Independence Blue Cross

Review: I signed up for medical insurance with Independence Blue Cross (at their site). My application was accepted on December 11th and payment was withdrawn from my account on December 12th. My policy was set to begin on January 1st, 2014. It is now January 13th, and I have received no ID card or policy number. I have no way of using the policy. I need a policy number to even print a temporary card. I have been calling the company constantly since January 1st. I have spent countless hours on hold. When I do get to talk to someone, they tell me I should receive my card any day or that someone will get back to me (neither is true). I can't see any doctors or get my prescriptions (which I really need). I haven't had my prescriptions since the end of last year. It is not a pleasant thought not having insurance. What will happen if I get hurt? I don't like to file a complaint in this manner, but I am getting nowhere with this company. I just want what I payed for from a company that should have been more honest with me. Time is critical.Desired Settlement: I need the policy I payed for as soon as possible. I need to be reimbursed for the time my policy was unusable. An apology might be nice, but I don't know what that would be worth from a company that wasn't honest with me from the beginning.

Business

Response:

Re: [redacted]

Dear **. [redacted]:

I am writing to acknowledge and respond to the January 14, and 27, 2014, inquiries you addressed to [redacted], Manager of the Executive Inquiries Department. Your inquiries were written on behalf of **. [redacted], who contacted your agency regarding his enrollment status with our plan.

As my January 16, acknowledgement email advised, under the Privacy rule, we are required to obtain an individual’s written approval before can disclose his/her protected health information. Unfortunately, we have not received the completed Authorization to Release Information form that accompanied that email. Therefore, I am unable to provide you with our findings.

Since we have finalized our review, rather than delay our response, we have addressed our findings directly to **. [redacted].

**. [redacted], we thank you for bringing this matter to our attention.

Sincerely,

[redacted], Specialist

Executive Inquiries

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

As of 2/6/2014, I still have not received any ID Cards. This person has not contacted me. And I have no idea where to "sign off" on my "privacy" so they can properly address this problem. This generic response is unacceptable.

Regards,

Business

Response:

February 4, 2014

Dear **. [redacted]:

I am writing to acknowledge and respond to the January 14, and 27, 2014, inquiries you addressed to [redacted], Manager of the Executive Inquiries Department. Your inquiries were written on behalf of **. [redacted], who contacted your agency regarding his enrollment status with our plan.

As my January 16, acknowledgement email advised, under the Privacy rule, we are required to obtain an individual’s written approval before can disclose his/her protected health information.

Unfortunately, we have not received the completed Authorization to Release Information form that accompanied that email. Therefore, I am

unable to provide you with our findings.

Since we have finalized our review, rather than delay our response, we have addressed our findings to [redacted].

