On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s case# [redacted] , filed by BCBSAZ member [redacted] , concerning her family’s Individual ON Exchange Medical plan purchased through the Federally Facilitated Marketplace (FFM) 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 shareI can tell you however, that when this correspondence was received, a priority review was initiated to assess the concerns Ms [redacted] brings to your attentionI hope the following information is helpful It may be helpful to note that when a medical plan is purchased ON the Federal Exchange, BCBSAZ is required to follow directive as received from the FFMBased on review, BCBSAZ was able to confirm possible confusion resulting from the receipt of multiple marketplace plan actions related to Ms [redacted] ’s plan and recent dependent additionWe corresponded directly with Ms [redacted] via telephone call on 7/19/to confirm plan reinstatement and return of the premium refundSystems were also updated to allow medical services Again, we hope this is helpfulWe do believe this to be resolved, however, if you or Ms [redacted] have questions, you are welcome to contact usSincerely, Anne K [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona ###-###-#### fax: ###-###-#### [redacted] @azblue.com
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# 10538151, filed by [redacted] concerning the processing of her BCBSAZ Individual coverage planI hope this information is helpfulBecause 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 shareI can however, confirm to you that BCBSAZ’s review of our records shows that Ms [redacted] purchased a Portfolio Alliance OFF Exchange plan effective 2/1/BCBSAZ also recognizes that confusion may have existed within the application and the verification processes confirming the contracting status of her providers in this caseBecause of this, administrative approval has been made to allow Ms [redacted] to change her plan from the Portfolio Alliance to the Portfolio Select plan as of her original effective date of 2/1/Any affected claims will be adjusted to process in accordance with the Select plan and premium will be applied accordingly Our attempts to reach Ms [redacted] by phone to confirm have been unsuccessful, so written confirmation of this action is also being mailedWe do appreciate the opportunity to review and resolve this situation and thank you for bringing it to our attention If you or Ms [redacted] have additional questions, please feel free to contact meSincerely, Anne KennedyCorporate OmbudsmanOffice of the President Blue Cross® Blue Shield® of Arizona [redacted] [redacted]
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 claimsI 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***’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 matterThe negative deductible concern mentioned in Mr***’s complaint was confirmed to be a result of the reversal of several prior pharmacy claimsReview also determined that due to what appeared to be a timing issue, a claim had indeed processed with an incorrect cost shareBCBSAZ acknowledged and apologized for this error and in a detailed letter to Mr [redacted] dated 5/13/agreed to not request reimbursement for this misapplied claimIt was also made clear that going forward, future pharmacy claims will be appropriately applied to the plan deductible, which was not yet satisfiedThis action and related information was also communicated to the ADOI on 5/17/ 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 meSincerely, Anne K [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona ###-###-#### | cell: ###-###-#### fax: ###-###-#### [redacted]
Revdex.com: 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, [redacted] ***
Revdex.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 [redacted] ,I have been a Blue Cross Blue Shield customer for many years nowEvery month, I faithfully pay my premium, without having been late on a payment once, NOT ONCEI make sure of this by having them automatically take my premium from my account every month on the same day of the monthI 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 notI have continued being a customer with them through the years despite the annual premium increasesI 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....NOBODYThe number to call for assistance is only available from to Monday through Friday, so any gainfully employed person will have a hard time reaching themI 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 workOn Saturday, the next day, I went to their site and the only.....ONLY....phone number where you could reach anyone was to the sales departmentSo 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 robbedI feel like all my years of paying premiums were for naughtAfter making an emailed complaint to Blue Cross Blue Shield on that very same Saturday I did receive an email response the next dayFortunately my sickness didn't put me in the hospital where a day might have been a day too late, but I still feel robbedIf 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 doesIt'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 5/2/Revdex.com’s case# [redacted] , filed by BCBSAZ member [redacted] ***, concerning premium payments he has made for his BCBSAZ coverage planBecause 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 shareI 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/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 specificationsWe believe this situation has been appropriately resolved for our member and again, hope this information is helpfulIf you or Mr [redacted] have additional questions, you are always welcome to contact me.Sincerely, [redacted] Corporate OmbudsmanOffice of the President
The response form BCBSAZ is inadequate and boarders in ridiculousIt is 2/6/and BSBSAz haas still not found an PCP for my daughterI have personally called Dr.'s #'s given directly from BCBS and NONE of them accept our planI received an email from BCBS stating that they had yet again reassigned her to a new Drand that they had "personally called and verified"When I attempted to set up and appointment with this provider the provider said that they have NEVER been contracted with this plan and had not received any calls from BCBSAZ The response from BCBSAz is a bold faced lie
