About Blue Cross of Illinois
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I trusted Blue Cross to review/vet the providers that they resell to their customers. I am a BLUE CROSS customer and I expect BLUE CROSS to be responsible for the quality of the providers/plans they sell. Their function in the marketplace is to use their expertise to ensure that I get my money's worth. I have a laundry list of legitimate complaints ranging from full mailboxes, long wait times for treatment approval, over-stretched staff that forgets to forward info to specialists, etc. and the contribution from Blue Cross is to transfer my call to an overseas "case manager" who is only authorized to apologize and cannot provide remedies.
I work in a Doctors office. The treatment for patients and the public in general is priority. We work hard to help everyone that walks thru the door or call the office. That's why it is sooo hard to come across with an organization that is "there to help" and get treated like this. I feel bad for the patients that has to deal with these people, I really do, I've been on the phone since 10am, my first call, is now 12:25PM. They hang up the phone, they put you on hold without notice, they ask for a call back number but never call you because they hang up, the worse customer service. I cannot believe the health and well being of the patients are in such hands.!!!
Company switched to BCBSIL to save a few bucks. This next year is going to be a nightmare as every claim submitted is denied as "not medically necessary" or "the doctor's office submitted it wrong" or some other lame excuse that denies payment without hours and hours of phone calls/writing letters. Plan documents show one thing and their EOB benefit determination show something else. If you call to try to straighten it out, be prepared for an ENTIRE day on the phone, speaking to different people who do NOT have a clue about what they are doing.
This process has made it very difficult to get any screening services done. PPO is no better than an HMO, and prior auth is required on ANY and ALL services you do, or expect to pay out-of-pocket. If I had a choice to use a different insurance, I would in an instant. I have 4 dispute letters to write and we have had this plan for 20 days! I have lost 7 hours of my day today on the phone with this company. RUN from BCBSIL!!!
Apparently a change was made on 1/1/20 that the insurance company did not notify me about that has left me without my blood pressure and Cholesterol meds in the middle of this Coronavirus outbreak. I pay 15k per year for my plan and here I stand at the pharmacy having my covered prescription denied because of an unannounced plan change that required me to have a 90 day subscription. REALLY!! This government constantly talks about how they can do better than Obama did. I can say this I NEVER had this happen to me before. Good riddance to private insurance. It is too expensive and inadequate.
My husband was to have surgery and called to ask how much of his deductible in network and out of network had been used. It has been going on a couple of weeks and they still are unable to give us that info...so we would know how much we will have to pay out of pocket. They have lied and given us the runaround. They say they will call back and do not. I have never ever had such a bad experience with a health insurance company. And they charge a lot for their coverage but their back office is completely a mess.
I have never been so frustrated trying to reset a password. It took an absurd amount of time to reset because it kept denying all my new password attempts saying when I was CLEARLY following the security guidelines. It kept saying foolish things like "you can't use this special character" or "you can't use the first three letters of days of the week" and I WASN'T EVEN DOING THAT!! So frustrating almost to the point of tears.
I started with my new company year end of 2018, and was eligible for Blue Cross Blue Shield PPO mid January 2019. Had a plan with $1000 Deductible and $1000 out of pocket. By October 2019, I had met the $1000 Deductible and was $455 from meeting the $1000 OOP. November starts and I receive a new Insurance card with the same I.D. Number but a new group number. It turned out the Company's Blue Cross Broker made a mistake and put me on the wrong plan, when I should have had a $500 Deductible / $1000 OOP for the year.
My Blue Cross portal was reset to $0 for both items. After numerous phone calls to Customer Service, I had to have the claims migrated over to the new group number, but I should be owed $500 as the plan I was put on in error by the broker had a higher deductible, which I met for 2019. After speaking with Blue Cross Customer Service multiple calls, they stated they would not re-reimburse me the difference for the error made by their broker. Horrible company to deal with.
I have been very satisfied with the Blue Cross FOR years until 2019 when I started to get premium bill showing nonpayments and threatening me with cancellation of my health insurance. After calling and writing to Blue Cross showing them that my payments were made on time and sending proof that I have been paying on time, this month, October 2019, the same threats continues. Not only is the bill wrong (with threats !), it was received by me on 10/26/19! My payment is due by 11/05/19.
