Aimee Rkf
map-marker Eagan, Minnesota

Prior auth denied due to assumptions

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3 years ago I had frozen shoulder in my left arm non dominant. Painful beyond belief. Now I have it in my right shoulder and it’s double the pain because it’s my dominant side. Previously dicoflonex gel took the edge off so I asked for it again. I had HP last time and had no problems they didn’t require a prior auth. BCBS does apparently because it’s part of their step therapy program. My MD submitted the PA and BCBS denied it. When I asked why they said because I had not been trying oral nsaids. Seriously? Really? You know this how? Because nobody asked me. For the love of my sanity I wanted to go off the deep end but I said funny I have a bottle of ibuprofen and Aleve sitting right next to me. Had the crap worked I wouldn’t ask for the topical gel. It’s 70.00 a tube out of pocket this condition can last up to 2 years. MdD resubmitted with notes letting them know I have been taking orals. Still denied. Lord hold me back. They won’t pay for this gel but would rather have me go I and have a surgical procedure done? Really? BCBS is like Medicare too big for their britches and a bully corporation. I can’t stand having them as my insurance carrier nor can I stand having to deal with them at work.
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amanda p Amo

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BCBS wasted my time & money, they lied and screwed me though I did my due diligence to get straight answers on covered benefits ahead of time

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I called my insurance customer service line today ahead of getting a couple of travel vaccines. I was told the Walgreens near my home was in my network and I could go there to get a Hepatitis a vaccine and it would be completely covered 100%, I wouldn't have to pay a copay. I was on the phone with my insurance company for a full half hour to get this info, they had to research it. I went to the Walgreens after work, waited in line for an entire hour, only to find out when the vaccine was ready that it was not in fact covered and I was going to be charged $101.02. I called my insurance again from the office where i was about to get the shot, asking why I had been assured earlier this was 100% covered. They told me this shot would be covered at a Walgreens minute clinic but not a pharmacy. The pharmacist told me there actually are no Walgreens minute clinics in the state of Minnesota. All the customer service agent could tell me was that they could see I had called earlier but the person I spoke to "didn't take very good notes" so their record didn't say what I had called about, but suggested I go to a different clinic to get this vaccine. Great! Can't wait to spend another half hour having BCBS research where I can go to get this vaccine, drive someplace else and then spend another hour waiting in line, and then it would still be a crap shoot because BCBS is clearly full of it. Too bad I can't get payed to do this, I could quit my job and make a living off of it. My other alternative the agent suggested was to dispute the charge later because I had been told it was covered. Sounds great! Can just picture how awesome it would be to spend more hours on the phone advocating for myself with the liars who led me on in the first place and don't know their you know what from *** in the ground! I had already wasted an hour and a half of my life at this point so I just got the damn vaccine and payed for it out of pocket. I am so frustrated that I did my due diligence to make sure this would be covered ahead of time, only to be led on and screwed in the end. I hate Blue Cross as much as any other insurance company out there because they all pull the same tricks. It's a racket, an industry that profits off those of us who are too busy to spend our whole lives navigating a broken bureaucratic mess just to use the service we pay dearly for in the first place. Shame on you BCBS! Get your act together!
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Loss:
$101
Cons:
  • Hate everything
Reason of review:
Poor customer service

Preferred solution: Full refund

Anonymous

Supervisors DO NOT do their jobs!

At least the one I didn't get the pleasure of dealing with didnt. I am a provider and called with what should have been a fairly simple issue to deal with. The representative I dealt with was foreign and spoke very well actually. But, he had a difficult time understanding what I was asking. I was on the phone an hour while he "researched" what should have been a simple issue. I asked 4 times to speak with a Supervisor! The first time he ignored me, the last 3 he put me on hold, I presume to get his supervisor. Each time he came back more flustered than before! If you are going to hire foreigners, then the least you could do is have a supervisor with enough of a back bone to get on the phone and deal with a providers office to sort out what the issue is, on behalf of YOUR customer! This call should have taken 10 minutes to figure out tops! I am not supporting this with anything due to the nature of the complaint and the fact that I am Hippa compliant!
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Reason of review:
Poor customer service
Anonymous
map-marker Saint Paul, Minnesota

MISERABLE BASTARDS DENYING TREATMENT FOR ALCOHOL/CHEMICAL ABUSE

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We have been trying for two years or more to get my brother into intensive treatment and counseling to deal with his alcohol and drug abuse issues, and to get counseling to reach the underlying issues driving those behaviors. He finally got to the point where he decided to pursue treatment because he feels his life is down the toilet. In spite of a strong recommendation from a Ramsey County CD assessment specialist that he go into residential treatment to ensure that he gets the full range of help needed, BCBS denied him because in the opinion of their bean-counters, residential treatment is not "medically necessary." Who in the *** do they think they are to decide what is "medically necessary?" These health insurance companies are nothing more than robbers. This is why we need single payer health care--to put bastards like BCBS out of business. Appeal? You can count on it, Blue Cross.
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Reason of review:
Poor customer service

Preferred solution: I want my brother to get the intensive chemical dependency treatment he needs to recover and begin rebuilding his life and relationships with his family.

Anonymous
map-marker Saint Paul, Minnesota

Archaic. Get with the times. Huge PITA.

