Blue Cross & Blue Shield of Minnesota

I am rejecting this response because:
I have received a voicemail from BCBS last Friday indicating...

that they are investigating the complaint. I called back Monday and left a voicemail with some more specifics.   In the meantime, HealthEast has sent my bill to collections. Is there any advice you have on this?   Thanks, [redacted]

I will be faxing the form requested for release of information

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. Per a phone conversation with Charity, this complaint was resolved by Blue Cross Blue Shield of Minnesota.

Initial Business Response /* (1000, 8, 2015/09/28) */
Regarding:[redacted]
Case Number: [redacted]
Dear Ms. [redacted]:
I am writing in response to your letter regarding the above-mentioned Blue Cross Blue Shield of Minnesota member. Thank you for forwarding these concerns presented to you...

by[redacted].
Due to confidentiality laws, we are unable to provide you specific information regarding[redacted] request, without a signed Authorization for Release of Information form. At this time we have not received an ARI from the above-mentioned Blue Cross Blue Shield of Minnesota member.
I trust this information has been of assistance. Should you have additional questions or concerns regarding this matter, please feel free to contact customer service at the phone number on the back of the member's Identification card.
Sincerely,
Consumer Service Center
[redacted]original document attached.
Initial Consumer Rebuttal /* (3000, 10, 2015/09/28) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The business did not attach the authorization or mail me an authorization so Blue Cross Blue Shield can communicate with the Revdex.com. An authorization can also be provided to [redacted]@yahoo.com and I can complete this so the Revdex.com, Blue Cross Blue Shield and I can all discuss this claim. Blue Cross Blue Shield is avoiding responsibility and is not accepting bills that this provider sends. They have no interest in correcting the problem and it is a shame that this organization refuses to communicate to resolve this issue and has put profits ahead of its customers.
Final Consumer Response /* (2000, 19, 2016/02/22) */
This complaint was resolved and the medical claim was paid. Please close this claim and thanks for your help!
[redacted]

Initial Business Response /* (1000, 8, 2016/03/03) */
[redacted]corresponding document attached.
Suscriber: [redacted]
Case # [redacted]
Dear Ms. [redacted]:
I am writing in regard to the inquiry Blue Cross and Blue Shield of Minnesota (BCBSM)received from you for the inquiry listed above....


Due to confidentiality laws, we are unable to provide you specific information regarding [redacted], without a signed Authorization for Release of Information Form. At this time we have not received an ARI from the above-mentioned Blue Cross of Minnesota Member.
Sincerely,
consumer Service Center
Enclosure(s)
lrg
Initial Consumer Rebuttal /* (3000, 10, 2016/03/03) */
(The consumer indicated he/she DID NOT accept the response from the business.)
They have not addressed the complaint or contacted me directly to address the complaint. If they require some type of release of privacy notice from me, they should have contacted me.
Again, this speaks for BC/BS of Minnesota's total disregard for their policy holders.

You recently contacted the Revdex.com (Revdex.com) concerning your experience with Blue Cross Blue Shield of Minnesota (BCSMN). Your complaint was provided to Prime Therapeutics LLC’s mail order pharmacy.  In your complaint, you expressed your concerns regarding billing you...

have received for your insurance premiums for you and your family.
 
 
We understand your concerns about your insurance billing. Prime is the Pharmacy Benefits Manager (PBM) for BCBSMN. We are your prescription drug programs administrator. We are able to address concerns only with regard to your pharmacy benefits.
 
Any questions regarding billing or insurance cost are handled through BCBSMN. Please contact BCBSMN directly to assist you with your concerns. BCBSMN can be reached at ###-###-#### or you may refer to the information on the back of your insurance card.
 
If you have further questions or concerns, please call Prime ###-###-####. Our member services are available 24 hours a day 7 days a week.

Initial Business Response /* (1000, 8, 2015/09/11) */
Regarding: [redacted]
Case Number: [redacted]
Dear Ms. [redacted]:
I am writing in response to your letter regarding the above-mentioned Blue Cross Blue Shield of Minnesota member. Thank you for forwarding these concerns presented to you by...

