Blue Cross of California
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Blue Cross of California Reviews
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My mother has this PPO insurance. They do not approve needed services that are recommended by the doctors. They will find the cheapest alternative, with no concern for the member’s best interest. You are most vulnerable when you have the greatest health needs. There is a rehab center that helped my mother in the past regain her strength after she had an infection with sepsis. We had to fight and appeal to get her there. My mom had the same infection after a biopsy done at the hospital. We again are having to fight with this insurance. They have denied it and any decent rehab facility.
They approved a cheaper rehab with terrible ratings. We have been told if she just had Medicare there would have been no problem being admitted. A lot of these places don’t even want you if you have Blue Cross because they are difficult to deal with. The New York Times has had articles about Medicare v, Medicare Advantage. I will not be choosing them for my future Healthcare needs after what I’ve seen with approvals. It’s fine if you are generally healthy and on the younger end of retirement.
This is absolutely the worst insurance company in the world, scam is more like it. They charge a lot for PPO insurance, but they don't pay for anything, everything is denied or not covered. when we call them they give us the run-around, we will never deal with this scam of company again. No wonder they lost a federal case for 2 billion.
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February 2023. I'm making this review in the hopes that anyone reading this during open enrollment will be able to make a better decision. No one expects to have a positive experience with an insurance company. But this one is far below average. The company is trying to boost profits by denying micro claims and it's just causing me way too much frustration. There is no reason for this but to squeeze every dime out of subscribers. I know our family's medical expenses are not covered. I know that this disease is too "new" and too "expensive" to treat. I get that and I pay for the insurance for emergencies only and for them to cover anything in the off chance that it falls under the "normal" treatment umbrella. So when my doctor prescribed an antibiotic, I assumed it would be covered. Well I assumed wrong. It needed prior authorization. Okay, I assumed it would be straight forward. Well I assumed wrong.
To make a long story short. Blue Shield apparently knows much better than my doctor and I should "try" two other antibiotics first before getting the one my doctor thinks will help my gut infections without causing more systemic harm. This is a petty petty company. I already pay over $30,000 in out of pocket medical costs every year because they don't cover those doctors and things. Okay. But they couldn't even pretend to want to be helpful and pay for one two-week prescription of antibiotic. Needless to say I will never do business with them again. I hope to save someone the heartache in the future. Also, talking to people, I learned from a friend that is older that the same thing happened to him 20 years ago. He also never went back to them. I guess things haven't changed at all.
Nice insurance. Covers maximum regular lab tests and visits. Rare lab tests which are not covered. Annual physical covers all lab tests. Apart from this provide less out of network cost. Easy billing from insurance
Worst insurance company I had to deal with in my entire life. The coverage is pretty good when things are going well, but it is rarely the case, and the stress of dealing with them is not worth it. They deactivated my coverage twice in 3 month due to a billing error, which happened as a result of their poor billing system, not because we didn't pay. We called them to fix the issue, the latest update was basically "we are aware of the issue and working on it", I heard this message 2 weeks ago. They are obviously not doing a good job working on things because I am without health insurance for over 2 weeks now, while pregnant, I must add.
When searching for a supplemental plan for my mother's Medicare A and B plan, I decided to select Blue Cross. I noticed that most of the benefits included were already perks in her regular Medicare plan but since I was bombarded with letters and tv commercials regarding the great additional benefits I figured we would give it a try. This “additional coverage” only prolonged doctors' appointments because of the excessive requirements for referrals. I think these plans exist to represent the political power of organizations proving limited coverage for the elderly and proving political strength of programmatic structure forces against expansion
I am a PCP and have been trying to get behavioral health services for a patient of mine since 2019. No luck. I have provided counseling for free in the interim because her HMO does not provide MH services. Today my assistant and I spent > 2 hours on the phone with provider services and then patient services. We were transferred 5 times and they then they just abandoned the call. They obviously just don't care. I will encourage the patient to file a complaint. I will file a complaint with the department of managed care services and her HMO.
I am trying to get a phone number and email for the Anthem CEO, Gail K. Boudreaux. Does she know what's really going on with her company? Are you really living up to your: Mission- Improving Lives and Communities. Simplifying Healthcare. Expecting More. Vision- To be the most innovative, valuable and inclusive partner. Our Values- Leadership, Community, Integrity, Agility, Diversity? I think not. Give me a call.
BlueShield is ridiculously expensive and almost every time my doctor needs to get approval for something, it is denied as Medically not necessary. My doctor and I always discuss treatment options and then proceed. How can a "doctor" who has NOT seen me, make a judgement as to what is necessary or not!? This is ridiculous. I have been in serious pain and this is the plan that the doctor and I decided upon (chose to try and avoid surgery). I pay extremely high amount per month for a PPO, plus I have to pay a copay, PLUS PLUS PLUS... I am getting NO care from Blue Shield! I have to appeal everything and in most cases appeal to the state board. Blue Shield is the WORST! If you can avoid this company, I absolutely recommend looking elsewhere!
Blue Shield did not cover their portion of a bill from an IN NETWORK provider that I was referred to and received prior authorization. I submitted an appeal/grievance, Crystal H was the coordinator, and she denied the grievance, stating the doctor was out of network. I was asked to re-appeal with my "new information." However it is not new information, all this information is readily available on their own Blue Shield website and within their own system. They apologize for being "so busy" but if they just do their job correctly the first time, they wouldn't be so busy. Ridiculous, and the cause of expensive health insurance fees - administrators who cannot do their job correctly the first time and get "so busy."
My experience with Blue Shield has been the worst. I will recommend or renew with this insurance provider. In July of 2018, I was taken to the ER in Nevada to Sunrise Hospital for immediate treatment. I had given all the proper documentation with correct Blue Shield insurance information - to the Sunrise Hospital. I ensured I paid the ambulance bill, which blue shield covered.
As for the hospital bill, it was not covered by Blue Shield. Sunrise Hospital did not submit the bill to my insurance provider within the year time frame. Instead, Sunrise sent me to collections in January of 2019. I called the hospital to inform them I had insurance on 7/7/2018 and re-given my Blue Shield insurance information and advised Sunrise of the date the day of service was covered by Blue Shield. However, Sunrise Hospital once again failed to submit within the required time. Sunrise billed too late, and in August 2019 Blue Shield denied my claim and refused to cover the medical bill. While in this process I was also advising Blue Shield of Sunrise’s unfair practices of not billing in proper time frame.
I have been proactive in following up on my case, but it is unprofessional from both parties that they are putting this sum of $4,000 on me the patient, when I was fully covered. It is gross negligence of Blue Shield’s behalf, since I was fully covered when taken to the emergency room. Sunrise is also committing fraud with sending me to collections and not billing promptly. I’ve disputed this multiple times in the past 3 years. I will be reporting this matter further to all media and medical platforms & making sure another patient is not stuck with outrageous medical bill when they have medical insurance. Very dissatisfied with Blue Shield for denying my claim and highly suggest consumers not choose Blue Shield based on my poor experience.
Blue Cross of California Company Information
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