ComplaintsforBlue Cross and Blue Shield of Illinois
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Complaint Details
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Initial Complaint
04/02/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
BCBS denied an emergency ambulance ride stating it was out of network despite my policy stating ambulance is covered in event of emergency. Keep requesting documentation for a secondary appeal request that they say they are sending but dont. They denied my one appeal and I cant get them to correct the issue.Business response
04/03/2024
Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.Initial Complaint
03/11/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
My mother, a senior citizen receives phone calls and letters which are purposely vague from ************* Supplement and Blue Cross Blue Shield of Illinois. Details and specifics are purposely being left out leaving senior citizens confused and seeking help from their children who also cannot decipher letters and calls that lack specific details. This is no way to treat seniors who are paying Blue Cross Blue Shield a great deal of money.On February 29th, my mother received a letter from ************* Supplement stating, "Thank you for your recent inquiry". When sending letters to seniors you should be more specific and list the exact "inquiry" you are referring to. My mother tells me she made no inquiry and I expect this business to call me and tell me what exactly they are talking about in the attached letter. This letter dated February 29, 2024 also shows a group number of "ILMS01" which is not the same group number listed on my mom's insurance card and we need to know why this would be. In the attached letter dated January 26, 2024, my mother received a letter stating her premium will go up in price but does not state the reason why they do this to limited income seniors. Worse, letter does not even confirm that this is the *** SELECT -PLAN F plan. This company should include such information on the 2024 Rates letters they send out to customers and I hope this is an oversight and they will resend out letters that list the exact plan name. How do they get away with not including this important specific piece of information on a rate letter?On the attached copy of a voicemail message my mother received from "*****" she is asked to call this same company regarding the ***** of ******** information they must have received from her physician. My mother asked me how this information becomes insurance companies business and the message vaguely states they are "calling to verify information" instead of specifically stating what information they are trying to verify. These letters and calls are inappropriate for seniors because they leave out important specifics and include false information like a group number of ILMS01 which we have never heard of. My mother is a senior and has asked for my assistance with these vague letters and calls. We expect better service and contact information is as follows;***************************** (***************************, daughter of **********************************)Initial Complaint
03/06/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My medication was approved by Blue Cross and Blue Shield on 2/23/2024 and since that time I have been unable to get their pharmacy Accredo Specialty to refill my prescription and now I am completely out of my medication.Northwestern Memorial was kind enough to call Accredo for me yesterday to try and get things straightened out with them, but when I called this AM (3/7/24) I still was unable to refill my prescription.Business response
03/25/2024
Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.Initial Complaint
03/04/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
As a pediatrician caring for premature infants I'm trying to get prior authorization for synagis from blue cross blue shield of Illinois. I have submitted this request via fax and have tried to get an authorization number since 2/14/2024. Every phone number I have tried to call is an automated voice system that sends me in a loop where I can not get to a live person to help resolve this issue.I have called nine different numbers. This is ridiculous. I have spent hours trying to service this patient and as a last resort I am filing this complaint against them for lack of service that the member has paid for and is entitled too.Business response
03/19/2024
Thank you for your inquiry. We are reviewing the case and a response will be sent in writing to the provider no latter than March 25, 2024. Thank you!Initial Complaint
02/23/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
I have gone though every step they have asked me to get a medication covered with them that I need. Gone to my doctor weekly, taken other medications ect. The dental letter they sent me does not even have correct information on it and when I call in they say there is no one I can talk to about it. What a scam!Business response
03/12/2024
Please see attached company response.
******************** U379487
Executive Inquiry Specialist
Blue Cross and Blue Shield of IllinoisInitial Complaint
02/19/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
Since December of 2023, I have been trying to schedule an appointment. My health plan has limited partners. The appointments were for pregnancy, thus time is crucial. I was told by blue cross blue shield that I needed a referral from my pcp to be patient at my hospital of choice.I went through the process of finding a doctor in network through Blue Cross Blue Shield. Four weeks after waiting for the first available appointment, (scheduled on 02/12/2024) at the conclusion, it was discovered that the office (located at: **************************************************************************************) was in fact not in network.I called blue cross and they told me that I couldnt get an authorization for a referral from that doctor anyway.During a call today with a customer advocate named *******, she refused to help me with cancellation of services or making a formal complaint. Then she placed me on hold for 10 minutes, idle, because I asked her to escalate the call.I am now 14 weeks pregnant and in my 2nd trimester and ** still being given the run around with no initial appointment for this pregnancy. If I get charged for going to that out of network appointment, blue cross blue shield should pay. If there is anything wrong that shouldve been addressed in my pregnancy thus far, Blue Cross Blue Shield will be responsible.Business response
03/04/2024
March 4, 2024
Better Business Bureau
*************************************
*******,** 60601
RE: Record ID: *********
Member/Inquirer: *************************************
File #: 21314497
Dear Better Business Bureau:
This letter is in response to *************************************** inquiry, submitted to your office and received by Blue Cross and Blue Shield of Illinois, a ******** of ******************************** a ***************************** an Independent Licensee of the Blue Cross and Blue Shield Association, on February 19,2024.
Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to *************************************.
We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible.If you require additional information, please do not hesitate to contact us in the future.
