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Blue Cross Blue Shield of Arizona, Inc.

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Reviews Blue Cross Blue Shield of Arizona, Inc.

Blue Cross Blue Shield of Arizona, Inc. Reviews (95)

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com case# [redacted], filed by BCBSAZ member [redacted], concerning the processing of his prescription claims. I hope this information is helpful.
 Our records do not document a release, authorizing us to share specific protected information with your agency; however, I can tell you that when we received Mr. [redacted]’s concern, we initiated a priority review, which showed prior contact with Mr. [redacted] as well as the Arizona Department of Insurance (ADOI) on this matter. The negative deductible concern mentioned in Mr. [redacted]’s complaint was confirmed to be a result of the reversal of several prior pharmacy claims. Review also determined that due to what appeared to be a timing issue, a claim had indeed processed with an incorrect cost share. BCBSAZ acknowledged and apologized for this error and in a detailed letter to Mr. [redacted] dated 5/13/16 agreed to not request reimbursement for this misapplied claim. It was also made clear that going forward, future pharmacy claims will be appropriately applied to the plan deductible, which was not yet satisfied. This action and related information was also communicated to the ADOI on 5/17/16.
 
We believe this concern has been addressed appropriately and are happy to continue to communicate directly with Mr. [redacted] on any further questions he may have.  If you have additional questions, please feel free to contact me.
Sincerely,
 
Anne K[redacted]
Corporate Ombudsman
Office of the President
 
Blue Cross® Blue Shield® of Arizona
###-###-####  |  cell: ###-###-####
fax: ###-###-####
[redacted]

Hello,
 
I just checked what BC/BS did to FIX the problem. I received a call from them, telling me that I do not owe any money to BC/BS and they wanted to deactivate the old plan [redacted] and apply the overpayment to the active plan [redacted].
Now the plan [redacted] (ended 12/31/2015) shows an open balance of [redacted]. This plan was always paid in full, actually overpaid by $ [redacted] which should be credited to my active plan [redacted]. The 2016 plan is correct, except the credit of the [redacted]
So they did not what they said they do and I still have 2 active plans in their system. It is actually an easy fix, BC/BS should really get somebody with common sense on that case and it could be resolved in minutes. Zero out plan [redacted] and deactivate it and apply the 13.58$ credit to my account[redacted]. DONE!
I am really upset, because BC/BS makes it look like I did not pay, and I am very particular with my payments. My bills get normally paid about 2 weeks before they are due.
 
Well, I hope this helps to clean up this mess and I hope I never have a real complicated case with BC/BS Arizona.
 
Respectfully
 

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s (Revdex.com) second submission of case#1080346, dated 10/27/15. [redacted] had previously expressed concern with the handling of premium rates and purchase of an Individual Off Exchange medical plan. Please refer to BCBSAZ’s response dated 9/18/15 to the initial Revdex.com case #1080346 with acknowledgement and apology for the initial confusion related to Ms. [redacted] residential address which directly affected the rates. I again hope this information is helpful.
BCBSAZ had also contacted Ms. [redacted] on 9/16/15 to also acknowledge and apologize for the confusion regarding her address on file and confirmed that her 2015 premiums were being recalculated using her address in Pinal County and her age at point of application for premium rate calculation. It was during this conversation, she advised us of her decision to purchase other coverage. We received no further contact from Ms. [redacted], however, upon receipt of the second Revdex.com notice, additional outreach was conducted to determine and address any possible remaining issues.

On 11/3/15, Ms. [redacted] was contacted by phone and confirmed her continued dissatisfaction with the premium rates associated with BCBSAZ benefit plans. She indicated her belief that additional negotiation on the rates associated with her specific plan could have been provided. During this telephone discussion, Ms. [redacted] also made very clear that it is her right to share her on-going dissatisfaction with the Revdex.com.

We are very sorry that Ms. [redacted] remains unhappy with BCBSAZ premium rates, however, it may also help to note that we are required to administer all aspects of our benefit plans, including those related to the cost for medical insurance plans, in a consistent manner for all BCBSAZ members. Because of this, we are unable to “negotiate” premium rates. If you or Ms. [redacted] have additional questions, or would like to discuss further, you are always welcome to contact me.
Sincerely,

[redacted]
Corporate Ombudsman
Office of the President

Blue Cross® Blue Shield® of Arizona
[redacted] 

