About Blue Cross Blue Shield of Florida
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Most of our claims are submitted by a provider and those claims seems to be handled smoothly. We have had 3 services done by providers who will not submit claims. Those self filed claims have been frustrating to say the least. I have attempted most of my contact through the secure message center as I don't have time to sit on hold for long periods of time. It took 3 different contact occurrences (including a phone call where the first customer service person sent me to a department that had nothing to do with my coverage) before I found out I had used the wrong claim form.
I resubmitted all 3 claims using the correct form and sent in the same envelope. One claim was processed 2 weeks ago. The other 2 have not yet been processed. When I asked for info on the 2 other claims I was told it can take up to 35 days to process claims. When I responded to that message asking if it was 35 business days or calendar days, the next customer service person told me it could take 30 to 60 days. THAT WASN'T WHAT I ASKED. Guess I'll just wait a while longer then plan to spend some time sitting on hold so I can hopefully talk to a person that really cares about customer service.
Blue Cross Blue Shield fraudulently took premium tax credits on my behalf for over a year. Never provided insurance coverage. Never received one document from them. I being audited for over $8,000.00 for premium tax credits provided to them on my behalf for insurance I never had.
Started calling 9am 12/2/19. Msg said wait time 5-8 minutes. I held 25 min then had to leave. Called multiple times during the day and message said wait time 6 to 9, 5 to 8 etc. The system said we will call you back within the allowed time. Never happened! Now at 5:15pm the message said wait time 1 minute. Now on hold 25 minutes and still no answer. Apparently they don't want my payment or the entire staff is using the computers for their Cyber Monday orders.
My employer chose this company for its employees' health insurance last year. For the most part, there weren't problems until this year, when Florida Blue started underpaying all in-network providers with whom I'd had appointments. Though I verified with the providers in advance that they accepted Florida Blue PPO insurance, and no referrals were needed, Florida Blue has been routinely paying 10% or less of the billed amounts. This is forcing me to routinely file appeals for every provider visit/service provided. If you have a choice on which insurance provider to choose, do NOT choose Florida Blue.
I have been taking a medication for years and all of a sudden BCBS declined the medication. After contacting them multiple times, being on hold for hours a day, being dropped or transferred to other departments that had no reason to be involved. I finally called Florida Blue where you can walk in or call, NOT IF YOU ARE ON A GROUP PLAN! Because of Obama Crap I pay almost $1100 a month for a single person policy which only tries to deny everything a Dr. says you need. After finally getting someone on the phone I called the Mayo Clinic and had them on the phone with an employee of BCBS and Mayo Clinic. Of course they couldn't take it over the phone!!!!
Dealing with BCBS is an absolute nightmare and a joke. Why are they in a business to make people suffer? I and other patients are the ones who suffer and they don't care. A technician is the one who denied my care that Mayo Clinic. Are you kidding me. An hourly paid computer call center is in charge of our health? ARE YOU KIDDING ME???? They are questioning the Mayo Clinic on the validity of a drug. Good Lord we are in trouble.
I signed up for Florida Blue through the open enrollment portal. I enrolled in auto pay -- they are supposed to automatically draft the premium payment from my bank account every month. It worked for a month or two, then stopped. They never called to let me know the payments stopped working, they never emailed me. They sent a letter to an old address. So I paid the past due month, re-enrolled in auto pay, and gave them my updated address. According to the reps on the phone, they can't change my address in their system; I have to do it through the Healthcare.gov website. Which, of course, I had already done.
So a few months go by, and again the auto-payment just stops working through some failure on Blue Cross's end. No calls, no emails, just letters to the wrong address. They still had not updated my address. I AGAIN went in and re-added the automatic payments. I received an email stating that the automatic payment (including pay for the months it had missed) was being processed. One month later, I receive a letter TO THE SAME WRONG PHYSICAL ADDRESS letting me know that my plan was being terminated for lack of payment. No calls. And the emails I received CONFIRMED THE PAYMENT WAS GOING THROUGH.
I am flabbergasted by this. Honestly how do you screw this up? It's autopay. You have my bank account information. You told me the payment was going to be processed. Then you didn't process it. And you didn't call me. You didn't email me. You sent a termination letter to the same old physical address that you PURPORTEDLY CANNOT CHANGE IN YOUR OWN SYSTEM. This level of incompetence is maddening. I would rather be insured by a mountain goat than Florida Blue ever again.
