Blue Cross of CaliforniaConsumerAffairs Unaccredited Brand
Keep an eye on your inbox, the lastest consumer news is on it's way!
As a provider, I have needed to connect with Anthem Blue Cross to resolve and complete patient claims. I have spent hours being re-directed, disconnected, unanswered, and ignored. The email and phone systems are completely dysfunctional and I am frequently met with responses that state, for example, "I'm sorry, I didn't hear that, please repeat your information." I repeat, I type it in, I repeat again (I speak clearly, and I have a good phone connection) and the system consistently drops my calls.
This has been going on for over two months, and has occurred with 5 patients now who are awaiting care. The stalling/stonewalling I have faced from Blue Cross is inexcusable, especially given that people's health and well-being is involved. I am concerned that this avoidance is a deliberate attempt on Blue Cross' part to deny assistance to providers and patients who have legitimate claims and have done their due diligence to follow the rules, only to be met with a gridlock of ineptitude and inertia.
We have been an in network provider for the past 3+ years with Blue Shield of California. We had originally signed up under our group name. However our group only includes one provider so all of the information is the same. We were informed that in order to change our contract we needed to re-credential with our individual provider's information. We were informed that the process would take 120 days at most. Lo and behold 180 days have gone by with no new credential. We are now being told that Blue Shield says the process is MINIMUM 120 days.
We have many patients who have been waiting for us to be in network. The majority of other insurance companies are able to credential quickly by using CAQH, however Blue Shield insists on a committee meeting once a month. This is highly impractical. We are considering simply telling our patients to drop Blue Shield as it seems to be extremely unreliable in terms of contracting providers. I would not recommend this insurance to anyone and would recommend telling patients to consider alternative insurance companies.
I accidentally signed up for coverage through Covered California. I realized it right away and went through a long phone process with Covered California and Blue Shield to get a refund. I was promised my $600 back in 30 days via check even though I paid with a credit card. This was May 1, 2018. (They wouldn't just credit me back.) On July 18, 2018 they are saying they never did anything to refund me yet I have no coverage with them. The person on the phone got nasty with me when I asked them to credit my card back. This is fraud.
I’ve been with A-Blue Shields for over 29 years never had an issue until 2006, I am a cancer survivor, but I’m not sure I can survive the health care cost, my story: I had a wonderful policy at approx $425.00/475.00 per month Before my battle with cancer after the police kept going up in price until it reached $1695.00/$1800.00 and it was going to take another increase and was no longer affordable by any means but due to a pre-existing condition I could not change, when I called they explained that my policy no longer existed and the price was going to continue to increase no matter what until everyone was switched to a different policy. Well not being able to afford it I had to downgrade my policy to a Bronze that may as well be a plastic garbage bag, my rate went down 500.00 per month but my deductible increase immensely 7000/4000?
After the downgrade they started to increase my monthly from $500.00 up to $996.00 now with still a 7000/4000 deductible. It’s just not affordable, yes I own a home but I don’t own it making payments. My health insurance issues have been going on for over 12 years but come on $996.00 for 1-one-☝️ person is insane, and the coverage is less and less, and the deductible same. It’s just not right, work hard follow the rules and no relief in sight, at age 60 may have to sell my 1st and only home just to pay health insurance, you can see how people develop bad credit and there life's starts to spiral downhill, lose your homes and live in the streets, Last; after all this try and get a decent Drs app with a new Dr with Blue Shield's coverage and not have to wait 30 to 45 days for an appointment. It’s just not right.
Affordable family plan health insurance that is easy to obtain with FAQ answered online. The prices are quoted on a general basis so that you are aware prices may be slightly different according to your needs.
- 1,191,201 reviews on ConsumerAffairs are verified.
- We require contact information to ensure our reviewers are real.
- We use intelligent software that helps us maintain the integrity of reviews.
- Our moderators read all reviews to verify quality and helpfulness.
For more information about reviews on ConsumerAffairs.com please visit our FAQ.
I have only had the occasion to contact My health insurance provider a couple of times. Both time I believe I was treated very respectfully. I had pointed questions which were answered very completely. I think this company does a good job of using its website that explain many of the little things that come up.