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s (Revdex.com) second submission of case#[redacted]. [redacted] had previously expressed concern with the handling of his prescription and medical claims. Please refer to BCBSAZ’s response dated 5/19/16. I hope this information is also helpful.
In his most recent comment, Mr. [redacted] requests a “30 day extension”. Additional review of BCBSAZ records shows adjustment of a claim recently questioned, contact with his provider and the issuance of a corrected Explanation of Benefits on May 28, 2016. Review also confirms Mr. [redacted]’s concerns regarding both pharmacy and medical claims have been addressed as appropriate, however, if you or Mr. [redacted] have remaining questions or concerns, you are always welcome to contact me. I will be happy to facilitate your request.
Sincerely
Anne K[redacted]
Corporate Ombudsman
Office of the President
 
Blue Cross® Blue Shield® of Arizona
###-###-#### 
fax: ###-###-####

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# [redacted], filed by BCBSAZ member [redacted], concerning...

the processing of claims under his BCBSAZ employer group plan. I hope this information is helpful.
Our records do not document receipt of a Confidential Information Release Form from our member, authorizing us to disclose specific information with your agency, which limits the information that I am able to share. I can tell you however, that when we received Mr. [redacted]’s concern, we initiated a priority review. Our records confirm Mr. [redacted]’s recent contact with BCBSAZ on 4/1/16 regarding the claim in question, which has now been adjusted accordingly and discussion regarding the verification process to determine if other insurance coverage is in effect.  
 
It may be helpful to first note that in cases such as this, involving employer group medical coverage, employee eligibility requirements are established by the member’s employer. BCBSAZ acts on the direction provided by the employer and the eligibility requirements set forth by the employer in accordance with their negotiated contract with BCBSAZ. In this case, Mr. [redacted]’s employer group plan requires coverage verification updates in 6 month increments.
 
We believe this concern has been addressed appropriately and are happy to answer any further questions Mr. [redacted] may have. We appreciate your bringing this to our attention and again, hope this information is helpful.
Sincerely,
 
 
Anne K[redacted]
Corporate Ombudsman
Office of the President
 
Blue Cross® Blue Shield® of Arizona
###-###-#### 
fax: ###-###-####
anne.k[redacted]@azblue.com

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s (Revdex.com) second submission of case#[redacted]. [redacted] had expressed concern regarding claims processing delays associated with completion of coverage verification required by his employer group and has also clarified he believes it is BCBSAZ’s handling of these verifications that may have attributed to these delays. Although our documentation appears to differ, we do appreciate his concern and have shared his comments with the appropriate claims management for continued process review. We are very sorry for any delay or inconvenience he believes is associated with the handling of his coverage verification submission and communication with BCBSAZ. As always , both you and Mr. [redacted] are welcome to contact me direct should he have further questions.
Sincerely,
Anne K[redacted]
Corporate Ombudsman
Office of the President
 
Blue Cross® Blue Shield® of Arizona
###-###-#### 
fax: ###-###-####
anne.k[redacted]@azblue.com

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

I disagree with their account.

Regards,

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
 
 [redacted],I have been a Blue Cross Blue Shield customer for many years now. Every month, I faithfully pay my premium, without having been late on a payment once, NOT ONCE. I make sure of this by having them automatically take my premium from my account every month on the same day of the month. I have faithfully made sure that every month on that day, the funds are in the account whether I have had a good month, financially, or not. I have continued being a customer with them through the years despite the annual premium increases. I have never made a medical claim since being a customer, and the one time ...the one time in all these years I have been ill, after having been a faithful paying customer, I can't reach anybody....NOBODY. The number to call for assistance is only available from 8 to 4 Monday through Friday, so any normal gainfully employed person will have a hard time reaching them. I called them the Friday before I entered the Revdex.com complaint and was put on a hold and had to almost go without lunch that day because it's only time I had to make a call at work. On Saturday, the next day, I went to their site and the only.....ONLY....phone number where you could reach anyone was to the sales department. So on a Saturday, I can be sick and dying without any hope of reaching anybody for help with my policy but I can sure as hell buy a new policy if I wanted to. [redacted], I feel robbed. I feel like all my years of paying premiums were for naught. After making an emailed complaint to Blue Cross Blue Shield on that very same Saturday I did receive an email response the next day. Fortunately my sickness didn't put me in the hospital where a day might have been a day too late, but I still feel robbed. If Blue Cross Blue Shield operated with any good faith towards their customers they would at the very least have their customer service department operate with the same hours of operation as their sales department does. It's really a damned shame that the Affordable Car Act has now made us hostages to the whims of these greedy [redacted] insurance companies.[redacted]

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# [redacted], filed by BCBSAZ member [redacted], concerning the processing of claims under her BCBSAZ employer group plan. I hope this information is helpful.Our records...

