About Blue Cross of California
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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!
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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.
I changed policy type for myself and 2 daughters in January to save money. They told my broker to start new applications for each of my daughters and they would keep me on the same policy number. That was the start of my problem. I paid my premiums on time for each policy separately. Come January I log on to my account and it says I owe over $1900! Their system has all 3 of us on the policy still and for the old higher premium from 2019. I call to get it fixed. I was patient and was told it was fixed.
5 days later I log on and the high balance is still there. I call again and was told it was fixed and then the same thing happened again. Third time I sit on the phone for over an hour and it’s finally fixed. I decide to put all 3 policies on Auto pay starting for March 1st because it’s hard to remember to pay when you have 2 small kids. It takes 1-2 billing cycles to take effect. With February having an odd number of days for leap year I call to confirm there is no issue with payment for March. The associate says it’s a good idea to pay March manually and he will change his system to reflect auto pay to start in April.
I check my credit card statement today and I have been charged twice for both daughters policy premiums. Over $1k! I call to get it credited back and they tell me they will have to cut a check for both overpayments. I ask why they can’t credit back the credit card. I am told that this is the way it’s done. So a screw up on their end will cost me interest on my credit card as it takes 7-10 business days to receive the checks! Bullshit! I wouldn’t stay with Blue Shield but given you can’t change health insurance midterm I am held captive.
I work in the UR department for Mental Health for adolescents. This company puts children's lives at risk by providing them with the less than minimal service. I have watched them for years get away with denying VERY sick children the mental health services they need. For perspective, other mainstream insurance companies provide up to 20 days of service for the children to get treatment. They give 6-8 days. If you have children, STAY AWAY FROM THIS INSURANCE COMPANY!
My husband and I are going through infertility treatments. We have Blue Cross Blue Shield of CA. First they told the fertility clinic that my procedure was covered. Now all of a sudden they are saying it isn't covered. My explanation of benefits show it is covered. The clinic has been fighting with them to cover it. While going through fertility treatment, it's best to minimize stress. This whole situation has been nothing but stressful. They are awful. I filed an appeal and the lady at my husband's district office is going to try to get it sorted out. If they stick with the denial, we are switching ASAP. Shame on them.
This is a widely accepted supplement in the area I live. I can use the best hospital for surgery and cancer radiation treatment. I can also use their local clinic that accepts very few supplemental insurances. The customer service has helped me with out-of-town providers having problems getting paid.
It got too expensive, so I switched plans to United Healthcare. Blue Shield did pay the bills in a timely manner. None of the supplemental policies are inexpensive, though. I have only had the new policy for less than a month.
I am 69 years old and have had insurance my entire life. When I became eligible for Medicare having a supplemental policy was a given. In the last four years of coverage, my out of pocket expenses for medical care have been zero. My single largest expense is the gap in medication purchases, which is covered somewhat by SilverScript. Most people don't realize that Medicare monthly payments from my SS is expensive, this added to my supplemental policy and RX policy is a burden.
Blue Cross of California Company Information
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- Blue Cross of California
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