Sincerely,
******************** U379487
Executive Inquiry Specialist
Blue Cross and Blue Shield of IllinoisInitial Complaint
02/18/2024
- Complaint Type:
- Order Issues
- Status:
- Unresolved
I have health insurance with blue cross blue shield through the marketplace. I've had it for a few years. I thought that the insurance rolled over to the next year as a renewal. Blue cross sa8d that I d8dnt renew by December 15, 2023 and the policy was canceled on December 31, 2023. Yet I have a new bcbs card with start date of ******* of 2024. I've been speaking to at least 15 to 20 people at Blue Cross Blue Shield of Illinois or just blue cross. Sometimes they would have to transfer me to Blue Cross Blue Shield of Illinois. This has been going on since the middle of ******* 2024. I have had at least 3 conversations with marketplace and Blue Cross as a 3 way conversation. Marketplace made sense said I was an "active" member of Blue Cross Blue Shield of Illinois since ******* 1, 2024. My premium for ******* was almost $1,000. My normal premium per month is ******. I spoke to one lady at Blue Cross of Illinois that was so helpful and we made payment arrangements to pay the ******* premium and february up to end of February 2024. Amount was approximately $289.00 per my paycheck, which I paid manually. I went to my general practitioner and was not charged for visit. Then I tried to get blood drawn for my medication I need and couldn't get in because they said I have no insurance, or I was "inactive" or "rejected". So of course, I was mad at everybody but blue cross. Finally last week I talked to ANOTHER bcbs of Illinois person for an hour and will be receiving a call on Tuesday. They finally put a rush on my phone calls. But he explained that they were applying my payments to last year's insurance! They said I didn't have insurance until February 1, 2024 when my new card says 1/1/24. I had a total knee replacement set for February 23, 2024 and had to cancel because of the red tape and Blue Cross mistakes. I should be paid accordingly or should have the whole surgery paid by blue cross. They should also pay all my bills from northwestern medicine to dateBusiness response
03/07/2024
Please see the attached company's response.Customer response
03/15/2024
Complaint: 21312083
I am rejecting this response because: Blue Cross Blue Shield responded. They made a grave mistake paid my premiums for last year. Fortunately they paid up through end of April. I paid ****** twice in January and february for the January premium of 950 for only January. My normal premium is ****** a month starting January. So they still owe me!!!!!
Sincerely,
*************************Initial Complaint
02/16/2024
- Complaint Type:
- Product Issues
- Status:
- Resolved
I have, and continue to be insured by BlueCross BlueShield (****) of Illinois for over 14 years. Several months ago, I filed a Claim (333523093950C) for services rendered between 6/8/2023 - 8/31/2023, in the amount of $1,620.00.**** approved $972.00, which I accept. HOWEVER, **** delivered the check to an old, outdated address. I have called **** several times, reached out via email, and even contacted them through their website to have my mailing address updated, and the check sent to the correct address. I have never received the check.This charade has been ongoing for several months now. Each time I call, I get conflicting information from the **** representative.**** needs to do following:1) Update my address to ***** **************************************************************** 2) Issue a check in the amount of $972.00 and deliver it to the address mentioned above.Business response
02/19/2024
Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.Customer response
02/19/2024
Complaint: 21305822
I am rejecting this response because: BlueCross Blueshield of Illinois has not provided a resolution. They merely replied to this complaint with a generic response.
Sincerely,
*********************************Business response
03/06/2024
Please see attached.Customer response
03/12/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. BlueCross BlueShield of Illinois finally mailed a check to the appropriate address.
Sincerely,
*********************************Initial Complaint
02/13/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
1.Deception: Contacted BCBSIL on December 1, 2023, informing them of pending payment from a client, assured I could pay balance upon receipt. Received payment on December 15, discovered policy terminated since December 1, despite assurances. Disputed termination, unsuccessful in reinstating policy. On January 23, 2024, therapist faced billing issues for October and November 2023; upon inquiry, discovered policy terminated since September 30, 2023. Promised refund of $500 for overpaid premiums between October and December; expected within 7 to 10 business days by February 6, not received.2.Lack of Communication:February 12, 2024, initiated multiple calls to BCBSIL customer service: a. First representative placed on hold for approximately 45 minutes before being hung up on. b. Second representative required explanation of situation again; placed on hold for 40 minutes, then hung up on. c. Third representative repeated explanation; put on hold for 45 minutes, finally connected to supervisor who seemed confused and subsequently hung up on. d. Cumulatively spent 3 hours on phone without resolution.3.Poor Customer Service:BCBSIL lacks record-keeping of customer interactions, evidenced by repeated explanations required.Unacceptable to engage with 5 different representatives, including 1 supervisor, in 2 days regarding the same issue.Concerns raised regarding BCBSIL's capability to maintain records, especially concerning financial matters.Similar complaints observed on Better Business Bureaus website, indicating systemic issue.Failure to follow up via phone or email, contrasting with standard industry practices.Lack of faith in BCBSILs ability to resolve issue, necessitating recourse through bank dispute resolution.Financial repercussions incurred due to withheld refund, impacting ability to manage essential expenses.Initial Complaint
02/07/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
My Group ID: ****** My Member ID: *********** I contacted BCBS at Phone No. ************** around 1-29-24 to get a copy of my payments from 2023 which was urgent because I am a Senior Citizen on food stamps and I had to show this information to DHS, I was told by their **************** Rep that they would handle it and email me the information asap. That never happened. So, I called BCBS yesterday and spoke to a **************** Rep by the name of *****. She said she saw no record in her system of this report being ordered. I said that cannot be. I told them this was ******. ***** was short with me on the phone and said she could put thru another request. I said I need it right away. She said that was impossible. I asked for a Supervisor. After a lengthy hold, I was connected with *******, the Supervisor. He kept repeating that he was sorry the original information was never put in the system. I told him I need him to expedite this process Immediately. He said he would do what he could. He said he would call me in another week to see if I received anything. I told him this is horrific that BCBS loses my request and I have to wait to see if I get my information. I told him I would contact the BBB in the meantime to lodge a complaint. BCBS should have a system that gives a customer online access to their payments. I need food to put on the table and I am suffering as a result of this.Business response
02/22/2024
Good morning
Please see the attached response.
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Customer Complaints Summary
244 total complaints in the last 3 years.
68 complaints closed in the last 12 months.