do not document our receipt of a Confidential Information Release Form from the member, authorizing us to disclose specific information with your agency, which limits the information that I am able to share. I can tell you however, that when Ms. [redacted] contacted BCBSAZ with her concerns, we initiated a priority review. Our records determined that confusion did in fact exist with regard to the required update of her plan’s information related to verification of the existence of other insurance coverage.  It may also be important to note that Ms. [redacted]’s employer plan requires this informational update in 6 month increments. BCBSAZ acknowledges the confusion noted above which caused the delay in claims processing and corresponded directly with Ms. [redacted] via telephone call on 8/6/15 to apologize and confirm our resolution in completion of updates and claims adjustment on 8/4/15. We believe an agreeable resolution to this issue has been met and will continue to communicate directly with Ms. [redacted] as needed to assist with future plan updates to her file.   Again, we hope this information is helpful. If you have additional questions, please feel free to contact me.[redacted]Office of the PresidentBlue Cross® Blue Shield® of Arizona

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

I respectfully request a 30 day extension while BCBS and I are in the process of resolving the issues in this matter.  The additional time would ensure time to address the issue and resolve any unresolved matters.
Thanks you for your consideration

Review: BCBSAZ has totally screwed up our insurance accounts and billing. They continue to send us bills for insurance we have cancelled and then the next week say we cancelled that insurance and then the next week bill us again. They have refused to pay our insurance claims that have been submitted while we were insured with them. We have spent countless hours on the phone trying to get this straightened out to no avail. They also took money for insurance they did not and could not provide as I turned 65, went on [redacted], and called them and the healthcare marketplace.Desired Settlement: Pay our medical bills and refund our insurance premiums that were overpaid

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# [redacted], filed by [redacted], concerning the processing of claims and premiums applied to his BCBSAZ Individual coverage plan. I apologize for the delay in this response and hope this information is helpful.Because our records do not document receipt of a release from the member, authorizing us to share specific protected information with your agency, I am limited in the detail I am able to share. I can however, confirm to you that our records show that changes [redacted] have requested on their BCBSAZ On Exchange benefit plans have been completed based on the direction received through the Federal Marketplace. Direction was received authorizing the termination of [redacted] BCBSAZ coverage, which included [redacted] as a dependent, effective 4/1/14 due to [redacted] eligibility. An On Exchange enrollment for [redacted] was also received from the Marketplace authorizing a separate coverage plan that was issued to her effective 4/1/14 under a different identification number. This new plan, issued to [redacted] effective 4/1/14, is now also showing terminated effective 10/1/14 based on further direction due to her own [redacted] status. Our review shows that excess premium under the initial plan was transferred to [redacted]'s new plan and a refund of the overage issued. We also determined the receipt of certain claims for [redacted] that may have initially processed under their joint plan that terminated 4/1/14. We believe this may have caused some confusion. The affected claims have now been adjusted to process correctly and in accordance with the coverage plan in place at the time of service. We have contacted [redacted] direct to confirm. We do appreciate the opportunity to review and resolve this situation and thank you for bringing it to our attention. If you have additional questions, please feel free to call me. Sincerely[redacted]Corporate OmbudsmanOffice of the PresidentBlue Cross® Blue Shield®of Arizona[redacted]

Review: I bought health insurance from Blue Cross Blueshield, through the website [redacted].com. I received an email as well as notification on the [redacted] website that my policy was carrier approved on September 28, 2012l I went to [redacted] Urgent Care on October 14, 2012 for a sore throat. I paid my copay of $50. I started receiving bills from [redacted] Urgent Care saying that this visit was not covered. They are charging me $285.00 and threatening collection action if I do not pay. I called Blue Cross Blueshield and they said that my coverage began October 15, 2012, one day after my doctor's visit. I received two separate notifications, and can prove it, that my coverage was approved on September 28, 2012.Desired Settlement: Blue Cross BlueShield needs to pay the $285.00 charge to [redacted] Urgent Care immediately. I do not want this to affect my credit score.

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# [redacted], dated 9/8/13, filed by BCBSAZ member [redacted], concerning the effective date of his BCBSAZ Individual benefit plan. I hope this information is helpful. Our records do not document our receipt of a Confidential Information Release Form from the member, authorizing us to share specific protected information with your agency, therefore, it is necessary that we correspond directly with our member regarding his BCBSAZ coverage plan. This will confirm however, that our records show that the effective date of Mr. [redacted]’s coverage was assigned based on the instruction noted on his application for coverage, which specifically asked that coverage not be issued prior to 10/15/12. This will also confirm that a detailed explanation, along with copies of his application and additional correspondence confirming the contract date has been mailed directly to Mr. [redacted]. We hope this information is helpful in providing an understanding of our position regarding the processing of this application. If you have questions, you are always welcome to contact me.Sincerely, [redacted]Corporate OmbudsmanOffice of the PresidentBlue Cross® Blue Shield® of Arizona

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I did not specify a begin date but did enter the date my last coverage ended. Your posting on ehealth as well as emailing me that my coverage was approved in September is misleading if you are saying it didn't begin until 10/15. It shouldn't even matter if I put a start date in, you said I was approved on the September date and that is the date that coverage should have begun. I'm a 19 year old boy who feels like I'm being taken advantage of by this system. I've never applied or had to obtain health insurance before. I'm unemployed and can barely pay for the coverage. I cannot afford to pay this bill and should not have to risk getting bad credit before I am barely old enough to obtain it.

