Blue Shield of California

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on June 4, 2015, concerning a Blue Shield enrollee by the name of [redacted] The information provided by the Revdex.com included a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that Bruce Schwartz, has completed our grievance process regarding this specific issueA response letter was mailed directly to the member on June 1, If the member is dissatisfied with the grievance resolution, he may contact the Department of Managed Health Care for additional assistanceThe department has a toll-free phone number (1-888-HMO-2219) and a TDD line (1-877-688-9891) for the hearing and speech impairedThe department's Internet Web site [redacted] has complaint forms, IMR application forms and instructions online.If you have additional questions regarding this matter, please contact me directly at the telephone number listed below

Company states that they are still adjusting the credit because the premiums were changedThe total refund of will be completed 7-business days from the 8th

I am rejecting this response because: The response from Blue Shield is completely acceptable in regards to refunding the premium payments that I made through NovemberHowever the refund does not include the $payment that was automatically withdrawn from my credit card account on 12/I no longer have access to my online Blue Shield account since the account was cancelled with the assistance of the Revdex.com at my request, so I was unable to go online to cancel the auto payment myself, but I called Blue Shield this morning to cancel the auto payment and it has now been cancelled as of today The total amount of premium payments that I have made to this account that was never activated is $which includes the $paid on 12/ Thank you for your assistance in completely resolving this matter[redacted] ***

Blue Shield of California has decided to reinstate our coverage.Thank you

Revdex.com: I have reviewed the response made by the business in reference to my concern and am wondering if I have to file a grievance directly with Blue Shield or whether that process was started for me on my behalf by Blue Shield Are there any other steps I need to take, or do I simply wait for Blue Shield to resolve this issue within days, which would be no later than the end of April Please let me know how I should proceed.Thank you, [redacted] ***

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on February 18, 2015, concerning a Blue Shield enrollee by the name of [redacted] The information provided by the Revdex.com included a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that Steve Ms [redacted] has not completed the grievance process with the planWe are initiating a grievance to address the concerns raised in the correspondence submittedPlease be advised that, grievances are resolved within days of the receipt dateA response to the review will be sent directly to Ms [redacted] , and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information with the correspondence submitted by the Revdex.com.If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely, [redacted] Regulatory CoordinatorGrievance Department( [redacted]

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on April 15, 2015, concerning a Blue Shield enrollee by the name of [redacted] ***The information provided by the Revdex.com included a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that we are currently reviewing the concerns raised in the correspondence submittedA response will be sent directly to [redacted] ***Our records do not reflect that a signed release of information was submitted with the correspondence sent by the Revdex.comUnfortunately, without a signed release of information from [redacted] ***, we are unable to provide a copy of the resolution to the Revdex.comIf [redacted] has signed a release of health information to the Revdex.com, you may send a copy to my attention via fax at 916-350-or by mail at: [redacted] [redacted] ***If you have additional questions regarding this matter, please contact me directly at the telephone number listed below

I am rejecting this response because: I spoke with [redacted] after making several attempts to contact herShe did not want to listen to what I had to sayI tried to explain to her that Blue Shield had charged me monthly, for a full year, after the original plan that I had for my son expiredIt was no longer a good plan due to the new healthcare reform,with no benefits/coverageIf I were to take my son to the dentist, I would have had to pay for all costs out of my own pocketI had made several calls to cancel this policyThe first time was in January I trusted that Blue Shield cancelled my plan, but they did notI spoke with numerous representatives who ALL stated, that my plan would be cancelled from the conversations I had with themOne woman, [redacted] , said she would send the confirmation letter via email and never didAfter another phone call, I stayed on the phone with the rep and demanded I recorge a confirmation via email while still connected on the phone with her [redacted] did not care that I was being charge for a service that I could not useShe dismissed my grievance claimThey made no attemp to help me

I am rejecting this response because: Blue Shield of California never contacted me directlyI called customer service on September 3rd, with reference number [redacted] I was promised a refund will be sent to my mailing address within 7-business daysAs of today, Sept24, I still haven't received the refund, no one has tried to contact me and also already back in August they promised me a refund tooI can't see this issue resolved until I actually receive the check/refundThank you

I am rejecting this response because: I have gotten no correspondence from Blue Shield besides a faxed email telling me to contact customer service, which I have ALREADY done several times and have gotten no where which is why I finally filed a complaintThis is NOT an appropriate response from themI souls like someone to contact me that can help!! Otherwise I have gotten nothing from themHELP!?!

