Complaints

This profile includes complaints for BlueCross BlueShield of South Carolina's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  BlueCross BlueShield of South Carolina

  8733 Highway 17 Byp S Myrtle Beach, SC 29575-7711

• 

  BlueCross BlueShield of South Carolina

  PO Box 100300 Columbia, SC 29202-3300

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:08/06/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In October 2024, my son was seen at *****************. Two charges were submitted to my insurance provider, **********************, for processing. Since then, I have been working diligently with ********** Blue Shield to get these claims processed. I have mailed numerous documents as requested, including physicals, a five-year medical history, and detailed explanations of the visit. Despite fulfilling all their documentation requests, the claims still remain unprocessed.I have been trying to resolve this issue since October of last year, and we are now approaching a year without any progress. I am seeking assistance to get these two claims properly processed and paid. The continued delays and lack of resolution have been extremely frustrating, and I need someone to intervene and help bring this matter to a close.

  Business Response

  Date: 08/12/2025

  We have referred this matter to our *************** team for further review. A representative has contacted the member directly to provide clarification and address any questions. Based on this outreach and the information provided, we consider this complaint resolved.

  Customer Answer

  Date: 08/12/2025

   
  Complaint: 23708401
  
  I am rejecting this response because: no one has contacted me and my claim has not been resolved. They still have not processed the medical claims in question. My my phone number is ************  and would love for someone to call me to resolve this matter.
  
  Sincerely,
  
  ***** ******

  Business Response

  Date: 08/20/2025

  Our member services team has successfully connected with the member, addressing their inquiries and providing feedback. A follow-up call has been scheduled with the member and our team to obtain additional information to ensure this issue is addressed. 

• Initial Complaint

  Date:07/18/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  ******** will not respond to emails, holding up an auto accident settlement.

  Business Response

  Date: 08/01/2025

  We have communicated with the complainant, and the matter has been resolved. BlueCross BlueShield of South Carolina has provided the required information within the requested timeframe. We believe that the issue has been resolved. 

• Initial Complaint

  Date:05/29/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Background:I have been paying nearly $600/month for coverage. Recently, I requested coverage for a Cologuard screening as a preventative measure due to my family history of colon cancer. I was informed by **** SC that the request was denied because I do not show symptoms and have not yet reached the age of 45, which, according to BCBS SC, is their policy for screening eligibility.Issues:Failure to Acknowledge Family History: My family history of colon cancer should be considered a valid medical reason for early screening, as per guidelines from both the *********************** and other leading medical organizations.Inadequate Reason for Denial: The reason provided for the denial that I do not have symptoms is not in line with best practices for preventive care, especially considering the rising rates of colorectal cancer in younger adults.Lack of Clear Communication: Although I contacted BCBS SC for clarification, I was told over the phone that I needed to send additional documentation to justify the request, which I did. Despite this, the denial was not overturned.Delayed Care: This denial delays necessary preventative care, creating unnecessary stress and health risks.Request for Resolution:I am requesting that BCBS SC review and reverse the denial for my Cologuard screening, taking into account my family medical history and the increasing rates of colorectal cancer among younger adults. I would also like an official written explanation of the policies and medical guidelines used to justify this denial, as the phone conversation I had did not provide sufficient information.f BCBS SC is unable or unwilling to reverse this decision, I request a detailed appeal process with all relevant policy references provided in writing.I have attempted to resolve this matter directly with BCBS SC but have been unsuccessful in getting a satisfactory resolution.

  Business Response

  Date: 06/12/2025

  We have communicated with the complainant and addressed their inquiries. In response to the requests from the **************************, we believe we have met the Departments requirements and are confident that our actions were appropriate.

• Initial Complaint

  Date:05/28/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  BCBS of South Carolina claim they sent their payment for Mr. **** ********' stay in The Greens at ******** directly to him. The family said that they never received any checks! we tried contacting BCBS of South Carolina multiple times, but we've waited on hold for over 2 hours and then their system hangs up! In addition since we are contracted with our local BCBS of North Carolina the payment should have been sent directly to The Greens at ********. Please have BCBS of South Carolina reissue the payments directly to The Greens at ********. Thank you.

  Business Response

  Date: 05/29/2025

  Our member services team has confirmed that it engaged in a conversation with the provider yesterday, May 28, 2025, and this morning, May 29, 2025, to review all pertinent information and address any inquiries they may have. The provider expressed satisfaction with the resolution, which we have deemed finalized on our end. 