Regards,

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s 2nd referral for complaint case# [redacted], dated 9/20/13, filed by BCBSAZ member [redacted], concerning the effective date of his BCBSAZ Individual benefit plan. As previously mentioned, our records do not document our receipt of a Confidential Information Release Form from the member, authorizing us to share specific protected information with your agency. Also, as previously noted, BCBSAZ records show his application was processed correctly based on specific instruction received. There is no indication of any miscommunication made on the part of BCBSAZ. This will also confirm that a second written communication has been mailed to Mr. [redacted] offering further explanation on why we cannot honor claims for services obtained prior to his plan’s effective date. We regret that Mr. [redacted] disagrees with BCBSAZ’s action. It may help to know that we are required to administer all contract provisions, including those related to the effective date of contract benefits in accordance with the contract. We are unable to discriminate in favor or against any customer in applying these benefits. Again, we hope this information is helpful in providing an understanding of our position regarding the processing of this application. If you have questions, you are always welcome to contact me.Sincerely, [redacted]Corporate OmbudsmanOffice of the PresidentBlue Cross® Blue Shield® of Arizona

Review: I've contacted them through their website and also through phone calls trying to get them to process a payment for health insurance. They state that they are denying it becuase I haven't filled out the "I don't have other health care" form. I did it online and also via the phone call in March, and May. Yet it's been four months and they still won't pay it and give the same excuse. We do this every year. This is the fifth year I've been with them, but I won't be repeating the experience. I'm changing to a different provider the next time. The last two years have been the problem years. Previously, Blue Cross Blue Shield was good. What changed?Desired Settlement: Please pay the claim and quit trying to deny benefits based on a false issue. We don't have other insurance, but we won't be with you again. I'm also telling people not to select Blue Cross Blue Shield. Other insurance has better options and benefits and pays their claims without this level of effort on my part.

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# [redacted], filed by BCBSAZ member [redacted], concerning the processing of claims under her BCBSAZ employer group plan. I hope this information is helpful.Our records do not document our receipt of a Confidential Information Release Form from the member, authorizing us to disclose specific information with your agency, which limits the information that I am able to share. I can tell you however, that when Ms. [redacted] contacted BCBSAZ with her concerns, we initiated a priority review. Our records determined that confusion did in fact exist with regard to the required update of her plan’s information related to verification of the existence of other insurance coverage. It may also be important to note that Ms. [redacted]’s employer plan requires this informational update in 6 month increments. BCBSAZ acknowledges the confusion noted above which caused the delay in claims processing and corresponded directly with Ms. [redacted] via telephone call on 8/6/15 to apologize and confirm our resolution in completion of updates and claims adjustment on 8/4/15. We believe an agreeable resolution to this issue has been met and will continue to communicate directly with Ms. [redacted] as needed to assist with future plan updates to her file. Again, we hope this information is helpful. If you have additional questions, please feel free to contact me.[redacted]Office of the PresidentBlue Cross® Blue Shield® of Arizona

Review: Blue Cross is not crediting my [redacted] subsidy and arbitrarily change my plan to a more expensive one. I have confirmed with [redacted] that I have been receiving a $413/subsidy and that I am signed up under a cheaper plan since Jan 1st. I have spoken with customers Sevierville and they agree with me but it never changes. I have been told I would get a call back from a supervisor several times since March, but have never received one or been able to speak with a supervisor.

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the 5/28/15 Revdex.com’s case# [redacted], filed by BCBSAZ member [redacted], concerning his [redacted] Medical plan and the associated subsidy amount assigned to his plan by the Federally Facilitated Marketplace (MP). Because our records do not indicate receipt of a release from the member authorizing BCBSAZ to disclose specific information with your agency, I am limited in the information I am able to share. I can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Mr. [redacted] brings to your attention. It may be helpful to first note that when a medical plan is purchased ON Exchange, BCBSAZ is required to follow directive as received from the MP. I hope the following information is also helpful.Our review of this case shows that in late December 2014, BCBSAZ followed specific direction from the MP in changing Mr. [redacted]’s BCBSAZ medical plan. In April 2015, updated information was received from the MP authorizing us to re-adjust the subsidy and his plan choice retroactive to January 2015. Review of recent billings statements mailed to Mr. [redacted] confirms these adjustments. Additionally, documentation of recent telephone discussions with BCBSAZ indicate Mr. [redacted]’s satisfaction with the action taken. As a courtesy, on 6/2/15 BCBSAZ followed up with a voice message and email to Mr. [redacted] to make sure his concerns have been addressed.Again, we hope this is helpful. We believe this to be resolved, however, if you or Mr. [redacted] have additional questions, you are welcome to contact me.Sincerely,[redacted]Corporate OmbudsmanOffice of the President