[redacted].
Due to confidentiality laws, we are unable to provide you specific information regarding Mr. [redacted]'s request, without a signed Authorization for Release of Information form. At this time we have not received an ARI from the above-mentioned Blue Cross of Minnesota member.
I trust this information has been of assistance. Should you have additional questions or concerns regarding this matter, please feel free to contact customer service at the phone number on the back of the member's Identification card.
Sincerely,
Consumer Service Center
Initial Consumer Rebuttal /* (3000, 14, 2016/01/07) */
BCBSMN's failure to provide accurate provider info resulted in me choosing wrong healthcare plan
I previously filed a complaint with the Revdex.com (#[redacted]). As I attempted to resolve the issue with BCBS and the state, the file expired. I would like to reopen this complaint since I have not yet received satisfactory resolution.
In late 2014, when I was reviewing health insurance options, one critical need was in-network coverage for the therapist I have been working with for the past couple of years (Kelly [redacted] at [redacted] in Saint Paul). Based on a search of the BCBS website, I determined that she was covered by the Allina Health Network, and so I chose that network. The premium was higher than I wanted, but I anticipated a high level of coverage and quality of service.
As a normal person does, I didn't review claims and billings too closely. In March, I logged in to the BCBS MN web site and found that none of my visits had been covered as "in-network". What I learned is that Kelly [redacted] was NOT, in fact, part of the Allina Health Network.
I contacted BCBS of MN and after a few weeks, they covered the cost of my previous visits. However, they refused to cover additional services at the in-network rate until Ms. [redacted] was accepted into the Allina Health Network. She applied to be in the network, and after several weeks of waiting, was denied. She filed an appeal, and is still waiting for a decision as of late August 2015.
During the interim, I opted to not continue therapy with Ms. [redacted] because of the cost. I expected that she would be accepted into the Allina Health Network and that foregoing therapy for a couple of months, while not ideal, was the best of several poor alternatives. Discontinuing therapy has resulted in my depressive symptoms being harder to manage, such that my quality of life over the past several months has deteriorated. I am now in the process of finding a new provider, and will begin the slow process of developing a relationship with a new therapist.
In the meantime, I have been paying a high premium for an insurance plan that does not provide the level of coverage that I expected to receive. In addition, I am unable to change to a new plan through MnSure for the remainder of the year due to rules about open enrollment and eligibility issues surrounding the circumstances under which insurance is discontinued. (At least, this is my understanding. I find health insurance to be needlessly complicated, to the point that I do not believe patient well-being is a priority for the insurance industry.)
Throughout this process, BCBS of MN has provided low quality customer service.
When I initially searched to find out if my therapist was in the Allina Health Network, their website provided inaccurate information, which resulted in me making the wrong selection for health insurance.
When I discovered the problem, it took several weeks for them to resolve it, and I only learned of the resolution by contacting the office - they did not contact me to notify me of the decision.
They refused to allow for additional visits unless Ms [redacted] was in the Allina Health Network, and then denied her membership in that network. They have been extremely slow in dealing with her appeal of that decision.
It is unfortunate (to say the least) that the quality of service provided by Blue Cross and Blue Shield of Minnesota has played a pivotal role in a months-long decline in my mental health. Since there is no feasible means for them to rectify the problems that have resulted from their poor service, I am seeking financial restitution.
At this point, BCBSMN has continued to deny my request, and I have made no headway through governmental channels, although I have a pending complaint to the Department of Commerce.
I have submitted an authorization for BCBSMN to release information to Revdex.com regarding this issue, and am willing to provide copies of correspondence if needed. In their system, the reference number for this complaint is 326679.
I am requesting a refund of all premiums paid from April to December of 2015. At $272.16 per month, this comes to $2,449.44.
[redacted]copied and pasted from 2nd complaint filed, extension of this original. Transferred data and re-opened this one, closed the duplicate.
Final Business Response /* (4000, 22, 2016/02/04) */
Dear Mr. [redacted]:
I am writing in regard to the inquiry Blue Cross and Blue Shield of Minnesota (BCBSM) received from Revdex.com of Minnesota and Dakota for the issue listed above.
Due to confidentiality laws, we are unable to provide you specific information regarding Revdex.com Inquiries, without a signed Authorization for Release of Information form. At this time we have not received an ARI from the above-mentioned Blue Cross of Minnesota member.
Sincerely,
Consumer Service Center
Enclosure(s)
Cc: Revdex.com of Minnesota and Dakota
Final Consumer Response /* (3000, 24, 2016/02/08) */
(The consumer indicated he/she DID NOT accept the response from the business.)
BCBSMN has taken no accountability for the impacts of their actions. At EVERY. SINGLE. POINT. they have illustrated that they have no respect for me as a customer or as a human being. Every correspondence I have had with them on this matter has further cemented my negative opinion of the organization.
Based on my experience, I no longer anticipate a satisfactory resolution to this issue. In fact, at this point, my original requested resolution is no longer acceptable to me. This issue has been going on for nearly a year, and I am now at the point where there is literally no action they could take that I would consider "satisfactory". They as an organization have continually refused to hold themselves to any reasonable ethical standard.