My physicians at Saint Mary's Spine Center have requested authorization for a spinal fusion procedure I desperately need to repair my lumbar spine. They deny claims that are medically necessary, resulting in prolonged severe pain and suffering to their insureds. Their greed for dollars over patient care is deplorable.
I call Blue Shield customer service from time to time and a simple request or single question can take up to 45 minutes or longer due to language issues and a complete lack of knowledge by the agent. They need to put you on hold every time you ask a question so they can look it up in their book and try to figure out what it is you are asking about. They literally know nothing and have zero training. Blue Shield outsources these jobs to save money, but if they hired people who spoke more than just a few words of barely discernible English in a heavy accent, the phone conversation would be all of about 5 minutes. Wouldn't that also save money? They would have to pay higher wages but it would not take an hour to answer a single and very basic question. There is only one explanation. Blue Shield is paying its outsourced workers three cents an hour. Blue Shield should be ashamed of themselves. Single payer now! End for profit heath care!
There is no way the government could be any worse than corporations at providing health care because health care corporations have hit rock bottom and can't possibly get any worse than they already are. Or can they? Either way, we need to try something else because this system is entirely dysfunctional and Americans are paying outrageous amount of money for some of the worst health care on the planet while executive sit on their yachts off Monaco counting their money and laughing at us.
This is by far the worst insurance I have ever had. I am diabetic trying to get my supplies for 3 weeks now and the authorization is still pending while I am running out of supplies. The customer service people don't care. Of course what health insurance company does care about its members? This one is by far the worst of any. Do not buy this insurance. It's a waste of money and nothing but trouble.
Had Blue Cross through my employer. Since I am retired living on social security have to be real careful about insurance cost. I paid for healthcare for 40 year. Rarely use it.
Very difficult for claims that are not routine. Correcting a typo they make is almost impossible as well. Rates for 2018 increased to the point of unaffordability.
I pay $1100.00 month for my insurance and Blue Shield has denied everything from X-rays to MRIs, my surgeries even my medication I've been in for years. Every one of my doctors and surgeons have to do a Peer to Peer just to get it paid for. Last year I waited 8 months for a medication to be ok. And it was something I had been on for 3 years. Just this last 3 weeks after being home from yet another surgery I was in the phone with Blue Shield. Not only is customer service there so rude this last lady had myself and my doctor's office on a 3 way call. This lady was rude. Had us on hold for over 40 mins before we realized she had hung up on us.
I don't think it's right we have to fight for medication that we need. And have been in for years. I'd like to know what they do when they need go to the doctor and need surgery and meds???? If a specialist is telling you you need surgery after looking at CT scans and MRIs and we are paying all this money to have health insurance but yet we are still being denied... Something needs to be done about this...
I don't know how many times I have called this company, and my enrollment issues are STILL unresolved! They have enrolled me with the wrong Drs., clinics and coverage, and when I requested that they send me another card with the corrected information, they sent me a card with an arbitrarily assigned doctor and clinic instead of the one I chose and had already seen! I really like my Dr., and I DON'T want another one.
I've worked in customer service in the past; companies rate their employees by how many calls they take each hour. If they can't get call queue down within a reasonable number, their performance ratings goes down and they can be fired. So there's no real incentive for providing quality service for the customers. There's only enough time to give people affirmative responses, promise to take care of the issue, get them OFF the line within 2 -3 minutes (sometimes more), and move to the next call. How much quality service can a representative give within that short time span, especially if there are complicated issues that involve inputting information on multiple screens?
Based on my own experiences doing that kind of work, it isn't easy trying balance speed with quality, especially when the employers' focus is on speed. One of my supervisors once said, "I feel it IS a service to take the customers' call quickly so they don't have to long wait times in the queue." That's true, but not at the expense of resolving that customers' issues!
I suspect that's what is going on with Anthem Blue Cross customer service. I hope I'm wrong, but I doubt it. I'm a former Kaiser Permanente member, and I switched to Anthem Blue Cross because I was very dissatisfied with their fast food industry approach to medical care. However, I never had any problems with their customer service. Now, I'm dealing with the exact opposite situation: great care from my medical providers, and ROTTEN customer service from my health insurance plan!