**. [redacted], we thank you for bringing this matter to our attention.

Sincerely,

Review: On April 23rd, Independence Blue Cross, [redacted] dropped my two children from their health insurance because the premium was late. I never received notice of expiration from the company but discovered this information, rafter a doctor's visit. I was told that the referral never went through. After speaking with representative, [redacted], from Independence, on the phone, I sent the company two checks each for $139.34, totaling $278.72 to reinstate my two children's policies. I told them that it was late because the father of my two children was not paying child support that was due. I sent the checks to the address at the bottom of the bill, per [redacted], to [redacted]. On April 30, 2013, I received statements for each child stating that the above amount was still due and that their insurance was still expired. I took copies of the checks, the letter, and faxed them over to the same company. On April 26, 3013, I was referred to a Supervisor, [redacted], at Independence, [redacted]. [redacted] told me that If I brought another $278.72 directly to her office on [redacted] in Philadelphia, that she would get the two previous payments equaling $278.72, refunded. She stated that the previous representative, [redacted], told me to send the money to the wrong place, and that the money was sitting inactive in an unattended lock box in [redacted], NJ to be processed by their bank. On April 26th, I drove from [redacted], PA to [redacted] and gave [redacted] a check for $278.72 to apply $139.34 to each of my two childrens insurance premiums for Feb., Mar., Apr., and May 2013. She accepted the payment, reinstated my two childrens' [redacted] policies, immediately, and told me that she would get me a refund for the previous two checks equaling $278.72. On April 30, 2013, [redacted] told me to fax a letter to their [redacted], NJ office, Accounts Payable Supervisor and ask that two checks be refunded to me, Mother of the two children, and to give them my demographic information and the children's identification numbers. I followed through and made copies of everything. I never received a refund or heard from anyone in the company. I called [redacted] about twice a week to ask when I would receive the refund. On about the sixth time, May 24, 2013, [redacted] told me that I could not pick up a refund, that "It required the signature of the Vice President of Independence", and that was impossible. She states that in the computer it was documented that a check was sent to me on May 22, 2013, by "regular mail". They did not send it Certified or by FedEx, and did not have it tracked. I told her that I have not received it. I spoke to [redacted], Supervisor again on 6/4/2013. I told her that I needed the money desperately to support my family. She said that "The computer shows that it was mailed out and that we have to wait 30 days to see if it is not cashed before another refund is issued". I told [redacted] that I want to speak to her Supervisor and want this escalated. They are holding my money unfairly and will not return it to me. She said that her Supervisor would call me. Never happened, no other communication. I call [redacted] every week and hear the same words over and over. They have been holding my $278.72 from April26, 2013, until now June 13, 2013. I have limited income. My June premiums are due. I need to purchase groceries and other daily items and have no money. I want an immediate refund overnighted to me, with daily interest for each day that they held on to the money, signed for personally by me, via FedEx or any other Currier.Desired Settlement: Immediate refund check of $278.72 plus 49 days interest at the average daily rate, refunded to me overnight by currier to be handed to and signed by me personally.

Business

Response:

Dear [redacted],

Attached please find our response letter for your case file [redacted].

Although the information is general, I trust that it is helpful. Likewise, we have sent a detailed response letter to [redacted] for her records.

Sincerely,

[redacted], Specialist

Executive Inquiries

Consumer

Response:

In response to this complaint, I received a telephone call from a [redacted], from the Office of Executive Inquiries of Independence Blue Cross, on Friday, June 14, 2013. As a matter of fact, the call came about one hour after filing this complaint. [redacted] stated that the company still states that they mailed two checks totaling $272.78 on May 22, 2013 to my home address. It was so unimportant to them, that there was no tracking or certification, or receipt that the check was actually sent. That was one month ago. It does not take 4 weeks to receive a letter by regular mail from less than 20 miles away in the same city. Once again, I told [redacted] that the check was never received. She stated that the May 22nd checks would be voided and that on Monday, June 17, another check for $272.78 would cut and sent overnight the next day, to be received by me on Tuesday, June 18, 2013. She stated that it would be sent by USPS with tracking and signature required. I told her that I am in dire need of that money and that this is unreasonable. I even offered to come and pick up the check that day. She stated that "It is not company policy".

On Tuesday, June 18, 2013, [redacted] called me again to tell me that the person who cut the new check sent it out by regular mail, no tracking. [redacted] stated that now they will once again void this check and cut another check on Tuesday, June 18, which would be printed on Wednesday, June 19th and sent overnight by USPS with tracking and signature required for me to receive on Thursday, June 20, 2013. She states that she is personally overseeing the follow through on this problem, but still no check in my hand. It is now Wednesday, June 18, 2013, 57 days since Independence has been holding my $278.72. They are refusing to include reasonable interest for 57 days to be included in the check, however they have been holding onto it and making interest off of my money, despite them saying that they are not. This issue is not considered to be resolved until $272.78, plus daily current interest for 57 days is in my hand.