I am a very healthy 87 year woman, seeing my doc only once a year for annual checkups. I am not complaining about the very high monthly bill, although it should be lower based on my health record. I know that, we old but healthy are not afforded Blue Cross's "health records review" to determine premium amount. Yes, I am old so anything can happen even if I am very well today. Sabina **
My Doctor ordered an MRI for a painful back condition. The test was denied. Last year I switched from United Healthcare to Blue Cross Blue Shield because it was a little cheaper. In retrospect that was a BIG mistake. It is benefits election time at AT&T and I will be sure to tell as many of my 300,000 coworkers to avoid BCBS and stay with ANY other medical insurance provider.
In 2019, dental claims processing can and often has taken months. The claims handling people don't seem to pay attention to anything your provider sends and things that used to be handled and paid easily are now routinely denied or multiple requests for more information are sent to your provider and then seem to not be looked at or considered at all. In fact, we even had a denial on a procedure for a tooth that BCBS claimed was missing (it is absolutely still in my mouth lol). We're waiting to see if calls to correct the mistake result in a correctly processed claim or another denial in the near future... So underwhelming experience to say the least. I wish we could switch to a different company because BCBS dental claims handling is so incredibly frustrating and poorly run.
A bit pricey, but top notch service and coverage. Am looking into mutual of omaha as their rates are significantly lower. Service and coverage are purported to be the same, so why pay more if you don’t have to?
I had Blue Cross Blue Shield for well over the past thirty plus years. The coverage is really the best. Especially, for a skin cancer removal for coverage with a specialist Dr. ** and staff at park ridge illinois, and Presence team for the day too, the care, the overall cost was 13,000 i was responsible for 1800. A Blue Cross Blue Shield Medicare Advantage representative contacted myself and my sister Lena, for a preview of the plans and questions of our senior living. That really was heart-warming.... Thanks.
Waste hours on the phone. Unable to accurately tell me if I am covered. Quick to pass the buck. ** and in the end run me around without any help. Bleeding out the bowels but I know you do not give a rat's **. Say 'go to the ER', but the ER has also been very indifferent, more concerned about their liberal social agenda than medicine. I am dying, but not at the hands of you scum.
Another insurance company driven by $$$ with no regard for its members health and well being. I recently started a new job, I had to switch from BCBS of Minnesota to BCBS of Illinois. Several important prescriptions that I need to take routinely were covered previously for a very low copay, mostly $60, $30 or $15.. These same medications with BCBS of Illinois are "covered medications" however the cost is 100% the responsibility of the member. Prescriptions that were very affordable with my previous insurance are now over $400 and $500 out of pocket.
This insurance company has NO regard for the health and well being of its members, it's all about how much money they can make. It's a joke.. our healthcare should not be loading the pockets of insurance companies with billions of dollars while we suffer with ridiculous amounts of money coming out of our paychecks just to be covered and then to find out the services and medications we need are priced so high we cannot afford them. This is the country we live in!!! When will someone stand up!!! They should be ashamed. But they're getting rich and that is their only concern.
All my previous Health care providers have helped cover the cover cost of ** nasal for migraines. This is a med is absolutely something that must be taken immediately when stricken with my type of migraine. It costs $512.00 for 6 vials at Walgreens. I tried a generic brand they covered and had awful side effects for several days. I called BCB Sheild today and since I read on this site earlier about a woman that wanted her recording of conversation and they told her she would have to get a lawyer, I announced to each rep I spoke to that I'm too am recording the conversation because "My husband isn't home and he needs to hear it."
Could tell they weren't happy to hear it. But what's good for the goose is good for the gander! They asked me what the Procedural Code is for a shot I now need. I'm like slightly stunned because they are the ones that set and have those billing codes are they not? Anyway I feel screwed over and have been quite ill without my med. So let them know YOU are recording them. Makes it a bit harder for them, and YOU have proof.
My daughter had dental implants done in May and our dentist office mailed in the claim shortly afterward (there were Xrays included). I called to check on it and was told they never received it. I found this odd because that happened to me twice earlier this year when I submitted large claims through the mail (I don't have a fax machine) and they "never received them".
I asked my dentist's office to resend the claim and they did. I called back weeks later and was told they didn't have anything for that claim. I made a 3 way call with my dentist's office manager and BCBS claims department and BCBS said the best way to submit a claim is electronically. The dentist office got the information, which they already had, and filed it electronically. Again, I called two weeks later to see if it was received and I was told it had not been. Of course, BCBS asked if my dentist office had the correct information on where to send it. Yes, they got it from BCBS and sent it while the woman was on the phone! I got the dentist office on the line with them again, and the BCBS rep said it's really best to FAX the claim. So the office faxed it right away and it is now a week later and they still don't have it. At this point, I don't know what I can do to file this claim. It's extremely frustrating!