Due to lay-off from work in 2017 I obtained insurance with Blue Shield through Covered CA. So far nothing but problems and unfortunately when calling in to customer service I reach non-US based help desk who are very difficult to understand especially with loud environment they apparently work in. I've asked multiple times for US-based rep to call me back. Each time they indicate call-back within 24 hours but is now a week later and I'm still waiting. Called again and was told call-back within 24 hours but I'm not holding my breath. Such a disappointment after 5 years at United Healthcare where all their support is US-based. Shame on you Blue Shield.
I switched from Covered California with Blue Shield to a regular policy with Blue Shield in March of this year. It's been one nightmare after another with them and it just keeps getting worse. Blue Shield deposits my premium checks every month but stopped crediting them to my account three months ago. I have spent an inordinate amount of time on the phone with them about this issue. The last supervisor I spoke with told me that they had recently changed their billing system and that's why my payments weren't showing up. He told me that everything was alright and I should just put a different code on my next check rather than using my account number. Well, tonight I get a message saying that my insurance was CANCELLED and that I had 48 hours to pay them $1700 or my account would never be reinstated! This includes a $548.17 "reinstatement fee".
I have a complete paper trail of every premium check I've sent which they have deposited (I send them 10 days early too just to make sure). I have lost sleep and time from work as a result of Blue Shield's negligence and ineptitude. They outsource their calls to a call center overseas and the people are not trained. I very much look forward to finding a different healthcare provider once this is resolved. Shame on Blue Shield! I have filed a complaint with the Insurance Commissioner as this has gone much too far.
I have been trying to get a response from Blue Cross as far as my payments are concerned. I hit my deductible in January 2017, and to date Blue Cross has not rectified my account. I've spoken to numerous people at Blue Cross in regards to this, and have been trying to get in touch with Holly to no avail. To date, October 5, 2017, has not returned my calls. The bills keep coming and of course, the doctors and hospitals want payment. I don't know what to do at this point. I have EOB's that indicate I have hit my deductible, but no one will call me back to get this taken care of.
They terminated insurance with no cause, reinstated after a month with apology, reimbursed for the missing month of coverage for the family. 1 year later, (not near an open enrollment period), extortioned me for their missing month of coverage. I had to pay, as no way to change providers due to the Obama-Care requirements. Dropped them at my first opportunity. I would love to see this company go out of business for how I was treated. Never again with these crooks!
I was out of the country and ran into financial troubles and did not pay my premium for two months. They sent me my new card and a statement which I was prepared to pay upon my return. I called them and they told me they would return my call in 7-10 days. After 12 days I called and they said I received the wrong information and would receive a call in 30 days. After 33 days I called again and they told me it would be after 40-45 days. I asked if this is because of the new legislation and they confirmed that it was. I own multiple properties and need to be covered in case of a catastrophic accident. Out of the country it doesn't matter because there I can easily afford health care. I told this company they were lying to me and they had another term for it. I'm seeking a new provider.
The government should either stay out of health care or simply provide a universal plan to all its citizens. I've come to find out that I can get an excellent plan in Asia for $60 a month that includes almost everything. You get excellent care beyond what you get here. I'm moving probably at the end of this year. ** this place and ** Blue Shield. Their coverage is garbage along with their customer service.
My bank sent me a new credit card. I'm enrolled in Blue Shield's auto payment option. I logged into my account on the Blue Shield website and tried to add a new credit card for my payment. The website said all my info was already on file, which it was NOT because it was a brand new credit card. Called. Had to waste time wading through the phone tree only to be told the office was closed. Then they hung up on me. They make everything so difficult and waste so much of my time they should be paying ME.
Blue Shield of CA arbitrarily denies you a vital medication/treatment which has been proven and documented to shield (excuse the pun) you from pain and improve your overall quality of life by improving your mobility - this has to do with gel injections into your knee which is, for all practical purposes, bone on bone. I believe this to be inhumane and cruel, especially considering that I pay $733 a month to Blue Shield each and every month which they have no problem with taking. Also, claims processing is at a snail's pace (took about one month to process my claim - still waiting for the money!). The only thing that Blue Shield of CA is great at is taking your money monthly!
