File Complaint

RE: File Complaint

careese — Thu, 23 Aug 2018 16:00:39 GMT

Just sent private message. Thank You!

RE: File Complaint

BCBSTX Connect Team — Thu, 23 Aug 2018 15:48:20 GMT

I'm very sorry about that. If you'd like to send us a private message I can have someone in our provider services department call you directly to discuss this. ~ Kayla

RE: File Complaint

careese — Thu, 23 Aug 2018 15:12:33 GMT

Customer Service Rep...Got a call from a customer service rep on behave of a patient. She was calling about a patients referral. After telling me that the patient didn't need a referral even though her card, emdeon and Availity site said referral required. She asked what tax ID we filed with. I told her. She rudely said that she does not need one for routine eye or diagnostic exam. So my next question was not even for diagnostic testing. This lady snapped at me like I was a child. And yes I yelled at her. To let her know you don't talk to me or anyone else like that. Explained to her. That HealthSelect has been kicking back claims stating that the patient needed a referral. And she never gave me a chance to tell her. We don't do routine eye exams. We are strictly medical.

RE: File Complaint

BCBSTX Connect Team — Tue, 05 Sep 2017 11:20:24 GMT

Hello, The authorization form can be found in English here - www.bcbstx.com/.../hipaa_standard_auth_tx_080115.pdf

If you would like to send us a private message we are happy to see how we can help or you can contact us at the number on your ID card for assistance. ~ Kayla

RE: File Complaint

xolaly75 — Fri, 01 Sep 2017 16:09:37 GMT

I have had to deal with unprofessionalism of Insurance companies but BCBS of Texas definitely takes the award for the worst service ever.
I have had so many problems with them from day one that I do not even know where to start.
Is there someone within the organization I can contact directly with my numerous challenges and difficulties?
Your organization requires HIPAA Request to Access PHI yet you currently only have the form in Spanish online??? When did the USA become Spain or Mexico???????????????

RE: File Complaint

CARRANZAJ1977 — Mon, 27 Mar 2017 09:14:19 GMT

Julie stated it would be 24-48 hours, it't been longer and nothing has been resolved. Stop giving me the run around!!

RE: File Complaint

BCBSTX Connect Team — Mon, 27 Mar 2017 08:58:45 GMT

We will be in touch as soon as we have information to share. ~ Kayla

RE: File Complaint

CARRANZAJ1977 — Mon, 27 Mar 2017 08:53:18 GMT

good morning, it's getting close to making another payment and this isn't resolved yet. This is ridiculous and fraud, I want my money back, I'm not making another payment until you give me back both $312.44 you took out of my bank acct with out authorization.

RE: File Complaint

BCBSTX Connect Team — Mon, 27 Mar 2017 08:48:36 GMT

Good morning, We are still working on this for you. We'll be in touch as soon as we have an update for you. ~ Kayla

RE: File Complaint

CARRANZAJ1977 — Fri, 24 Mar 2017 13:53:58 GMT

Has anyone else been over drawn from back acct? I can't seem to get anyone to call me back, last I heard from anyone was 2 days ago.

RE: File Complaint

CARRANZAJ1977 — Tue, 21 Mar 2017 15:31:10 GMT

sent!

RE: File Complaint

BCBSTX Connect Team — Tue, 21 Mar 2017 13:42:27 GMT

Hello, If you would like to send us a private message we can take a look at what's going on and see what we can do to help. ~ Kayla

RE: File Complaint

CARRANZAJ1977 — Tue, 21 Mar 2017 12:45:44 GMT

I have been drafted from my bank acct twice in the same month, I didn't sign up form my money to be taken out in the first place. I have called BCBS and they told me they would refund me my money, well its been over two weeks and nothing!! I also called my bank to stop these drafts. I wish I knew this company did business this way, would of gone with a different insurance. Still waiting for my money to be put back in my acct. Its over $600 I'M PISSED OFF AT THIS POINT!!

RE: File Complaint

BCBSTX Connect Team — Tue, 25 Oct 2016 11:41:22 GMT

Hello, I apologize if this was not made clear when you enrolled. A requirement of an HMO plan is to use an in-network PCP and obtain referrals to see any providers other than your PCP.

Unfortunately if you visited a provider other than your PCP without a referral those claims cannot be allowed and will be denied. You do have the right to appeal the decision on these claims. The information on how to appeal is listed on the back of your explanation of benefits.

You will need to select an in-network PCP. You can do this on your Blue Access for Members account.

Please note, we recommend editing your comment to remember your group and member numbers to keep that information secure. ~ Kayla

RE: File Complaint

lesa2016 — Tue, 25 Oct 2016 10:16:11 GMT

Why was that not explained when I signed up. I gave him the names of my doctors and he checked and told me they were not in network. I did call the name that has shown up as my PCP and we told I had to make an appointment and drive to Greenville just to get a signature for a referral. I've been managing my health myself, I don't need some doctor that Blue Cross picks, to be a gatekeeper. There are claims this year someone needs to look into to tell me what has to be done to get Blue Cross to except MY doctors to reimburse me for all the extra's I've had to pay. Member ID ZGN924887164 group 166913

RE: File Complaint

BCBSTX Connect Team — Mon, 24 Oct 2016 15:32:32 GMT

Hello, If you have an HMO plan you do need a referral from the Primary Care Provider (PCP) that is documented in our files. Your PCP would have to be an in-network provider under your plan and would have to be noted in our system.

I'm happy to have my team take a look at your claims if you still have any questions. You can send us a private message with your plan ID and contact information. ~ Kayla