My experience with Blue Cross was never good, it was terrible. Endless calls, customer service disconnects you all the time, you need to call numerous times and maybe, just maybe you will be in luck to find somebody who will actually pay any attention. So frustrating that you can have a nervous break down just to deal with BCBS of Illinois, at least. I was denied more than twenty claims for a treatment because they stated that I did one which required preauthorization which I actually did not, I did the standard one.
Their mistake... but my time, endless hours on the phone lines trying to talk to customer service of BCBS. Hundred times explaining, faxing materials, proving my point, no help. Got the call from debt collector. They just do not care to actually hear what you have to say. Until unfathomable miracle happened... When I started the appeal there is. In a matter of a week everything was straighten up and paid. Now I am at the square one, with one claim omitted in the appeal. Today I did call three times.
First call I got disconnected and nobody called back (even if they beautifully take your phone number, so you, silly, are hoping that they will call back), than called second time, was transferred to somebody else, supposedly higher with rank but ended up at the starting point, automatic voice command , just at the beginning of your call to regular customer service. Third one I spoke with after long holds, finally, told me to do another, external appeal. Lost another couple of hours today but it is nothing comparing to the previous Gehenna. Worst of all is that there is no hope that this will improve. There is not enough competition.
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!!!
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.
Making several attempts, On January 14, 2019, Blue Cross Blue Shield stole $738.03 from my checking account without my consent or authorization. Blue Cross Blue Shield was my health plan for one year, plan coverage was $29.27, THEY WERE NEVER AUTHORIZED TO STEAL $738.03 from my account, the last payment of $29.27 was 11/30/2018, I cancelled the coverage because I now receive Medicare. There was not a payment to them December/2018. The plan was cancelled November 13, 2018. Blue Cross Blue Shield has given several scenarios regarding this theft.
On March 19, 2019 I spoke to "Bonnie" who informed me that the plan was cancelled and that a refund was sent to my Bank on February 6, 2019; she put me on hold and came back saying that "we sent you a letter". The money was not put back in my account. She put me on hold, returned and claimed "you used the insurance in January/2019". I informed her that I did not use the insurance because it was cancelled in November/2018, I asked for information regarding any claims made in January/2019, Bonnie refused to mail or give information and refused to allow me to speak to a supervisor. I called back and spoke to another person who could not speak English well, I did not understand his name.
I asked him for a supervisor, he also refused and would not send information on any claims that were made, he accused Marketplace, for taking the money. I called MarketPlace, spoke to Greg, he transferred me to his supervisor 'Damarius **'. Mr. ** said that the account was terminated via my email at on January 14, 2019, this is the same day that $738.03 was stolen from my account. He then said that the insurance was "automatically renewed" for $738.03 without my authorization or consent. Not one person I spoke to would give information or documentation authorizing them to steal monies from my account or to 'renew' a health plan that was cancelled. I am currently waiting for the Attorney General and Better Business Bureau to settle this.
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.
We have this coverage because it is the only company offered through my husband's employer. They are a terrible company which pays as little as possible. We are currently in month 6 of a claims appeal for a test ordered which did not require preauthorization but was denied anyway because they deemed it not medically necessary. How would we know that if they don't require pre-approval? The doctor's office thought it was necessary. Now we know to NEVER have a test done without preapproval no matter what they say. I would leave in a heartbeat if given a choice. Don't buy their product if you have any other choice.
I wish I could give this company 0 stars. Please, do not even think about switching over to BCBSIL. I did routine bloodwork when I first got pregnant, and I received a bill from the lab for almost $4,000. Turns out, BCBS did not want to pay without having proof that I was pregnant. For months, they claimed they had been requesting my records from my doctor's office all while the doc's office was claiming they never received any requests. Months later (third trimester) I find out they had been requesting my records from the lab, which obviously does not have my records.
Only my doctor would have them. My doctor finally got the records to BCBS, and they had to go through a "committee" for review which was supposed to take 30 days. At this point, I am now being harassed on a daily basis by a collections agency hired by the lab. Approximately 60 days later, I find out the committee denied the request because they did not deem my STANDARD prenatal bloodwork medically necessary.
Not only have I spent my entire pregnancy dealing with this (I am about to give birth), but I am now left with a massive bill for something that should absolutely be covered by my health insurance. If this company is failing to provide what is necessary for pregnant women, there is absolutely no hope. I switched insurance companies months ago, but not everyone has that option. Shame on you, Blue Cross.
Blue Cross of Illinois Company Information
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- Blue Cross of Illinois
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