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] *. [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
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 planI 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 shareI 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 MarketplaceDirection was received authorizing the termination of [redacted] BCBSAZ coverage, which included [redacted] as a dependent, effective 4/1/due to [redacted] eligibilityAn On Exchange enrollment for [redacted] was also received from the Marketplace authorizing a separate coverage plan that was issued to her effective 4/1/under a different identification numberThis new plan, issued to [redacted] effective 4/1/14, is now also showing terminated effective 10/1/based on further direction due to her own [redacted] statusOur review shows that excess premium under the initial plan was transferred to [redacted] 's new plan and a refund of the overage issuedWe also determined the receipt of certain claims for [redacted] that may have initially processed under their joint plan that terminated 4/1/We believe this may have caused some confusionThe affected claims have now been adjusted to process correctly and in accordance with the coverage plan in place at the time of serviceWe have contacted [redacted] direct to confirmWe 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 meSincerely [redacted] Corporate OmbudsmanOffice of the PresidentBlue Cross® Blue Shield®of Arizona [redacted] [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the RevDex.com’s (BBB) second submission of case# [redacted] . [redacted] had expressed concern with the process of assigning a Primary Care Physician (PCP) to her daughter’s Individual BCBSAZ medical plan. Please refer to BCBSAZ’s response dated 2/1/17 to the initial BBB case # [redacted] . I hope this information is helpful. As previously explained, our records showed several documented discussions with Ms. [redacted] , in an effort to assist her in locating a PCP who met her needs. Current review confirms her comments regarding additional questions and also documents BCBSAZ’s communications with both Ms. [redacted] and medical providers to assist with scheduling appointments and obtain referrals. As is our process, BCBSAZ will remain available to continue this line of communication with Ms. [redacted] , to address any questions related to the medical plan purchased. If you or Ms. [redacted] have questions, you are also welcome to contact me. Sincerely, Anne K [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona [redacted] [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the 2/8/Revdex.com’s case# [redacted] filed by BCBSAZ member [redacted] , concerning duplicate enrollment with BCBSAZ in an Individual ON Exchange Medical planBecause 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 shareI can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Mr [redacted] brings to your attentionIt 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 MarketplaceI hope the following information is helpfulOur records confirm Mr [redacted] ’s comments regarding confusion with regard to receipt and BCBSAZ’s handling of his BCBSAZ enrollment, which resulted in the issuance of a duplicate identification (ID) numberBCBSAZ acknowledges the confusion noted above and this will confirm that our Membership Services office contacted Mr [redacted] directly via telephone call on 2/10/to apologize and confirm our resolution in his ID number assignmentThis will also confirm that premiums are being credited to the appropriate benefit plan and claims for services are being adjusted accordinglyWe do believe an agreeable resolution to this issue has been met and will continue to communicate directly with Mr [redacted] to address any questions that may arise Again, we hope this information is helpful and sincerely apologize for any confusion or inconvenience that may have resultedIf you or Mr [redacted] have questions, you are also always welcome to contact meSincerely, [redacted] [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the 10/1/Revdex.com’s case# [redacted] , filed by [redacted] ***, concerning a request made by BCBSAZ that he return the cost of a prescription obtained after the termination date of his BCBSAZ medical plan purchased through the Federally Facilitated Marketplace (FFM)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 shareI can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Mr [redacted] brings to your attentionI hope this information is helpful Our records confirm the termination of Mr [redacted] BCBSAZ plan effective 1/1/15, which was processed on 1/15/When the prescription in question was purchased on 1/7/15, the plan was still active because the termination had not yet been processedThis claim was processed appropriately based on the benefit plan’s specified day premium grace periodBCBSAZ did not make an error in the initial processing of this prescription claimWe do however, acknowledge the delay in communicating the request for reimbursement to Mr***, which made it difficult to resubmit under his new medical insurance carrierFor this reason, an administrative decision has been made to discontinue the recovery process for the prescription charges in the amount of $This decision has been relayed to Mr [redacted] via letter dated 10/5/and also by phone call on 10/8/ This administrative decision is based on the specific circumstances related to this situation only and does not in any way imply BCBSAZ has made an error in handling of the initial claim or application of contract benefits During discussion with Mr [redacted] on 10/8/15, he indicated his satisfaction with this actionIf you or Mr [redacted] have additional questions, you are welcome to contact meSincerely, [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona ###-###-#### fax: ###-###-#### ***[redacted] @azblue.com
Revdex.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, [redacted]