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Every time I have an issue with BCBS I have to call the hotline which is hard to find. Their website, although recently updated, is not helpful because I can't add a credit card. You have to add routing numbers and bank account info. You also cannot ask a question online ... only telephone again. I feel like they are stuck in 1987. I received a termination notice and to be re-instated you have to mail a form with routing information that I already submitted online for payment. Again, archaic. How about an email alert and a clear way to pay my bill in case it gets lost in the mail pile? I tried calling to pay the bill and after several minutes on hold being bounced around from one automated operator to the next, I was sent to a voicemail to leave a message so BCBS could call me back at their convenience and my inconvenience. My advice is to re-think your Customer Experience from start to finish.
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Cons:
  • Getting passed around
  • Total customer experience
  • Inefficient processes
Reason of review:
Poor customer service
Anonymous
map-marker Minneapolis, Minnesota

Cancel policy but take payment!

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I was 2 days late from the 30 day grace period to pay my monthly policy, so they cancelled me. At the same time they cashed my payment. I called them up and said WTF. They said that's how they do it, so payment doesn't get lost. But they are refunding the check. It is 9 days later, still no refund. I don't understand ... why would it get lost? How long can they collect interest on my money? They say now I have to fill out a reinstatement form and they will automatically take it out of a checking account. They didn't even offer a option. I said no way are you going into my checking account. Then they say OK. I am young but imagine an elderly person hearing this. They would just OK everything because they would feel they have to.
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Reason of review:
Poor customer service
2 comments
Guest

Did they reinstate your policy ?

Guest

I did have an individual policy with BCMN in 2015, however with an almost double premium, I most certainly can't afford to continue with this policy. I received a notice of the increase and threw it in the garbage deciding then and there not to renew or find a "new" equivalent premium policy with less benefits and higher deductibles...

what a joke! Now I just received a bill due for Jan of 2016 on an individual policy that I do not plan on taking. I waited on customer service for over a half hour spoke to a supervisor and the best I could get was you need to provide that cancellation in writing, we can't legally cancel your policy by phone.

Also, the supervisor said they would continue to bill me for 2 months and then they would cancel me for non-payment. Well that would be without my signature in writing, so cancel the policy when I call and tell you I DON'T WANT YOUR OVERINFLATED-STICK IT TO THE BARELY CAN MAKE IT-OVER THE INCOME LIMIT FOR "FREE" MEDICAL INSURANCE WORKER!!!!!

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Anonymous
map-marker Stillwater, Minnesota

REFUSAL OF SERVICES NEEDED FOR QUALITY OF LIFE

Following a state-fair hearing and judge’s ruling, Blue Cross continues to play dirty. My friend (Marguerite) has been suffering excruciating pain from the Essure birth control device and has been told by 4 doctors that a hysterectomy is necessary. Blue Cross has refused to approve the surgery. Marguerite has been in the emergency room 15 times with uncontrollable bleeding and pain, to the point she passes out. She is unable to care for her two young children because of the pain, yet Blue Cross will not approve the hysterectomy. Marguerite finally requested a State-fair hearing, Blue Cross called Marguerite the day before the hearing and told her they were changing their mind and they approved her hysterectomy she so badly needs. She was scheduled to have the surgery on November 11. BUT NOW, Blue Cross has pulled another fast one, by changing her group number, forcing her to obtain another prior authorization. After speaking with Jackie a customer service rep at Blue Cross who said the authorization was good until September of 2015 on her old group number, they called back and said that she would still need to get a new prior authorization because the approval was for her old group number. Blue Cross sees their clients as numbers, not people. They need to be stopped.
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1 comment
Cory Czi

Wow thats so sad

Anonymous

BCBS deliberately misleads customers, discriminates against people with psychiatric conditions

I was enrolled in a plan that did not last the full calendar year. BCBS MN explicitly stated on their website that when a non-calendar year plan ended, that counted as a qualifying event. The customer service representative confirmed it. Literally three weeks after applying (BCBS is about as reliable as a chocolate teapot when it comes to communication), BCBS denied my application, stating that my plan did not count as a non-calendar year plan, despite that it was a legitimate plan that did not last a full calendar year. I appealed this with evidence that the website lied to me, and they just sent me a letter saying my appeal has been denied, and the only evidence is contradictory: "You were enrolled in a plan lasting 90 days. That does not qualify as a non-calendar year plan under our standards." Funny, I didn't know a calendar year lasted only 90 days. I am appealing this once more in hopes that their customer services representatives actually passed first-grade reading and math. Also, BCBS MN apparently does not provide mental health coverage. Good to know psychiatric conditions are not covered. I was sexually assaulted last March and my health and work performance declined to the point where I needed to be hospitalized in inpatient psych. I was diagnosed with severe depression and anxiety that require intensive outpatient therapy and meds, neither of which I can afford. The flashbacks and panic attacks interfered with my ability to work and I had to leave with the requirement I get treatment. Now I'm trapped without a job, without treatment, and afraid to even unlock the door. I am barely scraping by just to pay rent. I also can't afford food and can't sleep. If BCBS had not screwed me over, I'd be getting the help I need.
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Loss:
$4000
Anonymous
map-marker Greenfield, Minnesota

Surgery Coverage Review

Said Anesthesiologist is not covered During surgery " your benefit do not provide anesthesia when administered by same physician who performed or assisted in surgery. No payment can be made" I have the best plan available at $700 a month premium. And physician had a helper and anesthesiologist was a different person. So three docs in the room
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