Blue Cross/Blue Shield business is appalling and if it was not such a large conglomerate it surely would have gone bankrupt because of their business practice. My story... For the past 2 years my prescription cost was $0 out of pocket. Come January 2017 my out of pocket rose to $535. Called BC/BS and waited on the phone for 35 mins on two occasions. Ok, I understand everyone is busy but really 35 mins!!! Third time was a charm as I got thru within 5 mins.
Went thru the menu and spoke with someone that deals with prescriptions. Told him since my conversation is being recorded I first I need to complain and it's nothing personal against him but rather for the company he works for. I said, "please let me know what kind of company is BC/BS that changes the conditions (I see it as a contract because a premium is being paid for service rendered) without notifying the customer first? I was paying nothing and now all of a sudden I'm paying over $500 a month. This is terrible customer service and because it is cost prohibitive, when I become ill (or die) for not taking my meds, I'll see BC/BS in court."
Enough said and as protocol dictates I started asking him what are the alternative meds I can take. I started with the 3 that cost the most; $394, $89 and $27. He gave me some alternative meds I could take and then I stopped him to ask a few more question. "How do you know what alternative meds to recommend? There is a chart that cross references to similar medications. So, for one of my pills the only alternative medication you are recommending is 10 mg; 20 mg is not available. Since I am taking 20 mg does that mean I double up on the medication or is it formulated to meet the 20 mg strength?" He could not answer and said he could transfer me to a pharmacist. I said "OK but I have one more question for you. Are you a Dr?" No. "If you are not a doctor how can you safely recommend an alternative medication?"
I am allergic to sulfur and how does he know any of these alternative medications do not contain sulfur. He said I should speak to their pharmacist and will transfer my call. As the call was being transferred it was dropped. I think they tried to call back within a minute but I was so pissed off with the answers I was getting I really did not want to speak with anyone.
So, I spoke with one of my doctors and he gave me enough samples of the $394 meds until there is a fix; whatever that may be. For the $89 meds, I am still waiting to hear from my other doctor and according to BC/BS there is no alternative medication. This experience is almost as bad as the EpiPen and my heart goes out to everyone that is experiencing similar medical cost problems.
Since I enrolled with Blue Shield CA in 2016, I have had ongoing repeated problems with the billing system. I am told that there is a 2 month delay in updates to the premiums due. This resulted in me being overcharged for my January coverage - the system continued to bill me for the 2016 plan, rather than the 2017 plan that I changed to effective Jan 1. I cannot believe that this level of service is considered acceptable by the California insurance bureau. Blue Shield CA should be required to upgrade their systems so that consumers are not routinely overcharged. I spent another hour on the phone with a rep who basically told me that I just needed to be patient and wait the 2 months for the system to catch up. I have taken the initiative to calculate and update my payments, so I am fine for moment... until the next Blue Shield SNAFU.
Blue Shield of California deceived me as to the terms of my dental plan. As a matter of fact, they did not disclose to me the complete terms of my plan either upon the enrollment or renewal. My plan had one year waiting period and when I wanted to use my insurance for the first time (after paying them for a year and half) they denied me practically everything.
It took me additional several months to get from them at least some explanation for their denial. Only then they sent me the evidence of coverage with some weird restrictions that had never been sent/disclosed to me before. When I complained to them that they failed to make proper disclosures, they prepared a false account of my complaint and just canceled my insurance, falsely alleging that the cancellation was requested by me. In such way, they managed to pocket all my premiums without having any expense. Since I had a deductible, I even had to pay for the full mouth X-rays they requested from my dentist without any legitimate reason (they did not need the full mouth X-rays to invoke the restrictions they had been concealing from me).
I am both a provider and a patient with Blue Cross PPO coverage, like many people, I also received a notice from this company indicating a 30% increase in my premiums, they also increased my deductible. I would like to share that as a healthcare provider, Blue Cross has slashed their reimbursement to providers by a whopping 60%. I will no longer will be accepting Anthem Blue Cross of CA. I understand this company wants to turn a profit; but increasing premiums by 30%, raising deductibles and co-insurances, and cutting back provider payments by such a huge percentage, one wonders how much profit is enough for this company. Unethical practice by this company.
