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As a person who has take ** in order to stay healthy, BCBSIL Blue Advantage with Advocate has routinely and thoroughly rejected my referrals, my prior authorizations, and "lost" records of their documentations so as to prevent necessary medical care. This is the third year of experiencing this in their customer services and medical services. This year alone, they have lost 4 prior authorizations since the beginning of January. The ineptitude is frankly astonishing, and they should be ashamed that they charge people for this kind of non-service. Still not approved, still waiting.
I spent 2 hours on the phone and could tell the Indian man had been given a scripts of things to say. It was horrible service and not helpful at all. The same thing happened the day before but that woman gave me incorrect information. I finally called back and talked to an American woman who was helpful and compassionate. They need to move their customer service department back to the states.
I have used some out of network providers and BCBS IL has a terribly slow process for responding to claims - taking up to 7 weeks to reimburse what they owe you under the plan. Additionally when you inquire it is clear they lie about their processing times. They only log the claim as the date they enter it into their system - not the date it actually arrived. I have proof of every delivery of a claim's arrival at their office and yet their claimed arrival dates is always 4-6 weeks after USPS confirms delivery. They refuse to acknowledge this or provide any indication of their process, instead using customer service jargon and avoiding any actual response. If possible avoid them.
I have a PPO Blue Choice plan through the Marketplace. The problems began in the fall of 2017 when a scheduled outpatient in-network specialty visit and outpatient test showed up on E.O.B.'s Service Descriptions as "Emergency Med Visit" & "Emerg Med Test." I was not treated in an emergency setting, nor an emergency room. My medical condition was not treated by my provider as emergent. Since these first 2 incidents, I have had 5 more with "Emerg Med Test," "Med Emerg Visit," "Medical Emerg Labs," appear in the service descriptions on E.O.B.'S.
Working with my providers, we discovered together that my medical records DO NOT INDICATE EMERGENCY CARE. The medical coders with the providers looked at my chart, coded everything correctly (meaning no emergent care nor emergent testing) and still mysteriously once the UB04 form reaches the hands of BCBS-IL it all becomes emergent with me paying more than the calculated 40% per plan booklet for these scheduled outpatient visits, labs and testing. It all rest in the hand of the Illinois Attorney General's Health Care Bureau at this point. BCBSIL reasons have always been inconsistent. The worst experience was when a BCBSIL customer service rep on a conference call with me and the provider billing rep stated that I had a medical emergency, a severe medical emergency and that my doctor ordered speech therapy. Bit codes 205,206,228.
What? My response, "Do you have the right patient?" I am a retired emergency medical technician in the state of Illinois and someone not licensed to practice medicine is telling me that I had an emergency! Not only that, I asked the BCBSIL rep if I sounded like I needed speech therapy! The provider billing rep had never heard of BIT CODES. The now 7 incidents of this are still under state review. Upcoding medical care, testing and conditions to emergent is fraud. The outcome has yet to be determined. What a nightmare. Until I was on the ACA, I never encountered this.
Started having severe tingling, numbness and pain (sometimes debilitating) in my left arm, hand and 2 fingers. The orthopedic doctor I was referred to ordered a MRI to find out the cause. The MRI showed disc bulging at my C5 and C6. 2 steroid packs and daily pain medicine did nothing to help the worsening pain. He ordered a steroid injection. Blue Cross Blue Shield is DENYING the claim for the injection as MEDICALLY UNNECESSARY! I don't know who these asshats are that decide which claims to okay, but they are absolute idiots!!! The large company my husband works for unfortunately switched from United Healthcare to BCBS of Illinois this year. BUYER BEWARE!!!
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What a freaking ripoff. I'm paying almost $1000 a month, getting little for it. People are getting ** in this country, all so the fat cat insurance execs (parasites actually) can make mega bucks. It is a disgrace. It is immoral.
Finished my blood pressure medicine and insurance company is forcing me to mail order. Why do they have to control all the time? We keep on paying each year more and more and get less and less each year.
They continue to move retired people's medications (**, etc) off the covered portion to non-covered. It continues to raise out of pocket expenses for me, retired and disabled, and my wife who has been disabled since 1997.
My son was denied health insurance after birth because he was born around the holidays so his social came late. I was told by 5 representatives that this happens all the time and he would most likely be added. I must be pretty unlucky. I've paid and will continue to pay out of pocket for all his doctor's appointments and hospital bills, because they denied my poor infant son. Absolutely disgusting company. I called when I received it and I missed the deadline by a day! 1 day/8 hr period. I asked the lady how can we be punished for not having his social in time. She told me that we should have called to let them know he was born.
Are you kidding me? I assumed the $21,000 hospital bill FOR BIRTH was a heads up. Not to mention in Pennsylvania when a child is born the first month is covered by the mother's insurance regardless of enrollment. My wife is covered and so was my son's first month. Shouldn't be too hard to put two and two together. I was also told you have 31 days to enroll, but 45 for if they make an exception. I did it, I tried. Still denied. Awful, deplorable, scum company. How anyone in high command of this company can sleep at night is beyond me. My employer switched to this company last year to save a buck and it's been a nightmare ever since. Blue Cross Blue Shield of PA is what I had before and they were amazing. If you're thinking of giving this company your money save yourself the hassle of a 45-minute pointless phone call and flush your money down your own toilet.
So sad that we lost the insurance coverage we used to have as a repercussion from Obamacare. Our deductible tripled. We used to have only small copays. Our prescription copay has double and tripled.
Blue Cross of Illinois Company Information
- Company Name:
- Blue Cross of Illinois