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.This response is entirely inaccurate. I have called five more times since April since the promised change never occured, until after this complaint was lodged, June 2015. I am still waiting on a call.

Regards,

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s (Revdex.com) second request received on June 10, 2015 for case #[redacted], filed by Mr. [redacted].As mentioned previously, a voice message and email was sent to Mr. [redacted] on June 2, 2015 in an effort to make sure his concerns regarding his plan were answered to his satisfaction. Because we did not hear back from Mr. [redacted], it was assumed (incorrectly) that he was satisfied. In follow up to the Revdex.com's second notice and the member's comment that his concerns had not been fully addressed, on June 11, 2015, BCBSAZ conducted another outreach call to Mr. [redacted]. During this telephone contact, a detailed review of the premium payments made to BCBSAZ was completed. In addition, a hard copy of his payment history was also mailed to his attention. A BCBSAZ contact has been established for any further questions. BCBSAZ apologizes for any confusion associated with this case and hopes this is helpful. If you or Mr. [redacted] have questions, you are also welcome to contact me.Sincerely,[redacted]Corporate OmbudsmanOffice of the PresidentBlue Cross Blue Shield of Arizona

I work in a healthcare providers office and have to deal with all insurance companies on a daily basis. BCBS of AZ is by far the friendliest and most efficient company I've ever dealt with. The phone tree on the customer service line is short and easy to use. There is never a long wait to speak with a representative. Every representative is friendly, helpful, and knowledgable, as well as speaks perfect english (which is hard to find these days). My authorization requests are never lost and are usually processed within 24 hours, where as the usual turn around time is 2 weeks and requires extra follow up on my part. Bottom line, they make my job less stressful and wish every insurance company operated the way they do.

Review: I have had Blue Cross since 11-01-2014. My premium payments are taken directly out of my bank account each month and my bank records show that each payment has been taken out by Blue Cross each month in 2015. I have gotten 4 letters from Blue Cross regarding a claim that they are not processing because I have "not made my premium payments for 3 months." I have called the company 4 times on this issue and each time I talk to a different person who says that their records do show that my premium payments are being made and that this is a clerical error on their part. At the end of each call I was promised that a supervisor would take care of the matter and call me, yet I never received any return calls. On 7-23-15 I got a letter from Blue Cross which I will attach threatening to cancel my insurance due to non payment of premiums since April 2015. I called the company that day and got a supervisor named [redacted] at ###-###-#### who promised to call me back in an hour. She did not. I called her again on 7-24, left 2 messages and she finally called me back and said she was working on it and would call me on 7-27-15. I have not heard from her.Desired Settlement: I want Blue Cross to correctly recognize that all my premiums have been met, to process my active claims in a swift manner and to stop threatening to cancel my insurance when it is they who have made the error.

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the 5/2/15 Revdex.com’s case# [redacted], filed by BCBSAZ member [redacted], concerning premium payments he has made for his BCBSAZ coverage plan. Because our records do not indicate receipt of a release from the member authorizing BCBSAZ to disclose specific information with your agency, I am limited in the information I am able to share. I can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Mr. [redacted] brings to your attention. I hope this information is helpful.BCBSAZ records show Mr. [redacted] was contacted on 7/28/15 by BCBSAZ enrollment management who provided him with confirmation of his premium payments, which included a credit, verification of his next payment draft and assurance that claims will be processed according to his benefit plan specifications. We believe this situation has been appropriately resolved for our member and again, hope this information is helpful. If you or Mr. [redacted] have additional questions, you are always welcome to contact me.Sincerely,[redacted]Corporate OmbudsmanOffice of the President

