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Insurance Companies
Anthem Blue Cross and Blue ShieldHeadquarters
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Complaint Details
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Initial Complaint
12/21/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I enrolled in Empire BCBS's (Empire) HealthPlus Gatekeeper X, for HSA, Bronze, *** **** *** Network, *** **, Ped Dental Plan on Sep 1 2022. Empire assigned a PCP to me, Dr ******************** I used to see providers at NYU Langone, so I called Empire to change my PCP to a doctor practicing out of NYU Langone who is listed as in network within the Empire network. On Dec 1, I spoke with customer service agent ******* for 1 hour and she confirmed a switch to ************************ I have a recording of her confirming this change. However, when I checked the system the next day, the change had not been made. On Dec 20th I called again, spoke with Supervisor ************ who told me he would make the change, but instead assigned me to ********************************* All doctors assigned to me by Empire to date, Dr ****** ********************* and ********************* are part of One Medical, and none are doctor I requested. Despite numerous calls and repeated requests, Empire does not assign me to Dr *** whom I have requested. When I called One medical, they told me their doctors are actually out of network for Empire. I would like to lodge a formal complaint against Empire and request them to change my PCP to Dr. ****Initial Complaint
11/18/2022
- Complaint Type:
- Product Issues
- Status:
- Resolved
I was insured by Empire BC/BS while employed by ********************* until my termination on 4/12/2022.Since June 2022 I have been trying to get a printed copy of my 2022 Explanation of Benefits from BC/BS. I have made a number of phone calls requesting a printed EOB for January 2022- April 2022. Each time I am told the printed EOB will be mailed out in ***** business days. It is now Nov 18th, and I still have not received the printed copy. That's an awful long ***** business days in my book!In addition to my telephone requests, on 9/28 I sent a certified letter to *** ********************** the Empire BC/BS CEO stating my frustration with his customer service department and asking that a copy of my EOB please be sent to me. I have received no response at all from his office.All I'm asking for is a printed copy of my EOB for January 2022 thru April 2022. Can someone please help me.Customer response
12/16/2022
Better Business Bureau:
At this time, my complaint, ID ******** regarding Empire Blue Cross & Blue Shield has been resolved.(By clicking "OK", your complaint will be closed as Resolved.)
Sincerely,
*****************************Initial Complaint
11/17/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
Good afternoon:We are writing to file a complaint against Blue Cross for patient P. ************************************, for date of service 5.11.22 surgery performed by ****************** for ******* claim submitted. Prior to surgery the benefits were verified as 90% *********** for out of network providers. Our verification **** s/w *** on 5.5.22 with a reference number of **********. There is NO WAY that the patients co insurance is ********* with a plan as this and only has a ******* deductible. Blue Cross needs to pay this claim according to *********** reimbursement amounts and I can provide you with those if you should need them , please note if this claim isn't processed according to patient benefits, we are filing a complaint with the attorney general. Thank you!Customer response
12/12/2022
Better Business Bureau:
At this time, I have not been contacted by Empire Blue Cross & Blue Shield regarding complaint ID ********.
Sincerely,
***************************Initial Complaint
11/09/2022
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Unanswered
My name is ***************************. I signed up on empireblue.com on Friday November 4, 2022, and I picked to have my coverage start February 1,2023. On November 6, 2022, I went on the live enrollment support chat and I spoke to ********************* Direct Sales Agent of ******** Sales from Elevance Health. ***** informed me that I cannot enroll into a plan for February 1, 2023 it has to be for January 1, 2023. I informed ***** I understand, and I will start a new application on the website and they told me that is fine and they will keep an eye out for the application. I picked the start date 1/1/2023. I picked a PCP in **********, ********. This Morning November 7, 2022, I received a voicemail from ********************* Locks at Empire Blue Cross Blue Shield and he informed me that my application was for 12/1/2022 and that I never added PCP. He informed me that he must send me a new application by email to fill out. When I went to the website with the pin ID, I could not review the application at all. He only allowed me to sign the application. After signing the application, I clicked on the print application and what he had on the application was wrong information. ****** told me that I saw this PCP in the past and on my application from November 6 I check **** no I did not see this PCP. ****** also checks **** I want Flex account to pay my electric and this is also wrong on my first application I check **** for Dental Vision. To me I feel this is very strange why this person *************************** contacted me and told me my application from November 6 2022 was missing information. The application I submitted for November 6 had no information missing at all and ***** even looked over the application. I would like for someone to please look into this matter and contact me. My cell phone Number is ************. I also enclosed in attachment all emails and documents. Something is strange going on. I have enclosed documents (PDF)Initial Complaint
11/03/2022
- Complaint Type:
- Product Issues
- Status:
- Unanswered
I started a blue cross blue shield dental plan for my son last month. I received the ** card. I just want to make online payment for premium, but the insurance provider website and APP cannot locate my account. I called Blue shield 5 time, got transfer through many departments, wasting my 2 hours. No one can help! No one can tell me how can I pay for my premium. No one can fix my online account issue. I call ***************** *** ****, and ************. No one can solve my problem.Initial Complaint