• Initial Complaint

  Date:02/13/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  i had a confirmed appointment with BCBS of South Carolina in their **************, ********* on Friday, Dec 13. it was confirmed when i booked it for 2pm EST on that date. i followed up with my contact ******** ******** via phone three (3) times and numerous times via email to confirm. she never got back to me. the deadline for open enrollment was that following day so it HAD to be done that day and i was told that was the only day and time she could do it. i was flying home from *** and my flight was going to be at the same time as the meeting, so i paid $135 (see receipts) to ***** to fly home for the confirmed appointment. she never showed. i have copies of the emails i sent to her. i ended up having to take three hours that afternoon and evening to call and get coverage. about 6 weeks of calls to the manager ****** ******** were never returned. finally spoke with his asst ********* and he finally called me back a week later. there was just excuses that they were "really busy" and knew they would be missing appointments but admitted they did nothing to follow up with anyone if they had an appt. i spoke with someone in corporate about this ***** ******* and today i find out that **** is refusing to credit me any money for the flight i had to take. this may seem ***** but after them s******* up and not responding to an existing customer is not okay. their "values" of Integrity, Respect, Commitment, Excellence and Caring are poorly represented by them and their staff. i was asking for a minuscule amount to account for the *** expense I had to incur because of their lack of customer care, staffing and follow up. its gross how much time i had to spend to even get a call back from them and then it was endless excuses. i can tell so many people have filed complaints with the BBB about them (and the other bad things i read online) so am now not surprised about this issue. OH they also never processed my Dental plan so i had no coverage for Jan 2025. another issue....

  Business Response

  Date: 02/25/2025

  We have reviewed the details of this matter and are satisfied that it has been addressed appropriately. We consider this matter to be closed.

  Customer Answer

  Date: 02/25/2025

   
  Complaint: 22934291
  
  I am rejecting this response because:

  for the many reasons i listed in my complaint -- the fact that my emails and calls to the person i had the appointment with never ONCE responded to me and the countless calls to the manager of that office (where this staffer worked) were never returned. countless hours of follow up with no response is unacceptable and unsatisfactory. of course BCBS does not care as i am now stuck with insurance with them for the next year -- so what do they care? i was asking for a measly amount to cover the cost of the airfare for the flight i took to come back for the **** confirmed and scheduled appointment so i am frankly not surprised at their lack of care since their staff and management can't be bothered to follow up with clients.

  
  Sincerely,
  
  ****** ********

• Initial Complaint

  Date:06/13/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Since April 18, my dentist has been attempting to obtain an auth for a crown. To date, June 13, it has still not been approved, and each time I call BCBS I am told it is being worked on and then the next time I call, I am told that nothing has been done with it. The dentist advised me in April that it needed to be done quickly. This is my second complaint with BBB about BCBS and their untimely managing of prior authorizations for dental work. I have been a BCBS client for almost 50 years, am a state retiree, and should not have to go through this to get a crown approved. My dentist has sent needed records to BCBS so I don't know what the issue is and BCBS can't elaborate.

  Business Response

  Date: 06/19/2024

  Our member services team successfully investigated the denial, made adjustments to resolve the issue, and has notified the member directly.

  Customer Answer

  Date: 06/20/2024

   
  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.
  
  Sincerely,
  
  ***********************

  I would hope to receive this approval in writing since I was told on Thursday the crown was approved and then told again on Friday that it kicked out again but would get resolved.  Thank you sincerely for your help.

   

• Initial Complaint

  Date:05/20/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am having billing issues with my ********** Blue Shield Account and have had them since I started my account this year. This started with the healthcare exchange telling me that they needed payment I have the Marketplace telling me that they do not accept payments but I had to make a payment to start the process so the first payment was made, then there were attempts on my checking account for BCBS Premium Draft andI called BCBS and they don't know I called the Government and they say they do not collect premiums, so now I am confused if this is Silver or bronze and have to make a decision and rates because I am starting a new job, so I am very confused and need answers

  Business Response

  Date: 05/24/2024

  Our member services team has reached out to the member to address their concerns regarding the mailing address and policy changes or renewals. The member has expressed satisfaction with the resolution, and we consider this issue resolved.