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on March 13, 2015, concerning a Blue Shield enrollee by the name of [redacted] The information provided by the Revdex.com including a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that [redacted] , has not completed the grievances process with the planWe are initiating a grievance to address the concerns raised in the correspondence submittedPlease be advised that, grievances are resolved within days of the receipt dateA response to the review will be sent directly to Ms [redacted] , and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information with the correspondence submitted by the Revdex.com.If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely, [redacted] ***, Executive Inquiries CoordinatorGrievance Department###-###-####

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on January 26, 2015, concerning a Blue Shield enrollee’s mother by the name of [redacted] ***The information provided by the Revdex.com included a consumer complaint against Blue ShieldWe thank you for forwarding these concerns to Blue Shield for review and would like to inform you that Ms***, has not completed the grievance process with the planWe are initiating a grievance to address the concerns raised in the correspondence submittedPlease be advised that, grievances are resolved within days of the receipt dateA response to the review will be sent directly to the subscriber, and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information with the correspondence submitted by the Revdex.comIf you have additional questions regarding this matter, please contact me directly at the telephone number listed below,

Initial Business Response / [redacted] (1000, 8, 2015/11/11) */ Dear Revdex.com: This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on November 10, 2015, concerning a Blue Shield enrollee by the name of [redacted] ***The information provided by the Revdex.com included a consumer complaint against Blue Shield We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that [redacted] ***, has not completed the grievance process with the planWe are initiating a grievance to address the concerns raised in the correspondence submittedPlease be advised that, grievances are resolved within days of the receipt dateA response to the review will be sent directly to [redacted] ***, and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information with the correspondence submitted by the Revdex.com Sincerely, Executive Inquiries Grievance Department Initial Consumer Rebuttal / [redacted] (3000, 10, 2015/11/13) */ (The consumer indicated he/she DID NOT accept the response from the business.) Blue Shiled has violated law by not reimburseing me foor the 20% deductable, on nPart B, which I paid at Rite Aid, and RITE aid told me, the supplement insurance would auto pay me, once the medicare billing was complete! UNREAL

Dear Mr [redacted] :This is in response to the grievance received by Blue Shield of California (Blue Shield) from the Revdex.com on April 21, 2015, regarding billing and compensationYou are requesting that you are able to use the service that you pay for and Blue Shield compensate you for your time spent fixing the billing problems.Your request has been approvedOur records indicate that your health plan is active and you currently have access to health careWe have placed a onetime credit on your account for your April premium in the amount of $Please allow three to five business days for the credit to reflect on your account.It is important to understand that this decision has been made on an exception basis and, in making this decision; Blue Shield does not waive any of its rights to enforce the provisions of your health plan on this or any otherclaim.The appeal review was conducted by a Blue Shield Grievance Coordinator with training and experience in processing member grievances.If you have questions regarding this letter, please contact me directlyIf you have questions regarding your health plan benefits, please contact your Customer Service Department at ###-###-####.Sincerely, [redacted] *., CoordinatorGrievance Department###-###-####

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on February 06, concerning a Blue Shield enrollee by the name of Wanjen **The information provided by the Revdex.com included a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that Ms [redacted] has not completed the grievance process with the planWe are initiating a grievance to address the concerns raised in the correspondence submittedPlease be advised that, grievances are resolved within days of the receipt dateA response to the review will be sent directly to Ms [redacted] and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information with the correspondence submitted by the Revdex.com.If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely, [redacted] ***, CoordinatorGrievance Department [redacted]

Customer states: We accept the refund amount

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on April 6, 2015, concerning a Blue Shield enrollee by the name [redacted] The information provided by the Revdex.com including a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that we are currently reviewing the concerns raised in the correspondence submittedA response will be sent directly to Ms [redacted] Our records to not reflect that a signed release of information was submitted with the correspondence sent by the Revdex.comUnfortunately, without a signed release of information from Ms [redacted] , we are unable to provide a copy of the resolution to the Revdex.comIf Ms [redacted] has signed to a release of health information to the Revdex.com, you may send a copy to my attention via fax at ###-###-#### or by mail at: [redacted] ***If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely, [redacted] ***, Executive Inquiry Coordinator [redacted]