Like the previous negative customer experience, I too have had one of the worst experiences of my life trying to resolve issues with Blue Cross/Blue Shield of Arizona. This is without ever having a claim filed against my coverage. Growing up in Arizona, I always had heard that BCBS was, "The Cadillac of Health Plans", however having struggled with every aspect of BCBS's customer service experience, I finally decided to terminate my, and my family's relationship with them. I would highly discourage BCBS of Arizona as your health insurance provider. I became so frustrated dealing with them as I tried to add my spouse, and two daughters to an existing plan that I had paid premiums for, for three years without ever having filed a claim. BCBS of Arizona greedily accepted my premium payments, and never paid out a penny for services. Every customer service representative I spoke to told me something different. Phone numbers provided the Health Insurance Marketplace by BCBS of Arizona were Spanish speaking only, even though the CSR on the other end spoke to me in English, two of the ladies informed me that because I was not a Spanish speaker, they could not help me? Most all of the female CSR's I spoke with were mis-informed, rude & indifferent. In dealing with BCBS, and then trying to facilitate the changes with the Federal Marketplace, I would try to work with the same CSR who was familiar with our situation. The CSR would ask that I call, and ask for her, and that she would receive an alert at her terminal that she had a customer requesting to speak to her, but this system did not work one single time. Everytime, it was someone different, and I would have to take the time to explain from the very beginning our situation in trying to work with BCBS, and then the Federal Health Insurance Marketplace to secure coverage for my family. Each time I was told something different. I must say that the most helpful person in the organization, and the individual who should probably be running the company, was Phillip Lowery of Concierge Svc.s. He was the most knowledgeable of anyone in the organization. Phillip took the time to explain the plans, and mailed, and e-mailed the plans we discussed. Phillip was far more knowledgeable than the female Supervisors I requested to speak to after getting nowhere with the entry level CSR's. I was never able to secure coverage for my spouse, and had my premiums jacked up sky-high when I added my daughters. On Jan. 1st 2015 BCBS claimed my coverage was terminated, but had already secured an $871.00 premium payment from me in Feb. 2015 that they refused to refund. A truly ethical company? I feel that BCBS is a 2nd tier provider in the market running on fumes, catering to the Hispanic community, providing lousy customer service. I will never have dealings with this company again in my life. I just hope Phillip Lowery can jump ship before it goes down. As opposed to the Cadillac of health plans, Blue Cross/Blue Shield of Arizona seems to be a broken down, dis-functional Yugo headed for a brick wall. Take your hard earned premium payments to another company. You won't regret it like I do.

Review: Please do not make my phone number public record as it is unlisted and private for our safety.

I have had my insurance effective in the first quarter of this year. This has been the worst nightmare. BSBC of AZ took my application over the phone and email in Feb. 2015. They made mistakes on my application that they still have not corrected to-date. And refuse to do so!

Then I sent my first premium check of $413.44 for my medical with another check in the amount of $70.22 for dental insurance for myself and my husband with the remittance slip of each. They cashed the check for twice my dental premium of $140.44 instead of $413.44. This took hours of phone calls, a letter to [redacted] CEO (which has never been responded to. After reaching his office help I was told they never received the letter.) to finally reaching a person in his office, calling my bank, calling member services, emailing to my BCBS of AZ agent [redacted] etc. This took over 1 month to get cleared up and BCBS of AZ drug their feet the entire time and was not cooperative.

Then they raised my insurance from the original quote of $413.44 to $424.04 with 2 weeks notice from a billing effective Sept., 2015. There had been a note on my bill effective 7-2015 & 8-2015 that said and I quote, "This bill may reflect a rate change due to renewal or age increase. Please refer to your contract booklet for more information." I did not ever find any information in any thing they sent me. And I had dismissed it because my Birthdate was before the notice was put on my billing and I was told at the time of my application in Feb. 2015 that my $413.44 would be the premium amount for the entire premium period from effective date in first quarter to last day of 2015 and there may or may not be a rate increase. I would be notified mid-December 2015 if there were going to be any rate changes.

I get a letter from them dated August 3, 2015 in the us mail on 8-12-2015 telling me they had yet another error this time in my premium amount effective 9-2015 would be going to $443.35. I started calling and emailing the agent that finished my application regarding this issue and that I would not be able to afford the increase. I got a real run around and a threat to drop me at the end of last month, August by a man at 602.864.4115 x 3149.

During this time period two additional BCBS of AZ employees accused me of lying on my application even though they had admitted that the error was theirs originally. At the time of application I had told the agent there was errors and gave information on my physcial and mailing addresses. I was told the changes would be taken care of.

The man at BCBS of AZ 602.864.4115 x 3149 told me a solution to my problem was to get a cheaper policy but that the policy I have already is unfortunately the cheapest they have and I should be grateful that they would be raising my insurance premium effective 10-2015 for the second time. Started at $413.44, 424.04 effective 9-2015 & $$443.35 effective 10-2015. Giving me time to come up with the additional money because even though they made a mistake in my original quote that I should be lucky that they decided not to collect the difference of $413.44 and $443.35. I did tell the man that if I had been quoted $443.35 in Feb. 2015 that I would not have taken their policy because I could not of afforded it them and I sure can not afford it know.