10/21/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I had a colposcopy in April 2022 that was not fully covered by my insurance. According to the language in the Explanation of Coverage document, this service should have been fully covered by BCBS. They refuse to cover it but have failed to quote *** language that supports their denial :Timeline:February 2022 (claim # ************* ): I had an annual exam with **************** who is my PCP. She performed a mammogram and a pap smear. March 2022: **************** received my pap smear test results and recommended that I receive additional testing. She does not perform colposcopies and therefor made a referral to see ************. Please see attachment of letter of referral from her office to ****************. April 2022 (claim #*************): I reported to **************** office where he performed a colposcopy as a follow up test for my pap smear. My medical record from **************** office states that the colposcopy was a diagnostic service to further evaluate the pap smear test performed by ****************. He sent the biopsy to ********** claim #************* ) which billed me separately from **************** office. My claims from **************** office (claim #*************) and from LabCorp ( claim #************* ) were not fully covered, however, language from the explanation of coverage document states:"Well-Woman Examinations. We Cover well-woman examinations which consist of a routine gynecological examination, breast examination and annual screening for cervical cancer, including laboratory and diagnostic services in connection with evaluating cervical cancer screening tests."The colposcopy that I received in April 2022 was a diagnostic test to evaluate my cervical cancer screening test from February 2022. The language in the *** says that these types of laboratory and diagnostic services are covered when they are "in connection with evaluating cervical cancer screening tests". There is no language in the *** that limits the type or quantity of "laboratory and diagnostic services".Initial Complaint
10/12/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I contacted empire blue cross blue shield to inquire about getting health insurance. On two occasions the reps put me through to an insurance agent unrelated to blue cross. Since contacting them I get phone calls all day from telemarketers unrelated to empire blue cross blue shield harrassing me to buy insurance. They refuse to stop calling meInitial Complaint
09/21/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I'd like to file a complaint against my HMO Empire Blue Cross Blue Shield. I've been struggling with my electronic motorized wheelchair that was given to me by my health insurance company. It shuts off when I leave my house to go to my doctor ************ in the middle of the busy ************* Streets. The battery has been changed as of Feb 2022 and this has been happening since Dec 2021. Its not the battery. I have charged it over night and continues to do this while I'm going grocery shopping with my aide. I'm disabled with an amputation to my right leg. I need a new electronic wheelchair.Initial Complaint
08/18/2022
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Resolved
Submitted a reimbursement claim on their website via their link on January 22, 2022. As per the President of *****************, once purchased at a local pharmacy, my insurance company is to pay a reimbursement for the purchase of two tests. I have corresponded with Empire regularly since January about this claim. They provide a link on their website to submit the covid tests receipt. The link is specifically for covid test reimbursement. They are refusing to pay it. They say my rx plan has to pay it. Originally they stated my claim was denied in error. They asked me to resubmit a copy of my receipt. Then they asked for picture of the covid tests. They have had me jumping through hoops to receive reimbursement that according to *****************, is due to me.Customer response
09/19/2022
They stated they were covering the cost of covid tests, then 8 months later denied the claim. I contacted them numerous times and appealed their decision and they send the standard generic we are looking into it response. Theyve been doing this for many many months.Customer response
09/21/2022
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 and the matter has been resolved.
Sincerely,
*************************
Initial Complaint
07/14/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
********************************************************** came for services at ********. Prior to starting we obtained benefit information from insurance company stating that this insurance plan had an out of pocket *** of ******** and that once it had been met the services would be paid. This information was told to us on several times, we have filed several appeals & a complaint with the department and insurance and BCBS refuses to pay. ******* dates of service range from 7/18/20-12/18/2021 for Occupational ****************** Therapy ***** dates of services range from 7/11/2020-12/28/21 for Occupational ****************** Therapy & Speech Therapy ***** dates of services range from 7/11/2020-12/28/21 for Occupational ****************** Therapy & Speech Therapy This totals over $126,855.00 worth of therapy. These services have been proven medically necessary as the children have an autism diagnosis. We have been in communications with the the company the entire time and have been getting the run around and saying it should and would get paid. We have several reference numbers of the recorded calls where this information was provided to ********. We have also filed complaints with the **** and have not found resolution. We appreciate you time and any help you can provide at holding this business accountable so the parents do not have to come out of pocket for this expense.Customer response
08/08/2022
Better Business Bureau:
At this time, I have not been contacted by Empire Blue Cross & Blue Shield regarding complaint ID ********.
Sincerely,
***********************************
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Customer Complaints Summary
122 total complaints in the last 3 years.
70 complaints closed in the last 12 months.
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