• Initial Complaint

  Date:04/09/2024

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  ********** Blue Shield of South Carolina contracts with OptumRX to handle their prescriptions. On February 9, they overcharged me on a copay by $291.08. Neither ********** nor Optum disagrees that they made this mistake and owe me this money. After 4 phone calls and no results, I filed a complaint with the Centers for ******************* Services. A couple of days later, ****** from **/BS of SC called me. She said that ***** told her the payment would be processed on March 16, and I should get it in 7 to 10 days. There was a long story about the claim for a refund having been approved on March 1, and that the processing would be March 16 (which is a Saturday, by the way). I forget the exact words she used, but I inferred that refunds are processed in groups. More than 10 days passed, and no payment. I called ****** again. She called Optum again and called me back. Now the story was that a check was mailed "yesterday," which was March 29. Now it is 12 days later and no check. It really sounds like Optum is telling stories, and I don't know when/how/if I can ever get my refund.I called ********* and ***** told me that she could file a complaint, but that the Centers for ******************* Services was over them. I told her that I already filed a complaint with them. I asked her what would happen. She said they would have 30 days to resolve it. When I asked what would happen if they didn't resolve it by then, she had no answer. It doesn't look like OptumRX is going to pay. I think BC/BS should pay me, and withhold that money from Optum. Barring that, ******** should refund me, and withhold that money from BC/BS. That's not going to happen, of course.So, I'm talking to people who have no power to do anything, other then file complaints, but with no teeth. There is no incentive for Optum or ********** to pay me. So, I'm reaching out to you to be another entity to complain, put pressure on them, etc. I am owed $291.08. Please help, thanks.

  Business Response

  Date: 04/18/2024

  Our member services team has confirmed with the member that the issue ******* raised has been resolved. Therefore, we consider this issue closed on our end.

  Customer Answer

  Date: 04/22/2024

   
  Complaint: 21550374
  
  I am rejecting this response because:
  
  Sincerely,
  
  *****************************

• Initial Complaint

  Date:03/18/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In the ***************** car insurance gives you the option to get a personal injury protection letter from your healthcare provider so I contact ********** Blue shield of South Carolina my provider through work I was awarded a letter to give to my insurance company for my car and it's been over a month and a half I still haven't gotten a letter I've contact them for additional times had to go over the problem three more times about this is what I need the second third and fourth time they all claim they understand and are going to send it out they never do the last time the fourth time I asked for an actual piece of letter in the mail because they cannot seem to email me what I need now it's been more than 14 days since that time and I still haven't received what I need their service is already subpar for the healthcare they do provide and all I'm trying to do is get a piece of paper and they seem to not be able to do that even though they say they will and they say over and over they're going to do it they're going to send it out they're going to email it over I have yet to receive anything.

  Business Response

  Date: 03/19/2024

  Our member services team was able to contact ******* and answer the questions presented, as well as send documentation as a follow-up. We feel this issue has been closed. 

  Customer Answer

  Date: 03/19/2024

   
  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.
  
  Sincerely,
  
  *******************************

• Initial Complaint

  Date:03/07/2024

  Type:Service or Repair Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  1/19/2024-filed an out of network health claim with BCBS of South Carolina. Date of service - 1/18/2024. Claim filed through their digital Health Claim portal using my BCBS "My Health Toolkit" account. After uploading, Given a "confirmation code" and message, "Please allow for the review process to be completed. Once the review is finalized, the status and details of your claim will be updated in your claims list." No confirmation email sent. No record of it anywhere else on file. Additional out of network claim filed with same provider 11 days later-date of service of 1/29/24. Same ambiguous confirmation code, no follow up communication.Did search in "claims list" for record 1/19/2024 claim. Records did not reflect claim being submitted-not listed under "pending", "processing" or "denied" was not shown processed claims list. became concerned that claim was not being reviewed. Called BCBS, was told, claim was being escalated would be about 2 weeks. No status change in online claims list. Called week later, told it was being escalated would be 2 weeks. Called today, 6 weeks from the initial filing date, was told it is being escalated and it will be two weeks. I said I was told that 4 weeks ago (really 5 weeks ago). Representative stated, online claims filing is "working out the kinks". Since filing the claims, 3 other claims sent directly from providers were processed and paid before these claims were even reviewed. After my call with BCBS today, the claims are now showing to be "processed" as of today. Not able to view the Explanation of Benefits for these claims. Link is there, nothing loads. Loads for other claims.BCBS notes on list - pay the full amount of 150$. Checked benefits guide: out of network states: Outpatient Psychiatry: $15/visit or 40% coinsurance. I have also nearly met my deductible.Claim#: C4053N9190000 Claim#: C4054N1330000