Initial Business Response /* (1000, 16, 2015/11/24) */
Regarding:[redacted]
Case Number: [redacted]
Dear Ms. [redacted]:
I am writing in response to your letter regarding the above-mentioned Blue Cross Blue Shield of Minnesota member. Thank you for forwarding these concerns presented to...

you by[redacted].
Due to confidentiality laws, we are unable to provide you specific information regarding[redacted] request, without a signed Authorization for Release of Information form. At this time we have not received an ARI from the above-mentioned Blue Cross of Minnesota member.
I trust this information has been of assistance. Should you have additional questions or concerns regarding this matter, please feel free to contact customer service at the phone number on the back of the member's Identification card.

Attached is the letter noting our response to Ms. [redacted] in regards to her open Revdex.com case. We are in the process of reaching out to her directly to resolve her case. Thank you,Brandon [redacted]

Complaint ID #[redacted]I am responding to the inquiry Blue Cross and Blue Shield of Minnesota received from you for the member listed above. We are reaching out directly to [redacted] to address their concerns. They will be provided a contact and their direct phone number should they have...

additional questions regarding this issue. We apologized for any inconvenience this caused them.Please know we take our members' concerns seriously. We encourage our members to work directly with us to resolve any concerns. M embers can reach us via the Customer Service phone number on the back of their ID card.Sincerely, Customer Service Center

Good afternoon.Attached is our response to Mr. [redacted]'s complaint.  I apologize for the delay. Lori [redacted]Senior Business AnalystBlue Cross and Blue Shield of Minnesota

Initial Business Response /* (1000, 8, 2015/11/02) */
Regarding: [redacted]
Case Number: [redacted]
Dear [redacted]:
I am writing in response to your letter regarding the above-mentioned Blue Cross Blue Shield of Minnesota member. Thank you for forwarding these concerns presented to you...

by [redacted].
Due to confidentiality laws, we are unable to provide you specific information regarding [redacted]'s request, without a signed Authorization for Release of Information form. At this time we have not received an ARI from the above-mentioned Blue Cross of Minnesota member.
I trust this information has been of assistance. Should you have additional questions or concerns regarding this matter, please feel free to contact customer service at the phone number on the back of the member's Identification card.
Sincerely,
Consumer Service Center
Initial Consumer Rebuttal /* (2000, 10, 2015/11/12) */

September 14, 2016     Revdex.com OF MINNESOTA AND NORTH DAKOTA ATTENTION: [redacted] 220 S RIVER RIDGE CIR BURNSVILLE MN 55337     Regarding: [redacted] Complaint ID #: [redacted]   Dear Ms. [redacted]:   I am writing in regard to the inquiry Blue Cross and Blue Shield of Minnesota (BCBSM) received from you for the concern listed above.   Due to confidentiality laws, we are unable to provide you specific information regarding [redacted], without a signed Authorization for Disclosure of Health Information (ADHI) form.  At this time, we do not have an ADHI form on file allowing us to share specific information with you regarding this case.  An ADHI form has been enclosed.   Please know we take our members’ concerns seriously.  We encourage our members to work directly with us to resolve any concerns. Members can reach us via the Customer Service phone number on the back of their ID card.      Sincerely,     Consumer Service Center