I have an individual policy with FL Blue. The vision misleads you into believing you have the benefits, even gives you doctors in the plan. The benefit is for individuals under the age of 19. The summary head lines "For individuals under 65, Benefit Summary for Pediatric Vision Care". This benefit has nothing to do with me yet it shows up on my account. It should not be on there when I look up my benefits and the exclusions are put on the last page. The doctor takes me in and now I am stuck with the whole bill.
Its coverage is great. We usually don’t have to pay any copays for doctors or hospitals. The customer service personnel are easy to work with try to help us. I can’t think of anything else to say except we are very happy with Blue Cross, Blue Shield supplementary insurance.
This evil health insurance company dropped my poor elderly mother which she obtained though the (scam) Obama Care. They canceled her policy, didn't tell her, made it retroactive for 2 months after she had 2 tests run. They sent her a payment back just to make it another month retroactive. This is fraud. I just found out about this and I'm helping my mother take legal action. Don't do business with these con artists. Just Google all the complaints filed against them! There's news articles about them all over.
Limited to local area, would prefer statewide coverage. Traveling could be a problem, wish it covered every Medicare covered incident. Other than that limitation we have no complaints. Have not ever had them decline payment. Have had them 15 years.
I had another insurance company with $0 monthly premium! And $15.00 copay. Now I have a $10.00 copay and a 42.00 monthly premium. The old saying is you get what you pay for! I am 100% happy with Florida Blue. I will never go with another insurance company.
Bought a dental plan direct from BCBS Florida by a pushy sales rep. Never told there was a 6 month waiting period before I would be able to receive any sort of treatment as I was out of the time limit from previous plan, infact I was inside the time frame by a day. Found out I was not covered on my first visit to dentist! Called BCBS and spoke to 6 different people in 6 different departments with no success, one manager just put the phone down on me!! Disgraceful behavior from a so called blue chip company! I complained in writing to the BCBS complaints department and never heard back!!! Just had a letter one month away from cover to tell me they had not collected my premium from the bank as they should have so have dropped me!!!!
Not worth calling because their customer care is horrible!! I implore you not to use this shady company!! I’m absolutely disgusted with the whole set up from sales, customer care and complaint department!! Someone needs to be looking for a new job as this comes from the top! It’s obvious that the leaders of this organization do not know what’s happening at lower levels!
100 dollars for copay for urgent care service is too much for a copay. This insurance is too expensive as it is and then charging 100 for a copay. Don’t want this insurance, how are people supposed to afford crap like this. I would give it 0 stars if I could.
Just tried to use my Florida Blue Insurance for the first time. Sent to one of their urgent care clinics and then was told all costs would be out of pocket until my $9,000.00 deductible was met. When I asked their price and then called around, I found that they were the highest priced urgent care clinic in the area. Why would Florida Blue send anyone to the highest-priced Urgent care in the area?
A PPO plan typically means that although the policyholder will save money by seeing a doctor in-network, they can still choose to pay more and see an out-of network doctor if they choose to. As a doctor who is not in-network (meaning I have no contract with Florida Blue), A patient could not see me under this plan even when they chose to go out-of network. When I called the plan to ask why I could not see this patient even when the patient was aware that they were going out of network, their response was the following: “We have a list of ‘in-network’ and ‘out-of-network’ doctors. Even our ‘out-of-network’ doctors have to be accepted and registered with Florida Blue PPO.” So I then asked how do I register as an "out-of-network" provider (something that doesn't make sense because you are out of network by default for the simple reason that you are not registered with them).
I applied-- and was denied. So you see what they are doing? They tell you that you can see out-of network providers but the PPO plan chooses even which "out-of-network" doctors you are allowed to see! Is this de facto in-network? So I make the case out of personal experience that those people searching for a plan who want the flexibility of going out-of network, should read the fine print. Do your research!!
