Care First BlueCross BlueShield

Review: I have been trying to obtain information on why I am not able to get health insurance since December 2013 when I first applied. I was told by different agents when I called that get information via email and paper mail. I received neither. I continued to call every few weeks to inquire but no one could help me. I was told to send my payment to an address( p.o.box [redacted] Kentucky) which I did. I waited and didn't receive any correspondence so I called again. Finally I got and agent that said I should pay now and when they receive my payment thru the mail they would apply it to the following month bill and that I should call back in two days to follow up. That conversation took place on June ninth. I called back in two and was told that my policy was cancelled. I asked to speak to a supervisor and was given to someone named Ashley who told me that the previous agent should not have taken my payment and that she would issue me a refund in 7-10 days. I called back to inquire about my refund an was told that they could not see any refund information so I asked to speak to Ashley the supervisor and she could no be found and that I should give it a few more days. Not only could I not get any insurance I can't seem to get my refund. All of this took six months without any resolutions.Desired Settlement: At this point I just want the bulls### to stop and give me back my payment immediately if not sooner.

Business

Response:

---------- Forwarded message ----------

Review: The BCBS customer cancelled his coverage with BCBS to end in February. He received confirmation from the insurance company that his policy was cancelled, effective end of February. BCBS proceeded to bill him for the month of March. When he called to address the issue, the representative confirmed that his policy was indeed listed as cancelled at the end of February (even at the time of of charging him), but nevertheless, it would take 6-8 weeks to refund him. This length of time is absolutely unacceptable, as is the company's practice of billing former customers even after their policy has been confirmed as cancelled.Desired Settlement: An immediate refund and apology.

Business

Response:

4/23/14 -[redacted], Customer SerVice Specialist contacted **. [redacted] and listed below is her update from that conversation

Per the complaint, **. [redacted]’s ([redacted]) policy was cancelled effective 03/01/2014. He was told to allow 6-8 weeks for the refund but said that amount of time would be completely unacceptable. He wanted the refund ASAP as well as an apology.

Review: I have for well over a month been trying to get my personal health care. I had submitted an online application through www.[redacted].com and got a reply saying that I was approved, and was than billed never having said that I wanted that particular plan (Platinum). After doing some more research I found a plan that better suited my wants and needs. I was told that in order to try and get the plan I wanted I had to write a letter including my name, ssn, address, phone number, and reason fo r not wanting the firstr plan before I could apply for the one (Bronze $100 ded) that I did want to purchase. I again went to the same site as before, followed the same process and was approved again. After a month of trying to simply get another plan I have spent/ wasted hours of my time on hold, only to have my calls repeatedly dropped, sometimes before even reaching an actual person. I did speak to [redacted] who assured me that by the end of the week she would have her CSS [redacted] finalize the process for me and would only give me a call reference number ([redacted]). Again after being on hold for hours I got in contact with a very rude woman who was no help at all, told me she didn't have any of the information that I provided to her, put me on hold a few times than hung up on me.Desired Settlement: Just to have someone compitant to finish what can not be a very difficult task and get me signed up on the correct health insurance plan that I have been trying to purchase for over a month now

Business

Response:

4/17/14_ [redacted], Customer Service Specialist attempted to contact **. [redacted] -Listed below are her notes

The **. [redacted]) complaint is that he couldn’t get the plan he signed up for. First, he applied for a BluePreferred Platinum, in error. This is not what he wanted. The policy eventually voided for non-binder payment. Then, he changed his mind and applied for a BlueChoice Gold $1000, EAB advised that in order for us to reinstate, he will have to pay the premium first.

Review: I applied for a health insurance policy for my family in December of 2013. On December 31 I was told by my insurance agent that we were accepted. On January 14th I got a call from CareFirst telling me that I needed to pay $662 by January 15th which I did so. The family policy that I signed up for had a premium of $1061 so I thought that the $662 that I paid was for partial payment for the month of January.At the end of January I received a bill again for $662 and I got my insurance card for myself and my son but not my wife. I called CareFirst and they told me my wife was not included in my policy. The consultant looked at my application and said it was their fault she was not on the policy and she would add her but for me to go ahead and pay the $662 and they would rebill me by adding my wife to the policy. In February again she was not added to the policy. Finally in April I received her insurance card and a bill for the correct amount being $1061. CareFirst billed me for my wife for the months she was not on the policy. After many attempts to contact the company to solve this no luck. I continued paying the $1061 but then recieved a cancellation notice for they want me to pay for the months my wife was not covered. So now I do not have health insurance because of their mistake.Desired Settlement: I want this matter to be taken care of for I will not be able to reapply for insurance til October

Business

Response:

CareFirst has tried to contact the member regarding their inquiry.

