OUT OF POCKET EXPENSE GO UP EVERY YEAR. THEY BLAME IT ON HEALTHCARE COSTS. BUT THE PROVIDERS AND MEDICAL CENTERS TAKE A REDUCTION IN REIMBURSEMENT EVERY YEAR. BUT ALL INSURANCE COMPANIES ARE REPORTING YEARLY PROFITS IN THE BILLIONS. CUT AND DRY CORP GREED. 25 iNSURANCE COMPANIES ARE IN THE TOP 100 BUSINESSES ON THE FORTUNE 500 LIST. IT IS A SHAME THAT NO ONE IS COMING DOWN ON THIS ISSUE. NO ONE IN GOVERNMENT CARES PROBABLY BECAUSE THEY ARE SHAREHOLDERS OF THESE COMPANIES. IDK.