I really thought that subscribing to a well-established insurance carrier like Florida Blue would be best for my family. After 6 months of paying my premium with no real medical visits, I decided to schedule an overall checkup for myself. I went to the Florida Blue website and after calling several offices that said they no longer accepted Florida Blue. I found a couple of options and one said he was no longer accepting Florida Blue and the other said they could schedule an appointment for me three months out. That was ridiculous so I waited another month or so and went back to the Florida Blue website and found Sanitas Medical Center Dr. **. I scheduled an appointment with him and the day before my appointment they called me to cancel the appointment. I am fed up with this sub par medical plan. I pay nearly $600 p/ month to be treated this way! DO NOT GO WITH FLORIDA BLUE for good healthcare!
I have been dealing with Florida Blue for 2 months now, trying to get them to pay out claims they have retroactively denied because they've suddenly decided that I'm covered by my old insurance, despite me switching to Florida Blue a year ago and not having any problems with them before 2 months ago. I've been checking in and asking if I need to do anything frequently and keep getting told no. Now I've received a letter from them asking me to ask my old insurance to send them proof that my old coverage is over. This is absurd and a waste of time, and I'm getting the impression that they're just hoping I'll give up so they won't have to pay out the claims.
When I search for insurance each year, my number one thing I look for is to ensure my one medication is covered. I did this with Florida Blue prior to registering for their insurance. Upon having to refill my medication I was informed that it was not approved. I went through a 7 month back and forth with several representatives within several departments, appeal forms from myself and my actual doctor. Calls and emails from my doctor and myself to have them deny the medication stating it wasn't "medically necessary". A medication that I had been on for 7 years.
I gave up after 7 months of fighting and am not allowed to register for another insurance company because I don't have a life change (like having a child). I tried contacting the State Insurance to fight this, but they indicated that they could "advocate" for me, but it doesn't mean that the insurance company would give in and cover the medication. I decided to not go through all of the hoops with them because a fight of 7 months was enough.
This is the biggest piece of crap insurance company I have ever worked with and they play you against other departments stating this isn't our approval process, it's so and so's. I will NEVER go with this insurance again, and will continue to speak poorly to all of my family and friends about my horrible experience. If there is a medication listed on your site that needs approval prior to being approved for a patient, then the site should depict that so this could be a red flag for a person applying for the insurance to not go that insurance company.
I'd give a Zero stars if it was possible. We recently moved to FL from SC and the Humana plan we had was not available here. Because we travel a lot, we wanted a plan that would be easily used in other parts of the country and the agent said Florida Blue would be a good choice. EVERY SINGLE THING HAS BEEN WRONG!!! They said that they were told I was getting premium reduction help - that's wrong, they gave the pharmacy the wrong co-pays and then sent me a letter that I owed them money for the mistake ($158) and if I didn't pay they would increase my premium. Finally got that corrected, then got a letter that my premiums hadn't been paid correctly - and I owed them money...or they would just take it.
These are pretty significant problems and ones that COULD have been easily fixed - but NO, they have made every step as painful as possible.. I absolutely hate them! I will NEVER NEVER NEVER renew and hope this warning helps someone else NOT get into their plan. They even lied about a letter they sent to my physician about getting a "tier" exception for a drug I use - they said the doctor never responded - a HUGE LIE! They, it seems, can't even keep track of their own processes. Humana was as big as Florida Blue - and they were not perfect, but I could at least get anything wrong corrected with just one phone call.
While traveling abroad I had disabling back pain. I could not sit or walk for more than 30 seconds without level 10 pain. I had myself driven to the best doctor that was recommended. He evaluated me, had determined I needed an MRI. Upon reviewing the MRI he determined I needed immediate surgery. I contacted my insurance company and they they could not approve anything immediately. They demanded two days for approval. Despite the fact that I told them I had major loss of function in my left leg due to the herniated disc, and broken bone in my spine. I waited two day, and my condition worsened. I was losing feeling in my left leg now.
I returned to the doctor and he immediately admitted me to the emergency room. I had emergency surgery that day. When I was coherent two days later, I called the insurance. Yay- they had approved my surgery. Now a month later they are refusing to pay because I had the surgery two days before they had approved. I still suffer from the loss of feeling in my leg that occurred while I waited the two days for approval that did not come till much later. Medicare for ALL!! These insurance companies are ripping off the USA.