My employer changed our company insurance plan to Anthem Blue Cross from AETNA, effective 8/1/2016. I provided all the necessary information so that deductibles would carry over from AETNA. In mid-September, I went to an in-network lab for lab work that my doctor had scheduled. The billed total was a little over $1400. In October, I received a bill from the lab stating that the claim had been denied. I went online to look at the EOB and found that the claim was denied pending my answers to a questionnaire about Medicare coverage that Anthem claimed to have sent me. When I still hadn't received that questionnaire 2 weeks later, I called Anthem, waited through the interminable delays, and explained my problem. The rep said they'd send another copy.
A week later, no questionnaire, I called again. I explained that I do have Medicare pt A, but I haven't signed up for the rest since I am employed full time and I have insurance through my employer. This second rep was polite and helpful. She took the time to call Medicare, got the proper information, and said she would submit it to Anthem. She assured me this would take care of things. A week later, no progress, the website said the claim was still denied, and now there was a second denied claim for the doctor's appointment that followed the lab work. Same explanation, they were awaiting the answers to the questionnaire. The one I still have never received.
The rep I spoke to on the third call somewhat rudely advised me that I needed to be patient because it would take 30 days to make the change (30 days to make a simple change as to whether I was covered under Medicare? What the heck?) Since then, I have been monitoring the EOB online. Until this past weekend, there was no change. Then, suddenly, the lab EOB disappeared and only the doctor visit EOB was visible.
A few minutes ago, I checked again, and I found an "adjusted EOB" which now states that they have denied the entire $1400 charge and that I am responsible for that charge. There is no reason given for the denial. I am flabbergasted. I have no other insurance that will cover this claim. I have paid my Anthem insurance premiums through my employer on each paycheck. I went to an in network provider. What is their problem? Can't wait for them to deny the doctor visit as well. I used to have good credit scores. Wonder what they'll be when Anthem is through with me. And my employer made this change because the Anthem premiums were a better deal for the employees. I was never thrilled with AETNA, but I never had problems like this with them. No wonder Anthem is cheaper. They keep premiums low by denying legitimate claims. I've emailed them this evening. I'm lodging a complaint with my HR department tomorrow.
Blue Shield of California increased my monthly from $815 to $1200 as of 2017. I called them and increased my yearly deductible from 6000 to 10,000. My monthly went up to $950 per month, an increase of $135 per month and worse coverage. I called to complain and got nowhere. They called me today on a robo call to tell me how good they are. That's it!!! All I can stand. I called them and told them that they are as bad as the government. They lie!!! They are complicit. Why did other company's opt out. I'll tell you why --- because they are honest. This company prefers to deceive their customers instead of standing up and telling the truth. NEVER BUY FROM THEM!!!
We lost our insurance last year and it was 2 months before I figured out what happened. I think it is deceptive practices how many notices Anthem sends out. After a while it's like the boy calling wolf. We always paid our premium on the 5th or 6th of the month. If you didn't pay by the 1st, notices about losing your plan start going out... and they keep going out. After a while we were kind of numb to them. We always paid... until something happened with our card and we didn't... problem is we didn't know it.
We eventually got other coverage (I was 9 months pregnant), but we just had to pay the penalty for not having insurance for 2 months. $1,100 people... If it was my fault then I would have no problem paying the penalty. But the fact that we had no idea we had even lost our insurance should be an exemption. Also I think Anthem needs to revisit how the issue notices and let you know about the status of your account. I think their current practices are intentionally confusing and it is wrong.
My husband carries me and our children on his Blue Cross/Blue Shield Federal Employee insurance through his job. On September 20, 2016, my husband, whom I am legally married to and have been for 17 years, called and told the representative that we were divorced and I was then terminated from the insurance plan as of September 30, 2016. We are not divorced. I was not notified and found out about the cancellation by accident. I am scheduled to have major surgery on October 31, 2016. On October 7, 2016, I called the hospital to verify my co-pay and register for surgery. At that time the assistant attempted to access my insurance information and it said I was inactive. I was informed to call BCBS to inquire about the issue. When I called BCBS, I was told that I had been removed from the policy because my husband called and said we were divorced. Again, we are NOT divorced.