CareFirst has updated the policy to reflect family coverage. This is effective for 4/1/2014. The family policy is paid through 6/30/2014.

A Customer Service representative has left a message for [redacted] with their name & direct phone number for him to contact if he has additional concerns or questions.

Review: CareFirst BlueCross BlueShield's website does not respond to messages placed on their message center. They have not responded to my repeated requests to cancel my policy and they have even continued to withdraw my funds. Their phone number is either busy or not working. There is no way to contact them concerning cancelling your policy.Desired Settlement: I want my money back for March since I cancelled my policy in February and have been unsuccessful in contacting them either by phone or webpage.

Business

Response:

4/16/14, [redacted], Customer Service Specialist review results are below:

4/16/14 changed the member’s cancellation date to 03/01/2014 per her request.

Review: I never had any health insurance with care first, last month they send me 5 bills, I called them and send them a letter, 2 days ago I got another bill.Desired Settlement: They need to fix this

Business

Response:

CareFirst has reviewed [redacted]'s inquiry and has tried to contract regarding this information.

The following is our findings:

[redacted] signed up for a policy via the Federal Exchange in Virginia:

Review: I resigned from my job where I had health insurance as I am moving out of the country. Instead of working through COBRA I decided to get a new policy since I would be out of the country by the time the COBRA documents would had arrived. I called the Carefirst sales dept various times to get info. Knowing that I would be leaving the country mid month I asked each sales repp. could I cancel mid month and be reimbursed. Each time I was told yes that I could. On 2/3/14 I called to cancel my policy and was told that I could not cancel mid month. After spending TWO HOURS on the phone I was told a high up in the sales Dept. would call me. A [redacted] did call me to say one of the repps. I spoke with (the only one whose name I could recall) was held in conference to review the policies of the company. I have still not been offered a refund per the promise that I was able to cancel my policy. Had I known that I couldn't I would have just done the Cobra. I keep hearing "there is nothing we could do, the sales dept. should have known better". However, at the end of the say its not my fault that one hands does not talk to the other at your company. It is ENTIRELY possible to not cancel my account until the end of the month and yet only charge me half a month.

Let me put it this way..... I KNEW the whole time I only wanted half a month of service.... I asked in ADVANCE if this was possible and was told yes......WHY would I waste HOURS of my time calling and trying to get this done if I was not TOLD NUMEROUS times that that I could get a refund!Desired Settlement: I want to only be charged 1/2 a month for Feb. 2014. I would like a refund of $531.00

PLEASE EMAIL ME ONLY at [redacted] I am moving out of the country and DON'T have a phone set up yet!!!!!!

Business

Response:

CareFirst Customer Service is attempting to contact **. [redacted]. A message was left at the phone number we have for **. [redacted] as well as sending an email since he is out of the country. At thie time we have not heard back from **. [redacted]. We hope to hear from him soon and work with him to resolve the issue.

Review: Began treatments with a dermatologist regarding a long-term skin issue ([redacted]) but treatment was suddenly stopped by my doctor after about 15 treatments due to the failure of Blue Cross Blue Shield to pay the doctor for the treatments. This type of treatment requires bi-weekly visits and I was finally getting results that I have not seen before. The sudden halt reversed my results and am back to where I first began which caused me much agony. After NUMEROUS contact with Blue Cross Blue Shield, all associates FAILED to correct this issue which should not have been my problem in the first place. I STILL have not returned to the dermatologist as she will not see me until Blue Cross Blue Shield clears this issue up which they have NOT. It has been over four months now since my last treatment. The utter lack of respect and customer service is baffling. The length of time it has taken and lack of concern to fix this minor issue is remarkable.Desired Settlement: Revdex.com has to pay the price for their TERRIBLE customer service

Business

Response:

See attachment or check attachment tab.

Review: My doctor called in a prescription for [redacted] and the cost was around $500. I called the insurance pharmacy number and the representative told me that if I ordered a 90 day supply then it would be less than $200. I did this and it was over $700. I called the number again and another representative told me it was $700 and she did not know where the other representative came up with that number. I called today and spoke to Takera (spelling may not be correct). She told me that I had met my Out of Pocket $1800. This I also know because I picked up 3 medications this morning and there was a $0 copay. Takera told me that my medication would be $0. This was a 45min phone call because I was on hold. She told me to have [redacted] rerun prescription and [redacted] and it remained the same cost. I called back, another 45 min wait and Takera told me that I was responsible for 50% cost of medication and that the medication was not covered. This is different from what she originally told me. I was told that there was no manager to speak with me. Once I told them that I would file a complaint with Revdex.com and DISB they suddenly found a manager. Rebecca told em that the out of pocket cost is stored in 2 places and that one account showed I was over $1800 and the other said I was at $1798 and that she would have to request an audit which will take 30 days. So now I can not afford my medication and will have none for 30 days because of a glitch in the Carefirst system. I do not think it is fair that my health is at jeopardy because of this.Desired Settlement: I need my medication at an affordable price ASAP or my health is at risk

Business

Response:

CareFirst has contacted [redacted].

