Dental Programs Horizon Blue Cross Blue Shield of NJ

Insurance company denied claim times saying we did not submit the claim documentation when different times my dentist supplied the paperwork they specifically requestedThe 4th time I submitted the correct paperwork, confirming it with a rep from the company on the phone as I put it in the envelopeI sent it certified mailA rep called me on the phone to tell me she received the paperworkThen weeks later I got a letter from Horizon BCBS that they did not receive the paperworkI think they have fraud built into their systemThey asked for the same paperwork a 5th time and that's the fraud partThey get the paperwork, throw it out, and claim they never got it

I had signt up for a dental plan which I had cancelled and requested a refund which I have not received yet and been about three month nobody seems to know what going on with my refund.please be attentive to these matter thank u

I am a resident of Indiana whose husband's health insurance is provided through the above listed insurer as he works for LG (headquartered in NJ)Our oldest son (age 20) has had ongoing ear dysfunction for 15+ years and has been treated by ENT's in various states during this time Recently, a tube self-extracted and created a deflated Eustachian tube that is creating negative pressure which may/will likely result in some level of hearing loss for him Our current ENT submitted to Horizon BC/BS for a replacement tube, a re-inflation of the Eustachian tube, and a subsequent fix of a very deviated septum (polyp, extended Turbinate blocking the Eustachian tube, etc) in order to reach the Eustachian tube with the required tool (The tool cannot currently access the E-tube due to severe deviation from the above factors) Horizon BC/BS is repeatedly denying all but the replacement eardrum tube installation stating that there is no history or documentation of "breathing issues" My son's hearing is at risk How long must an insured risk permanent damage for the sake of "history" in a file to appease Horizon BC/BS? We've never encountered repeated insurance related denials such as this now through Horizon BC/BS of NJ These are not cosmetic procedures; they are restorative proceduresI do not submit to the undertakings of our litigious society; but I imagine I will float that balloon with an attorney against Horizon if a loss of hearing occurs