I asked if he needed to show some type of legal documentation like a divorce decree and was told that "Your policy does not require that and that no notification goes out to the cancelled party." However, I was told that I had a 30 grace period. Today, I called BCBS back because the pharmacy said I have no insurance. BCBS now says that there is no 30 day grace period because the cancellation is due to a divorce that never happened. The representative told me that if I can prove that I'm still married then maybe you can fix this. So now I have to prove that I'm married, but he does not have to prove that we are divorced. This is just wrong!
So here I sit with no insurance, no asthma medication, no blood pressure medication and no very necessary major surgery that has been planned for 6 weeks. All of this because my husband is angry that his child support increased and BCBS does not care enough about its clients to at the very least verify the information that is being told to them, especially when benefits are being terminated. That's not just a minor thing. And why isn't the terminated party notified? If I had gone to my pre-op appointment tomorrow I would have unnecessarily been billed hundreds of dollars because I wasn't informed. I'm fortunate that I have a job that offers medical insurance. However, it won't be effective until November 1, 2016 because I was originally told that I had a 30 day grace period. Thanks for treating me like the number and cash cow that I and all of your subscribers obviously are to you. Shame on you Blue Cross Blue Shield!
I transferred my medicare plan over to Blue Shield 65 plus HMO plan several years ago. I just received a letter from them on September 29, 2016 in the mail but the letter was dated October 2, 2016. It stated that Blue Shield 65 Plus HMO won't offer our Medicare plan in 2017. It also stated that this means our coverage through Blue Shield 65 plus will end December 31, 2016 and that we should make a decision to take action about Medicare coverage by before December 31, 2016 or prescription drug plans will not be covered. In addition we should look into choosing a plan before February 28th 2017. There was no other explanation for why this was happening. I called the customer service line and they told me I should be receiving another letter stated that if I want to continue Blue Shield 65 plus I must fill out another application and pay a $29 premium monthly.
So I asked the customer service rep "I thought they were no longer handling medicare or taking over medicare". The representative told me they would still be an HMO with medicare but I have to pay a $29 a month premium in addition to what I pay each month for Part B Medicare out of my social security check. I said this is extortion of senior citizens who are on HMO because they can't afford supplemental medical insurance on fixed or low incomes. There was no explanation for the increase or what it would improve.
Blue Cross 65 plus has hoodwinked seniors into this plan knowing that they would be increasing. Also I am under Hills medical group which takes Blue Shield 65 plus but does not take straight medicare. I may have to find a new doctor which I am very upset about. Something needs to be done about Medicare, and these HMO plans that they sell out to. The newly elected Vice President Margaret Anderson of Senior Marketing is obviously stupid and not very good at her job, otherwise she would not have to send out two letters confusing people.
My husband and I have been paying for our Blue Cross policy for over four years now and the first time we are in dire need of it, we are denied. My husband is a severe alcoholic. We checked him into a rehabilitation facility after he ended up in the hospital on a breathing machine unable to breathe on his own. My husband is near close to death and this insurance company is only willing to pay for 5 days of treatment with complete disregard for all recommendations that he needs to be in house rehab for at least a month and then on to a sober living house.
Through group therapy I have learned he is not the only one with this problem and in fact it is common for Blue Cross to do this. They know his drinking has landed him on life support, many other hospital stays and that his addiction has been with him for the past 10 years. Going into the facility they ask many questions to submit to the insurance company to determine how dire a need the treatment is. It is clear to all doctors, myself, counselors and my husband himself that if he does not get help he will most certainly die. We have submitted all documentation that is required.
By law all insurance companies are now required to treat chemical dependency as they would any other disease. Blue Cross is blatantly ignoring the dire life-threatening situation and has made it clear they will only consider this medically necessary once he is no longer around to need it. Like I said, they're required by law to treat him as any other life threatening patient. They are ignoring that law and my husband may pay the price with his life. Another couple went through this with them and they lost their son to a drug overdose. It's up to my husband to do the work but it is up to Blue Cross to provide the service we pay for.
Blue Cross of California Company Information
- Company Name:
- Blue Cross of California