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, for case # [redacted] , filed by Mr [redacted] .As mentioned previously, a voice message and email was sent to Mr [redacted] on June 2, in an effort to make sure his concerns regarding his plan were answered to his satisfactionBecause we did not hear back from Mr [redacted] , it was assumed (incorrectly) that he was satisfiedIn 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 completedIn addition, a hard copy of his payment history was also mailed to his attentionA BCBSAZ contact has been established for any further questions BCBSAZ apologizes for any confusion associated with this case and hopes this is helpfulIf 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
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/ [redacted] had previously expressed concern with the handling of premium rates and purchase of an Individual Off Exchange medical planPlease refer to BCBSAZ’s response dated 9/18/to the initial Revdex.com case #with acknowledgement and apology for the initial confusion related to Ms [redacted] residential address which directly affected the ratesI again hope this information is helpfulBCBSAZ had also contacted Ms [redacted] on 9/16/to also acknowledge and apologize for the confusion regarding her address on file and confirmed that her premiums were being recalculated using her address in Pinal County and her age at point of application for premium rate calculationIt was during this conversation, she advised us of her decision to purchase other coverageWe 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 issuesOn 11/3/15, Ms [redacted] was contacted by phone and confirmed her continued dissatisfaction with the premium rates associated with BCBSAZ benefit plansShe indicated her belief that additional negotiation on the rates associated with her specific plan could have been providedDuring this telephone discussion, Ms [redacted] also made very clear that it is her right to share her on-going dissatisfaction with the Revdex.comWe 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 membersBecause of this, we are unable to “negotiate” premium ratesIf you or Ms [redacted] have additional questions, or would like to discuss further, you are always welcome to contact meSincerely, [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona [redacted] [redacted]
I have sent the required documents three times and been promised a check was being issued twice prior to this contact Until the check is received I am not in agreement onclosing this complaint
I respectfully request a 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
Hello, I just checked what BC/BS did to FIX the problemI 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 plan is correct, except the credit of the [redacted] **So they did not what they said they do and I still have active plans in their systemIt is actually an easy fix, BC/BS should really get somebody with common sense on that case and it could be resolved in minutesZero 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 paymentsMy bills get normally paid about 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 ArizonaRespectfully [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s case# [redacted] , filed by BCBSAZ member [redacted] , concerning her family’s Individual ON Exchange Medical plan purchased through the Federally Facilitated Marketplace (FFM) 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 shareI can tell you however, that when this correspondence was received, a priority review was initiated to assess the concerns Ms [redacted] brings to your attentionI hope the following information is helpful It may be helpful to note that when a medical plan is purchased ON the Federal Exchange, BCBSAZ is required to follow directive as received from the FFMBased on review, BCBSAZ was able to confirm possible confusion resulting from the receipt of multiple marketplace plan actions related to Ms [redacted] ’s plan and recent dependent additionWe corresponded directly with Ms [redacted] via telephone call on 7/19/to confirm plan reinstatement and return of the premium refundSystems were also updated to allow medical services Again, we hope this is helpfulWe do believe this to be resolved, however, if you or Ms [redacted] have questions, you are welcome to contact usSincerely, Anne K [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona ###-###-#### fax: ###-###-#### [redacted] @azblue.com
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the Revdex.com’s complaint case# 10538151, filed by [redacted] concerning the processing of her BCBSAZ Individual coverage planI hope this information is helpfulBecause 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 shareI can however, confirm to you that BCBSAZ’s review of our records shows that Ms [redacted] purchased a Portfolio Alliance OFF Exchange plan effective 2/1/BCBSAZ also recognizes that confusion may have existed within the application and the verification processes confirming the contracting status of her providers in this caseBecause of this, administrative approval has been made to allow Ms [redacted] to change her plan from the Portfolio Alliance to the Portfolio Select plan as of her original effective date of 2/1/Any affected claims will be adjusted to process in accordance with the Select plan and premium will be applied accordingly Our attempts to reach Ms [redacted] by phone to confirm have been unsuccessful, so written confirmation of this action is also being mailedWe do appreciate the opportunity to review and resolve this situation and thank you for bringing it to our attention If you or Ms [redacted] have additional questions, please feel free to contact meSincerely, Anne KennedyCorporate OmbudsmanOffice of the President Blue Cross® Blue Shield® of Arizona [redacted] [redacted]
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 claimsI 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***’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 matterThe negative deductible concern mentioned in Mr***’s complaint was confirmed to be a result of the reversal of several prior pharmacy claimsReview also determined that due to what appeared to be a timing issue, a claim had indeed processed with an incorrect cost shareBCBSAZ acknowledged and apologized for this error and in a detailed letter to Mr [redacted] dated 5/13/agreed to not request reimbursement for this misapplied claimIt was also made clear that going forward, future pharmacy claims will be appropriately applied to the plan deductible, which was not yet satisfiedThis action and related information was also communicated to the ADOI on 5/17/ 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 meSincerely, Anne K [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona ###-###-#### | cell: ###-###-#### fax: ###-###-#### [redacted]