January 12, 2017 Revdex.com OF MINNESOTA AND NORTH DAKOTA Regarding: Ms. [redacted] Complaint ID #: [redacted] Dear Ms. Moore: I am responding to the inquiry Blue Cross and Blue Shield of Minnesota received from you for the member listed above. We are reaching out...

directly to Ms. [redacted] to address her concerns. She will be provided a contact and their direct phone number should she have additional questions regarding this issue. We apologized for any inconvenience this caused her. Please know we take our members' concerns seriously. We encourage our members to work directly with us to resolve any concerns. Members can reach us via the Customer Service phone number on the back of their ID card. Sincerely, Consumer Service Center

Regarding ID # [redacted]Dear Ms. [redacted]:I am writing in regard to the inquiry Blue Cross and Blue Shield of Minnesota (BCBSM) received from you for the issue listed above.Due to confidentiality laws, we are unable to provide you specific information regarding [redacted], without a signed...

Authorization for Release of Information form.  At this time we have not received an ARI from the above-mentioned Blue Cross of Minnesota Member.Sincerely,Consumer Service CenterEnclosure(s)lrg

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. Per phone call with consumer, Blue Cross Blue Shield resolved the complaint.

Because we value the confidentiality of our member's private health information, I have attached a response to your request.

I am rejecting this response because:I already gave you HIPPA release on the internet but will fill out the form that Blue Cross Blue Shield request and send it to you.  Thanks [redacted]

Initial Business Response /* (1000, 14, 2016/02/08) */
Patient Name: [redacted]
Case Number Referenced: [redacted]
Dear Revdex.com:
This letter is in regards to your recent request for information regarding the above-mentioned patient.
With the information provided, we aer unable to locate...

this as a patient in our system. If you have additional information that may help us, please remit that and we will research this for you.
I trust this information has been of assistance. should you have additional questions or concerns relating to this issue, please feel free to contact me directly at [redacted] or toll free 1 -[redacted], extension [redacted].
Sincerely,
Consumer Service Center
Final Business Response /* (4000, 16, 2016/02/17) */
Patient Name: [redacted]
Case Number Referenced: [redacted]
Dear Revdex.com:
This letter is in regards to your recent request for information regarding the above-mentioned patient.
With the information provided, we aer unable to locate this as a patient in our system. If you have additional information that may help us, please remit that and we will research this for you.
I trust this information has been of assistance. should you have additional questions or concerns relating to this issue, please feel free to contact me directly at [redacted] or toll free 1 -[redacted], extension [redacted].
Sincerely,
Consumer Service Center

I am rejecting this response because:
This statement might technically be true: "Blue Cross accommodated the requests to change the coverage effective date. As each request was processed and completed, a new bill was generated affecting the premium due at that time." However it entirely ignores the fifteen complaints I had delineated on 3/19, the four additional complaints noted on 4/11, another additional complaint noted on 4/17, the varied and changing lies they told me about why they couldn't give me a discount, and the continued poor customer service over the course of the year. Honestly I can't keep track of it. They have treated me with disrespect at every turn and the only positive thing I can say about them is that they were able to correct their own errors and provide a corrected bill, but that was only under duress of my excessive persistence, complaints, escalations, the involving the Revdex.com, the Attorney General, and multiple state representatives. It should not be this difficult to receive and pay a bill, and I reject the idea that my reward for helping them correct their problematic bureaucracy is that I get to pay my premium in full. In addition, I remain of the belief that they owe me a total of $1596.42 for the duplicate charges for my children for March, April, and May. I have communicated this to them in a letter dated 8/7. I believe they are guilty of fraud in this situation until they correct it.Not to mention the way they screwed MinuteClinic out of a payment through their incompetence: They paid the bill, then incorrectly changed the policy and rolled the payment back, and when I had them correct the policy back, they informed me they no longer needed to pay it because it was more than 120 days past the initial service. Disgraceful.