Florida Blue has a LOUSY customer service team, useless customer service attitude, starting with Victor, Natalie and Olga, Olga's Extension is **. What a waste of space she is taking up at Florida Blue, Liar, incompetent and useless. What a shame these 3 are to the word customer service. Let's not leave behind Emily, she has no clue of what her job is, even though the notes are in the system. Hire better people. Robert **.
Working for a provider, it is exhausting to call BCBs and spent 1-2+ hours on the phone to get BCBS to pay for services provided. Their newest tactic is to deny claims and say there is other insurance as primary, despite the fact that a patients auto claim or work comp claim had settled 4-5 years prior. I have witnessed this numerous times with numerous patients over the past 3 months. It is very difficult for the patient to get this updated short of having a old work comp carrier or auto carrier call BCBS to update. The hoops that BCBS makes patients and providers jump through is ridiculous. In addition their call center in India has POORLY trained personnel, they barely speak english and have no medical experience or knowledge.
What is going on with Florida Blue, Blue Select? We upgraded to this plan after having Florida Blue HMO last year. Mistake! We now have even fewer providers, especially in our area. Half of the doctors our family used last year quit the plan, some in the mid-year, yet we cannot do the same. I contacted Florida Blue customer service for help finding a doctor and was given names one hour north and one hour south of me. That's ridiculous. There are numerous doctors right here in town and in the surrounding cities. Why do none of them take this plan (anymore)?
I called Florida Blue several times, regarding issues logging into the web site. The automated system sent me to the wrong Dept several times. Each time I was transferred I was put on hold. This is not the first time I have had log in issues. I have changed my password and all that entails several times. One password worked for a period of time. Than I got an error code it could not find my information. This has happened after several calls in the past regarding this issues. One on seems to be able to figure out the issue, for 5 months. I am sick of paying for lousy service. I have talked to multiple people re set password multiple times, did many tech maneuvers on my computer, still can't sign into the web site. If you can get through the automated phone, maze customer service is incompetent.
Insurance is not like it was in the old days (80's and 90's). I guess doctors back then weren't getting sued enough. Premiums are ridiculous and so is the deductible. I am not impressed with the prescription options. I can get some of my prescriptions cheaper without using the insurance and with FAR less hassle. I do like the online web interface though. It is easy to use and somewhat helpful.
I recently had a colonoscopy. After the procedure I was in a great deal of pain, I was bleeding and I could not pass the gas use during the colonoscopy. Borland Groover Clinic where the procedure was performed sent me home claim I would be fine. Twelve hours later I was close to death. My wife rushed me to the emergency room at Mayo Hospital in Jacksonville Fl. and they performed emergency surgery that saved my life. I spent 8 days in the hospital where there were times I didn't think I was going to make it. I now have a colostomy bag, a huge foot long scar wound from my groin to the bottom of my chest and hospital bills approaching $100,000. I will need further surgery and that means more bills.
Florida Blue has agreed to pay $10,000 and says I am responsible for the rest. They are claiming that since Mayo is not in their network they will not pay. Florida Blue representatives are telling me that I should have gone to an in network hospital. I was in no position to shop around for hospitals, I was dying. Regardless my policy claims in writing that if I go to an in network hospital my maxim out of pocket is my deductible $7900. If I go to an out of network hospital my maxim out of pocket is $15800.
Florida Blue is not honoring that clearly written claim and standing by their $10,000 payment. I am trying to recover from this life changing medical event and now shouldering what will be a long tiresome battle to make Florida Blue pay my hospital bills. I have always had health insurance Coverage to protect me in case something like this happens. I am 62 years old and have never had a claim. What an eye opener this has been. I never dreamed Blue Cross Blue Shield could be so unethical. I don't know how they live with themselves.
BC and BC PPO is accepted everywhere by all providers. There is never a question about coverage. Provider and insurance company resolve issues if any without input from the client. Hassle free and reliable.
Insurance and Gen needs to be revamped. I had a hospital stay for five days - the bill was $57,000. My insurance cover the majority of it. My portion of the bill was 2500 but honestly, if I didn’t have insurance I don’t know what I would’ve done.
The high deductible is just too much for someone to meet. I no longer go to the doctor unless I am really sick. It just way too high. You need to lower it. My deductible is $7500, that is totally outrageous.
Blue Cross Blue Shield of Florida Company Information
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