Revdex.com: 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, [redacted] ***
Revdex.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 [redacted] ,I have been a Blue Cross Blue Shield customer for many years nowEvery month, I faithfully pay my premium, without having been late on a payment once, NOT ONCEI make sure of this by having them automatically take my premium from my account every month on the same day of the monthI 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 notI have continued being a customer with them through the years despite the annual premium increasesI 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....NOBODYThe number to call for assistance is only available from to Monday through Friday, so any gainfully employed person will have a hard time reaching themI 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 workOn Saturday, the next day, I went to their site and the only.....ONLY....phone number where you could reach anyone was to the sales departmentSo 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 robbedI feel like all my years of paying premiums were for naughtAfter making an emailed complaint to Blue Cross Blue Shield on that very same Saturday I did receive an email response the next dayFortunately my sickness didn't put me in the hospital where a day might have been a day too late, but I still feel robbedIf 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 doesIt'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 5/2/Revdex.com’s case# [redacted] , filed by BCBSAZ member [redacted] ***, concerning premium payments he has made for his BCBSAZ coverage planBecause 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 shareI 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/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 specificationsWe believe this situation has been appropriately resolved for our member and again, hope this information is helpfulIf you or Mr [redacted] have additional questions, you are always welcome to contact me.Sincerely, [redacted] Corporate OmbudsmanOffice of the President
The response form BCBSAZ is inadequate and boarders in ridiculousIt is 2/6/and BSBSAz haas still not found an PCP for my daughterI have personally called Dr.'s #'s given directly from BCBS and NONE of them accept our planI received an email from BCBS stating that they had yet again reassigned her to a new Drand that they had "personally called and verified"When I attempted to set up and appointment with this provider the provider said that they have NEVER been contracted with this plan and had not received any calls from BCBSAZ The response from BCBSAz is a bold faced lie
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] *. [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
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 planI 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 shareI 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 MarketplaceDirection was received authorizing the termination of [redacted] BCBSAZ coverage, which included [redacted] as a dependent, effective 4/1/due to [redacted] eligibilityAn On Exchange enrollment for [redacted] was also received from the Marketplace authorizing a separate coverage plan that was issued to her effective 4/1/under a different identification numberThis new plan, issued to [redacted] effective 4/1/14, is now also showing terminated effective 10/1/based on further direction due to her own [redacted] statusOur review shows that excess premium under the initial plan was transferred to [redacted] 's new plan and a refund of the overage issuedWe also determined the receipt of certain claims for [redacted] that may have initially processed under their joint plan that terminated 4/1/We believe this may have caused some confusionThe affected claims have now been adjusted to process correctly and in accordance with the coverage plan in place at the time of serviceWe have contacted [redacted] direct to confirmWe 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 meSincerely [redacted] Corporate OmbudsmanOffice of the PresidentBlue Cross® Blue Shield®of Arizona [redacted] [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the RevDex.com’s (BBB) second submission of case# [redacted] . [redacted] had expressed concern with the process of assigning a Primary Care Physician (PCP) to her daughter’s Individual BCBSAZ medical plan. Please refer to BCBSAZ’s response dated 2/1/17 to the initial BBB case # [redacted] . I hope this information is helpful. As previously explained, our records showed several documented discussions with Ms. [redacted] , in an effort to assist her in locating a PCP who met her needs. Current review confirms her comments regarding additional questions and also documents BCBSAZ’s communications with both Ms. [redacted] and medical providers to assist with scheduling appointments and obtain referrals. As is our process, BCBSAZ will remain available to continue this line of communication with Ms. [redacted] , to address any questions related to the medical plan purchased. If you or Ms. [redacted] have questions, you are also welcome to contact me. Sincerely, Anne K [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona [redacted] [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the 2/8/Revdex.com’s case# [redacted] filed by BCBSAZ member [redacted] , concerning duplicate enrollment with BCBSAZ in an Individual ON Exchange Medical planBecause 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 shareI can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Mr [redacted] brings to your attentionIt 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 MarketplaceI hope the following information is helpfulOur