Complaints

• Initial Complaint

  04/05/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was auto enrolled in an insurance plan I did not approve to be auto enrolled in. On Jan 10, 2022 I called to have the policy cancelled. I was told it was cancelled, and I would receive a letter in the mail stating so. I never received this letter. The next thing I received from them was the  bill for February. I again called to state this should have been cancelled and was told :"that is weird, I do not see that your account is active, but they are billing you. I will pass the information on to Billing to have this changed. Your policy is not active." I assumed all was cancelled. Then I received a bill for March. I call, again. and go in circles with different employees. After months of this they finally conference call with Pennie who was able to have the policy cancelled on Pennie's end and notified Blue Cross to cancel the plan on their end. Not a single person at blue cross, in all the months I called, ever told me I needed to talk to Pennie. I would have called them in January to have this resolved if that was the case. Blue cross then informs me I still owe 4 months of payments, on a policy that I requested to be cancelled in January, and had no claims against. I was able to get through to the Escalation line and was told "Give me 24 hours to review the phone calls and information, I promise I will call you back." 24 hours pass and no phone call. I continued to call the next two days and cannot get put back in contact with the escalation line. I was finally told the lady handling my information "had personal issues come up, and someone else will handle the information." I was told they would call me back in 48 after someone new reviews my case. It has been well over 48 hours and no call back from this company. I just want my issue resolved and for this company to take responsibility for their error. I should not have to pay 4 months of payments for mistakes they kept making. Any charges beyond 01/10/2022 are fraudulent charges.

  Business response

  04/13/2022

  Dear **************:
  
  I am writing to acknowledge receipt of the April 13, 2022 correspondence you addressed to ******************************************, Manager of the Executive Inquiries Department. The complaint was received in our office on April 13, 2022.
  
  As you know, the Federal Health Insurance Portability and Accountability Act, known as HIPAA, requires that we obtain an individual's written approval before disclosing his/her protected health information (PHI). In order for us to provide your office with a resolution, ************** may complete the attached HIPAA Authorization form.
  
  **************, thank you for bringing this matter to our attention.
  
  Sincerely,
  
  Jason S*********, Specialist
  Executive Inquiries
  Independence
  1900 Market Street, 6th floor
  Philadelphia, PA 19103
  ************ 

• Initial Complaint

  03/31/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Hi, my name is *************************** and in December 2017 my Husband ****** was awarded Social Security Disability. After you are on it for 2 years, you are on ********* In 2018 I started a new job and signed us both up for Insurance Personal Choice. So, I updated ***'s coordination of benefits with ******** and Personal Choice. At the time since my work had less then 100 employees' ******** was Primary and PC secondary. Once *** turned 65 on July 19th, 2020, and my job had more then 25 employee's PC was now Primary, and ******** was secondary and then his Coordination of Benefits were updated. January of 2022, I started receiving numerous Explanation of Benefits from IBC for current and previous paid claims. I called PC they told me that we were signed up as of 4/1/2019 under a Cobra plan (which made ******** Primary and PC secondary now) that was incorrect I've been with this company since 6/2018. I contacted my HR department, and this issue was corrected Feb 2022. Since then, I have called IBC at least 20 times or more. Updated his Coordination of Benefits 5 times and it is still not corrected. Every time I call, I get the run around no one knows what they are doing. I am very stressed out and angry. There are 46 claims either denied or insurance paid and took money back because of this. My husband has a lot of Health issues and goes to the doctors a lot. We started receiving bills& phone calls now. Can you help us or get a name and phone number of a supervisor? Thank you

  Business response

  04/04/2022

  Dear **************:
  
  I am writing to acknowledge receipt of the April 1, 2022 correspondence you addressed to ******************************************, Manager of the Executive Inquiries Department. The complaint was received in our office on April 1, 2022.
  
  As you know, the Federal Health Insurance Portability and Accountability Act, known as HIPAA, requires that we obtain an individual's written approval before disclosing his/her protected health information (PHI). In order for us to provide your office with a resolution, ********************** may complete the attached HIPAA Authorization form.
  