I did receive notice via email after I had written to [redacted] regarding the increase asking me if someone form BCBS of AZ had called me regarding additional information request of my property tax information. I wrote back asking if I had to be a property owner to get health insurance and no one had called by as of 9-1-2015. I reminded [redacted] that my AZ Drivers Licenses information had been collected and my physical address was on the license. BCBS of AZ has known from the beginning where I live in Pinal County and that I have a PO Box for all my mail in Queen Creek Arizona - Maricopa County. I have had this mail box longer that I have lived in my current location. The response to my question about property ownership and I quote from the email,"[redacted] Sep 2 (3 days ago)to me You should be. Let me know when you do! Thanks, [redacted]".

I am but that is not the point. BCBS of AZ has made a lot of mistakes and I am paying for them and they still are calling me a liar and want more information that they already have. I believe that I am being scammed and I am not to sure that I am even talking with BCBS of AZ all the time when people call me or email me. After, talking with the fella from the AZ Department of Insurance (I was referred by the Department to the marketplace to see if I would qualify for a special enrollment due to all the issues and not being able to afford the premiums. I also received their phone number from the fella.) I learned that the agents should have the basic information available to them and it did not make sense that I was being asked from my personal information over and over again. And why was I really being asked to send BCBS a copy of my property taxes? I can understand asking qualifying questions to identify me but to call me a liar due to their errors and their unwillingness to correct information and give me the run around with a number of different answers regarding why my rate has changed twice since 3-1-2015 and why the rate is going up over $30.00 before the end of the premium period and why they do not correct information after I have brought it to their attention a number of times.

On 9-3-2015 I received a call from a [redacted] from BCBS of AZ at [redacted] telling me that they now needed me to prove that I lived in Pinal county again and wanted my property tax information. I told her I had just requested my effective date to be End of this month 2015 because I was able to get another policy that I could afford. I had called marketplace the day before and was told I qualified for a special enrollment, my application was taken and that I would qualify for a premium tax credit. At the time of application in Feb. I was told I did not qualify for any tax credit. I was told my the marketplace rep and they gain my the BCBS of AZ phone number to call and tell them I was moving to another policy and to discontinue my current policy effective end of month 2015. I did as I was told. This call from [redacted] is related to the email I had received from [redacted] asking if anyone had contacted me about wanting my property tax information.

I am suspicious about all the calls and emails and requests for additional information that was supposedly collected at the time of my application that I did not believe I was talking to BCBS and as I told a couple of BCBS I guess employees that it seems I was getting ripped off. The increase seems alot out of line especially since they know that they just priced me out of the market.

I called the marketplace back as instructed on 9-5-2015 and received the shocking news that I did not qualify after telling BCBS of AZ to discontinue my policy because I could not afford the new premiums and found out the first person had not given me the correct information and telling me to call my health insurance to cancel my insurance invalidated me being able to get insurance through them at this time. I am devastated now.

The woman told me basically and I paraphrase, to bad. I did not qualify for premium help, special enrollment exemption, & I should of finished my application with them on 9-2-2015.

At this point I asked for a supervisor to get help. One came on the phone she told me the same basic thing. I just lost it; I could not longer keep from crying. 7 months of stress due to the heath insurance issue is wearing me out. I now have no health insurance. I was told to call back November 1 and re-apply for effect date in January 2016.

I asked what was going to happen for Oct, Nov. Dec. 2015 without insurance. Answer from the supervisor of the marketplace. The IRS will now assess a penalty on me. I told her I can't afford health insurance with BSBC of AZ and now I have a penalty being assessed on me that I can not get around. I am literally stuck with no options.

To add insult to injury according to the first person I talked to at the Marketplace I was told I was qualified for a $140.00 premium credit based on my net household income. I was given the healthcare.gov website address to compare plans even though I told the agent I wanted to keep what I had with the premium less the tax credit so now I could afford BCBS of AS Portfolio 6300 policy. This is the cheapest policy I could find.

When I went out to the healthcare.gov website I realized that they wanted my gross income so I plugged it into the calculator and I qualified for $97.00 tax credit per month. That still made the premium affordable. But not to be, according to the two women at the marketplace today 9-54-2015. I do not qualify for special enrollment because I dropped my insurance even though their agent told me to do so and supplied the phone number to BCBS of AZ to do so.

This means that according to the Marketplace and Healthcare.gov that I qualify for $980.00 - $679.00 in premium tax credits. BCBS of AZ told me that I did not qualify for any premium tax credit.

Note: I would never of taken this policy had I been quoted $443.35. I could not afforded it in Feb. 2015 nor can I afford it now Sept. 2015.