records confirm Mr [redacted] ’s comments regarding confusion with regard to receipt and BCBSAZ’s handling of his BCBSAZ enrollment, which resulted in the issuance of a duplicate identification (ID) numberBCBSAZ acknowledges the confusion noted above and this will confirm that our Membership Services office contacted Mr [redacted] directly via telephone call on 2/10/to apologize and confirm our resolution in his ID number assignmentThis will also confirm that premiums are being credited to the appropriate benefit plan and claims for services are being adjusted accordinglyWe do believe an agreeable resolution to this issue has been met and will continue to communicate directly with Mr [redacted] to address any questions that may arise Again, we hope this information is helpful and sincerely apologize for any confusion or inconvenience that may have resultedIf you or Mr [redacted] have questions, you are also always welcome to contact meSincerely, [redacted] [redacted]
On behalf of Blue Cross Blue Shield of Arizona (BCBSAZ), I am responding to the 10/1/Revdex.com’s case# [redacted] , filed by [redacted] ***, concerning a request made by BCBSAZ that he return the cost of a prescription obtained after the termination date of his BCBSAZ medical plan purchased through the Federally Facilitated Marketplace (FFM)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 shareI can tell you however, that when your correspondence was received, a priority review was initiated to assess the concerns Mr [redacted] brings to your attentionI hope this information is helpful Our records confirm the termination of Mr [redacted] BCBSAZ plan effective 1/1/15, which was processed on 1/15/When the prescription in question was purchased on 1/7/15, the plan was still active because the termination had not yet been processedThis claim was processed appropriately based on the benefit plan’s specified day premium grace periodBCBSAZ did not make an error in the initial processing of this prescription claimWe do however, acknowledge the delay in communicating the request for reimbursement to Mr***, which made it difficult to resubmit under his new medical insurance carrierFor this reason, an administrative decision has been made to discontinue the recovery process for the prescription charges in the amount of $This decision has been relayed to Mr [redacted] via letter dated 10/5/and also by phone call on 10/8/ This administrative decision is based on the specific circumstances related to this situation only and does not in any way imply BCBSAZ has made an error in handling of the initial claim or application of contract benefits During discussion with Mr [redacted] on 10/8/15, he indicated his satisfaction with this actionIf you or Mr [redacted] have additional questions, you are welcome to contact meSincerely, [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona ###-###-#### fax: ###-###-#### ***[redacted] @azblue.com
Revdex.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, [redacted]
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, for case # [redacted] , filed by Mr [redacted] .As mentioned previously, a voice message and email was sent to Mr [redacted] on June 2, in an effort to make sure his concerns regarding his plan were answered to his satisfactionBecause we did not hear back from Mr [redacted] , it was assumed (incorrectly) that he was satisfiedIn 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 completedIn addition, a hard copy of his payment history was also mailed to his attentionA BCBSAZ contact has been established for any further questions BCBSAZ apologizes for any confusion associated with this case and hopes this is helpfulIf 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
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/ [redacted] had previously expressed concern with the handling of premium rates and purchase of an Individual Off Exchange medical planPlease refer to BCBSAZ’s response dated 9/18/to the initial Revdex.com case #with acknowledgement and apology for the initial confusion related to Ms [redacted] residential address which directly affected the ratesI again hope this information is helpfulBCBSAZ had also contacted Ms [redacted] on 9/16/to also acknowledge and apologize for the confusion regarding her address on file and confirmed that her premiums were being recalculated using her address in Pinal County and her age at point of application for premium rate calculationIt was during this conversation, she advised us of her decision to purchase other coverageWe 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 issuesOn 11/3/15, Ms [redacted] was contacted by phone and confirmed her continued dissatisfaction with the premium rates associated with BCBSAZ benefit plansShe indicated her belief that additional negotiation on the rates associated with her specific plan could have been providedDuring this telephone discussion, Ms [redacted] also made very clear that it is her right to share her on-going dissatisfaction with the Revdex.comWe 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 membersBecause of this, we are unable to “negotiate” premium ratesIf you or Ms [redacted] have additional questions, or would like to discuss further, you are always welcome to contact meSincerely, [redacted] Corporate Ombudsman Office of the President Blue Cross® Blue Shield® of Arizona [redacted] [redacted]
I have sent the required documents three times and been promised a check was being issued twice prior to this contact Until the check is received I am not in agreement onclosing this complaint
I respectfully request a 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
Hello, I just checked what BC/BS did to FIX the problemI 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 plan is correct, except the credit of the [redacted] **So they did not what they said they do and I still have active plans in their systemIt is actually an easy fix, BC/BS should really get somebody with common sense on that case and it could be resolved in minutesZero 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 paymentsMy bills get normally paid about 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 ArizonaRespectfully [redacted]