Initial Business Response / [redacted] (1000, 5, 2015/12/29) */ Contact Name and Title: [redacted] ExecCoord Contact Phone: (XXX) XXX-XXXX Contact Email: [redacted] @BlueShieldCA.com December 29, Revdex.com Beacon Blvd West Sacramento, CA XXXXX Re Case #: XXXXXXXX Dear Revdex.com: This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on December 29, 2015, concerning a Blue Shield enrollee by the name of [redacted] The information provided by the Revdex.com included a consumer complaint against Blue Shield We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that we are currently reviewing the concerns raised in the correspondence submittedA response will be sent directly to [redacted] Our records do not reflect that a signed release of information was submitted with the correspondence sent by the Revdex.comUnfortunately, without a signed release of information from [redacted] , we are unable to provide a copy of the resolution to the Revdex.comIf [redacted] has signed a release of health information to the Revdex.com, you may send a copy to my attention via fax at XXX-XXX-XXXX or by mail at: [redacted] Box [redacted] El [redacted] CA XXXXX If you have additional questions regarding this matter, please contact me directly at the telephone number listed below Sincerely, [redacted] Executive Inquiry Coordinator (XXX) XXX-XXXX Initial Consumer Rebuttal / [redacted] (3000, 14, 2016/01/04) */ (The consumer indicated he/she DID NOT accept the response from the business.) There isn't a response? I don't want to have to call Blue Shields again and get the whole runaround againThat's the problem Final Business Response / [redacted] (4000, 18, 2016/01/28) */ This is in response to the grievance received by Blue Shield of California (Blue Shield) on December 29, 2015, regarding a stale-dated claim check in the amount of $138.36, for the dates of service of March 4, 2014, through March 20, 2014, provided by United California SurgicalYou hove requested an explanation from Blue Shield of California (Blue Shield) for why we have not reissued this check to you During the research of your concerns, we found that the claim associated with this claim check was reprocessed by Blue Shield after receiving a corrected claim from your providerThis corrected claim included additional proceduresAfter processing the corrections on your claim, it was determined that payment for the original procedures were included in the payment of the additional proceduresThe adjusted claim has been finalized, and a check in the amount of $was cashed by you on March 5, 20)Based on this information, we will consider this matter resolved and no further action is necessaryWe are therefore closing your case We would like to take this opportunity to advise you That the service expectations of our members are very important to usPlease be assured that all member concerns are tracked through our grievance process as Blue Shield uses the information received to continually improve the services we provide If you have any questions or additional concerns regcrding this matter, please contact me directly Sincerely, [redacted] Final Consumer Response / [redacted] (2000, 20, 2016/01/29) */ (The consumer indicated he/she ACCEPTED the response from the business.) I do accept the responseIt would have been if they would have told me this back in July when I first starting calling about the checkThank you for your time and the explanation

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on December 03, Concerning a Blue Shield enrollee by the name of [redacted] ***The information provided by the Revdex.com included a consumer complaint against Blue Shield.We thank you for forwarding these concerns to Blue Shield for review and would like to inform you that Ms [redacted] has submitted a grievance on November 17, Please be advised that grievances are resolved within calendar days from the date of receiptA response to the review will be sent directly to Ms [redacted] and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information attached with the correspondence submitted.If you have any additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely, [redacted] ***, Executive Inquiry Coordinator###-###-####

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on November 24, 2014, concerning o Blue Shield enrollee by the name Shirley [redacted] The information provided by the Revdex.com included a consumer complaint against Blue ShieldWe thank you for forwarding these concerns to Blue Shield for review and would like to inform you that Ms [redacted] has not completed the grievance process with the planWe are initiating a grievance to address the concerns raised in the correspondence submittedPlease be advised that, grievances are resolved within days of the receipt dateA response to the review will be sent directly to Ms [redacted] Our records do not reflect that a signed release of information was submitted with the correspondence sent by the Revdex.comUnfortunately, without a signed release of information from Ms [redacted] , we are unable to provide o copy of the resolution to the Revdex.comIf Ms [redacted] has signed o release of health information to the Revdex.com, you may send a copy to my attention via fax at ###-###-#### or by mail at: P.OBox El Dorado Hills, CA