Her out of pocket maximum as of today is $1185.77. The change in the amount was due to several test prescriptions that were processed and then removed from her policy.

The drug - [redacted] - will currently process with coinsurance until the out of pocket is met.

A pharmacy audit is being conducted. As soon as this is completed, [redacted] will be contacted with the results.

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

Review: I have contacted Carefirst on at least 10 separate occasions via phone (spoke to several different reps), message on their website (message was never returned), and via their [redacted] page twice. My coverage was to start 7/1. I called around 7/3 because I had not received an explanation of benefits or my member ID card. I also requested that the dental portion be cancelled because I decided to go with someone else for that. Today marks my 11th call to them and nothing has been done. I have paid for coverage for a month and have not been able to use it. This is ridiculous.Desired Settlement: I would like for them to either refund my first month premium in the original form of payment or apply it to my next premium due (assuming that the issue is fixed by then). I don't feel that I should be liable for their system error which prevented me from using a service that I paid for.

Business

Response:

CareFirst has been in contact with the member.

CareFirst is waiting for the member to contact us regarding her policy. CareFirst needs to know if [redacted] had services in July that we have not yet received as we wish to know if she would like to keep the 7/1/14 effective date or go with the 8/1/14 effective date that management has approved.

Either way, CareFirst is offering a 1 time credit due to the inconvenience she has experienced. This will be applied to the next billing period.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Regards,

Review: I had health coverage through care first starting December 2, 2013. I had a seep study done on December 5, 2013. Care First refused to pay saying I did not have coverage. My company human resources corrected the start date to reflect 2 December 2013 with care first. I had to pay the total $3998.00 out of pocket to keep from going to collections. The start date was corrected and I was told by care first to re-file and there will be no issue of getting repaid. Now I have been told that it must go through the local blue cross blue shield/ Care first office, and it did, now I have been told since it was out side the normal filing time that I will have to wait after it is resubmitted with an exception to timely submission letter that I will have to wait another 30 days on-top of the 6 months I have already waited. I am attaching the supporting documents to this complaint. I want my money refunded to me as I am tired of the run around. I want my money refunded now!!Desired Settlement: refund the total amount of 3998.00 to my credit card on file

Business

Response:

July 14, 2014Dear [redacted]:This is in response to your inquiry in which you requested an investigation of a complaint filed by [redacted] regarding a claim for medical services rendered on December 5, 2013.ResponseUnfortunately at this present time, CareFirst will not be able to respond to the Revdex.com's request for information because an authorization to release information was not attached. However CareFirst will still review the matter and respond to the member directly.If you have questions or concerns regarding the information provided in this letter, please contact me at ###-###-####.Kimberleigh T.

Review: I was over-charged for my health insurance due to an error on CareFirst's site. When I submitted payment on the site, I was shown an error that the payment did not go through successfully when it actually had. I tried three times before giving up, without realizing I was being charged each time.

I have called them 3 times already and have still not received a full refund of the two extra charges (totaling $508.56 - 2 x $254.28). Each time I have been assured that they are going to refund the money, but have yet to receive a full refund.

On November 15, I received a notice that my credit card had been credited for the $508.56, but I just checked my statement and have only received a credit for $248.61.

On top of this, they have an failed to remove an outstanding invoice from my account for $190.30. I had previously had direct consumer insurance with them but switched over to being covered through DC HealthLink. I paid my premium for my insurance through DC HealthLink for the month of September yet I also received an invoice for my direct consumer insurance for September. I have called about this issue 4 times and have not been able to get the pending invoice removed from my account, despite being assured each time that it would be taken care of.Desired Settlement: Full refund of the $508.56 that I was overcharged.

Removal of the $190.30 outstanding invoice.

Business

Response:

CareFirst has been in contact with [redacted].Due to an online billing issue, an error message was displayed when a member made a payment even though the payment went through and processed.CareFirst did credit back $508.56 to [redacted]'s credit card on 11/14/14. We have asked that he verify this with his credit card company.[redacted]'s premium for 9/1/14-12/31/14 was $1017.12. CareFirst received $1271.40 but refunded $508.56, which left a balance due of $254.28.[redacted] has notified CareFirst that he was attempting to pay the balance due online but was not seeing his current invoice, only an invoice for an older policy. This issue has now been resolved and [redacted] should only see the invoice for his current policy. This should allow him to make his payment without delay or confusion.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Regards,