I really need your help. My insurance is paid to 10-1-2015. It seems that know one really knows all the rules about healthcare policies and each person I have talked to be it BCBS of AZ or the marketplace I get conflicting answers and conflicting information all the way around.

All I know it I have been priced out of my medical insurance, I do not qualify for a special exemption to get on medical insurance and I will be fined with an unknown fine amount by the IRS for every month (even though it is beyond my control) that I do not have health insurance. So, I can afford insurance how in the world will I ever afford the penalty?

Sincerely,

Please do not make my phone number public record as it is unlisted and private for our safety.Desired Settlement: Make my policy affordable.

Give me the real reason in writing whey they will not correct my information as I have requested many times.

And reinstate my insurance through the end of the year.

And give me a letter of apology.

And give me a direct phone number and name of a person I can contact when I have concerns.

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s case# [redacted] received on 9/9/15, filed by BCBSAZ member [redacted], concerning her purchase and handling of her BCBSAZ’s Individual Off Exchange Medical plan. Because our records do not indicate receipt of a release from the member authorizing BCBSAZ to disclose specific information with your agency, I am limited in the information I am able to share. I can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Ms. [redacted] brings to your attention. I hope this information is helpful. It may first be helpful to note that premium rates associated with Individual plans are determined based upon certain factors, including geographic location and age. Ms. [redacted] Individual Blue Portfolio Off Exchange medical plan for herself only became effective March 1, 2015. The original application processed with the address location within zip code 85140, in Pinal County, AZ. On February 25, 2015, Ms. [redacted] contacted BCBSAZ to update her address to a P.O. Box located in zip code 85142. This mailing address is in Maricopa County, which triggered a rating area change. During a routine audit of files, it was determined that Ms. [redacted] was in the wrong rating area for her corrected address. This was the reason for the initial premium increase, which she mistakenly believed was due to “renewal”. Premium rates are is also based on the age at the time of the application and do not increase until the plan renewal even if the individual has a birthday in the meantime. Unfortunately, the letter BCBSAZ sent Ms. [redacted] informing her of the audit, misquoted Ms. [redacted] premium, and included an increase for the next age band for a female living in Maricopa County. As we now understand it, Ms. [redacted] lives in Pinal County but uses a post office box address in Maricopa County. On September 16, 2015, BCBSAZ Membership Services contacted Ms. [redacted] to apologize for any confusion and inform her that her 2015 premiums will be recalculated using the initial Pinal County and age at point of application premium rate, with any overpayment refunded to her. Ms. [redacted] has advised us that she has obtained coverage through the Federal Marketplace. At her request her Blue Portfolio policy has been terminated effective October 1, 2015. We apologize for any inconvenience this confusion may have caused Ms. [redacted] and appreciate the opportunity to address her concerns. If you or Ms. [redacted] have questions, you are welcome to contact me. Sincerely, [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona [redacted]

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I disagree with their account.

Regards,

Business

Response:

On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s (Revdex.com) second submission of case#1080346, dated 10/27/15. [redacted] had previously expressed concern with the handling of premium rates and purchase of an Individual Off Exchange medical plan. Please refer to BCBSAZ’s response dated 9/18/15 to the initial Revdex.com case #1080346 with acknowledgement and apology for the initial confusion related to Ms. [redacted] residential address which directly affected the rates. I again hope this information is helpful. BCBSAZ had also contacted Ms. [redacted] on 9/16/15 to also acknowledge and apologize for the confusion regarding her address on file and confirmed that her 2015 premiums were being recalculated using her address in Pinal County and her age at point of application for premium rate calculation. It was during this conversation, she advised us of her decision to purchase other coverage. We received no further contact from Ms. [redacted], however, upon receipt of the second Revdex.com notice, additional outreach was conducted to determine and address any possible remaining issues. On 11/3/15, Ms. [redacted] was contacted by phone and confirmed her continued dissatisfaction with the premium rates associated with BCBSAZ benefit plans. She indicated her belief that additional negotiation on the rates associated with her specific plan could have been provided. During this telephone discussion, Ms. [redacted] also made very clear that it is her right to share her on-going dissatisfaction with the Revdex.com. We are very sorry that Ms. [redacted] remains unhappy with BCBSAZ premium rates, however, it may also help to note that we are required to administer all aspects of our benefit plans, including those related to the cost for medical insurance plans, in a consistent manner for all BCBSAZ members. Because of this, we are unable to “negotiate” premium rates. If you or Ms. [redacted] have additional questions, or would like to discuss further, you are always welcome to contact me. Sincerely, [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona [redacted]

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Description: Insurance - Health

Address: 2444 W Las Palmaritas Dr, Phoenix, Arizona, United States, 85021-4860

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