  **************, thank you for bringing this matter to our attention.
  
  Sincerely,
  
  Jason S********, Specialist
  Executive Inquiries
  Independence
  1900 Market Street, 6th floor
  Philadelphia, PA 19103
  ************ 

  Customer response

  04/18/2022

  I mailed 2 signed Hippa forms one for me and my husband

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

  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. 
  
  Regards,
  
  ***************************

• Initial Complaint

  02/23/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I had a mammogram which should have been covered under Obamacare but wasn't. I had to pay out of pocket $527.48. I called 2 times. On the first call, I was told it was covered, but this last time I called I was told it wasn't it was considered preventive.I was on the phone for an hour and when I asked to speak to a manager I was told they'll call me back in 48 hours. How does Bluecross not have a manager available?!?They also didn't cover my ultrasound because they claim it's preventive. My mammogram did not pick up a lump they found during the ultrasound. One would think Buecross would want to cover this because it will cost them more if I get breast cancer(which runs in my family and I've had lumps) or die. Then they would get no money!!I AM SO ANGRY because I know for a fact that Obamacare covers 100% of a mammogram...GUESS JUST NOT WITH BLUECROSS!!The fact that I called and had 2 different answers and that they are plain out denying coverage is so wrong!

  Business response

  02/28/2022

  February 28, 2022 
  
  Dear *** *****: 

  Our Supervisor of the Executive Inquiries Department, Detra Davidson-Stewart, has requested that I acknowledge your recent correspondence regarding *** *****. The  
  purpose of this letter is to provide your office with an authorization form. 
  

  Compliance with the HIPAA Privacy Rule. The federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an 
  individual’s written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy  
  Rule or other applicable law. PHI is individually identifiable health information transmitted or maintained in any form or medium (including written, spoken, or  
  electronic) related to: health care, health conditions, payment for care, and identity. The written approval, called an “authorization”, must contain certain required elements for us  
  to consider it valid under the HIPAA Privacy rule. 
  

  As such, we have enclosed an authorization form so that *** ***** can complete the form naming you and your office as an authorized recipient of her PHI. Upon receipt  
  and confirming the form’s validity, we can release our findings to you about the case. 

  *** *****, should you have any additional questions please contact me at ******** ****. I will be glad to assist you. 
  

  Sincerely, 
  
  Tedra F****** 
  Specialist 
  Executive Inquiries Department 
  

• Initial Complaint

  02/17/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I saw a provider located in Philadelphia that I accepts the BlueCard PPO network but is not contracted directly with the Independence Administrators network. The provider was not listed on the provider search tool function as IBX will only show Personal Choice PPO providers when searching within the Philadelphia Area 5 counties, but I knew my plan allowed me to see any BlueCard PPO provider so I moved forward. My provider experienced much difficulty submitting my claims resulting in my deductible not reflecting my true expenses and delaying payment of services rendered. I'm requesting assistance on how ******** BlueShield should be filing claims for Independence Administrators patients. This has been extremely frustrating and a lot of time has been wasted due to the lack transparency in inter-plan agreement claim filing practices when they're overlapping coverage (IBX &*********** in PA). I’m seeking help on getting these claims processed. I’ve uploaded two examples of where the provider appears in network and then doesn’t show up when using the IBXA tool. This is false advertising if this provider is in network and your limiting results to only show personal choice PPO providers and not also BlueCard PPO providers.

  Business response

  02/25/2022

  
  Dear **************:

  Our Manager of the Executive Inquiries Department,**************************** has requested that I acknowledge your recent correspondence regarding ******************.
  The federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy Rule requires that we obtain an individuals written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. PHI is individually identifiable health information transmitted or maintained in any form or medium (including written, spoken, or electronic) related to: health care, health conditions, payment for care, and identity. The written approval, called an authorization, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule. As such, we have enclosed an authorization form so that **. ******* can complete the form naming you and your office as an authorized recipient of his PHI. Upon receipt and confirming the form's validity, we can release our findings to you about the case.
  **************, should you have any additional questions, please contact me at ************. I will be glad to assist you.
  

  Kathleen L***************, Quality Executive Inquiry Specialist, Executive Inquiries Department

*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. ↩