Lets think about why people have this type of insurance, because of some unfortunate circumstance in their lives has forced them to become low income and unable to afford regular commercial insurance to protect their families. I am extremely disappointed with the customer service of this company. Nobody knows what the other person is doing. I have read a lot of similar complaints posted on different internet sites regarding the same issues with this company, They know how to send the premium invoices out on time and drop you if you are late, but try getting your own overpayment money refunded. "Not company policy", No follow-up, No checks and balances, mistake after mistake, no documentation of receipts or tracking of mail. If the money is not in hand by the close of business of Thursday, June 20th, I will contact Revdex.com again and follow up with legal action.

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Regards,

Review: I am currently on hold waiting to talk to customer service for the 4th time and once again the wait time is extensive. I have been on hold on the phone for 55 min now for an issue that should take only 5 minutes. I'm ver dissatisfied with the custore service by independence blue cross.Desired Settlement: I was charged more than my max deductible for my insurance plan. I would like them to answer the phone first, and then figure out why I was charged more than the deductible and fix it. First and formost, at least answer the phone during their business hours. 55 min on hold is unacceptable.

Business

Response:

Good afternoon [redacted]:

this is just an alert to inform you that I will be handling the review and response for this case file [redacted]. Please have the member complete the attached HIPAA form so that we may correspond with your office.

thank you,

[redacted], Specialist

Executive Inquiries

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

Regards,

IBC didn't respond with a resolution, rather a request for more info. Where is the HIPPA form they are requesting to fill out? There was no attachment.

Business

Response:

attached is the HIPAA Authorization form to be completed by the member. Please return it to my attention.

Thank you,

Executive Inquiries

Review: I was incorrectly charged for a month of insurance coverage, after having canceled my policy and received notice that the cancellation had gone through. I have called the business three times to try to rectify the situation, each time I have been put on hold for over an hour and the situation has not been resolved. The last time I tried to call, the representative on the phone told me they would call me back within 24 hours, which they did not do.Desired Settlement: I would like to get a $97 refund check for their billing error. I would also like them to strongly consider addressing their human resources, as my experience on the phone was extremely frustrating and unhelpful.

Business

Response:

Dear **. [redacted],

I am acknowledging receipt of your correspondence dated May 1, 2014, addressed to the manager of the Executive Inquiries Department, [redacted].

Member/complainant: [redacted] Revdex.com Case file: [redacted].

Compliance with the HIPAA Privacy Rule. The federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule requires that we obtain an individual’s written approval before using or disclosing his/her protected health information or PHI for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. PHI is individually identifiable health information transmitted or maintained in any form or medium (including written, spoken, or electronic) related to: health care, health conditions, payment for care, and identity. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule. If **. [redacted] would like to appoint you or the Revdex.com as the recipient of her PHI, she must complete and return the attached Authorization form to us.

If we do not receive the signed Authorization form within 10 business days from today, we will respond to **. [redacted] directly.

Thank you for bringing this matter to our attention. We will begin our investigation and respond accordingly.

Specialist

Executive Inquiries

Review: Independence Blue cross has failed to credit my account in the amount of $1,132.82 since July 2014.

Although the company has received the above funds, they posted it to someone elses account.

I have sent them proof of payment 4 times,and it still is not being resolved.

My most recent inquiry did not result in the credit being applied.

I have been told a supervisor will call me... but they do not.

I receive late notices and letters saying my account may be cancelled.

The level of incompetence there is alarming.Desired Settlement: Credit my account for the amount I have paid 4 months ago.

Additionally I have spent countless hours on hold and sending them information.

I would like to be compensated for my time in the form of an account credit.

Business

Response:

November 7, 2014Dear [redacted]:Our Manager of the Executive Inquiries Department, Detra D[redacted], has requested that I respond to your recent correspondences regarding [redacted]. The purpose of this letter is to inform your office that [redacted] is not entitled to a refund at this time.In accordance with the federal Health Insurance Portability and Accountability Act, known as the HIPAA Privacy rule, it requires that we obtain an individual’s written approval before using or disclosing his/her protected health information (PHI) for any purpose not permitted or required by the HIPAA Privacy Rule or other applicable law. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule. We appreciate your office submitting the authorization from [redacted] listing your office as an authorized recipient of his PHI.The matter at hand In his complaint to your office, [redacted] stated that, “Independence Blue Cross has failed to credit my account in the amount of $1,132.82 since July 2014. Although the company has received the above funds, they posted it to someone else’s account. I have sent them proof of payment 4 times, and it still is not being resolved. My most recent inquiry did not result in the credit being applied. I have been told a supervisor will call me...but they do not. I receive late notices and letters saying my account may be cancelled. The level of incompetence there is alarming.”Our review Upon receipt of [redacted]’s concerns, we commenced an investigation and our examination revealed that effective January 1, 2014, his premium responsibility is $1,132.82 with no subsidy.We discovered that we erroneously applied a premium payment in the amount of $329.71 to [redacted]'s premium account on October 1, 2014; however, on October 21, 2014, we removed the $329.71 amount from his policy and applied it to the correct member's policy.As of the date of our response, [redacted]’s account is paid to September 30, 2014 and his current balance is $2265.64 for the months of October and November 2014. Our records do not reflect that he is entitled to a premium refund.[redacted] we appreciate the opportunity to address [redacted]’s concern. If you have additional concerns regarding this matter, please feel free to contact me via email at[redacted] I will be pleased to assist you.Sincerely,Rafael D.Specialist, Executive Inquiries Department

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

Regards,

Business

Response:

December 9, 2014

Review: I cancelled my policy on or about the 15th of March 2014 and I was informed at that time that I would be receiving a refund as my employer policy had begun on Jan. 1st 2014. While being refunded for this amount was above what I expected my bank account was charged again on or about April 1st 2014 for the cancelled plan. I spoke again to the company on April 15th 2014 and they told me that I would have to wait until the next round of refunds that would be processed on May 14th 2014. I spoke with the company again today May 30th 2014 and they had no record of the refund needing to be processed. I informed them that the taking of my funds from my account after the policy had been cancelled amounted to theft. They told me that my refund check will be mailed in 3-5 days. At this time I have no faith that the check will actually be mailed and they did not offer to put the money back in my account the same way that I made payment.Desired Settlement: At this point they should just refund the money onto the bank card from which payment was made.

Business

Response:

Dear [redacted]:

I have enclosed a HIPAA form to be completed ny the member so that we can correspond directly with your office. In the interim I have already begun my investigation regarding the concerns presented in your inquiry.

If you have any questions, please contact me at ###-###-####. I will be glad to assist you.

Sincerely,

Executive Inquiries

Review: October 23, 2013, I sent a letter of disenrollment for myself and my wife to Blue Cross Medicare Rx. In November my wife, [redacted], received a letter stating that they accepted her disenrollment. However, there was no letter of acceptance sent to me. They will not accept my disenrollment. They keep sending me a bill. I have spent HOURS on the phone with them. They will not admit that they lost my letter.Desired Settlement: We want a post dated disenrollment letter send to [redacted]. Dated 11-09-2013 The same date of my wife's disenrollment letter.

Business

Response:

Dear **. [redacted],

Thank you for contacting our office on behalf of **. [redacted]. We checked our records and we were unable to identify him as one of our members. Please contact **. [redacted] to verify his coverage. It is possible that he is enrolled in another plan. If you find that this information is incorrect please provide his member identification number. Once received we can investigate his concerns.

Thank you for contacting our office

Sincerey,

[redacted], Specialist

Executive Inquiries

Review: I have had horrible experiences every time I call them for service. Usually the people are rude, uninformative and provide no real solutions. I've called before to inquire about my id cards, they couldn't tell me if they were sent out. I called about my welcome packet , they didn't know what I was talking about and provided me with no real solution. I was given the wrong benefit information several times, given the wrong information on whether or not my mental health provider was in or out of network. I called today because my medication was denied at the pharmacy. I have been on this medication which is [redacted] for almost a year. I was told that I needed prior authorization for the drug when I called Member services and spoke to [redacted]. I explained to [redacted] that I needed this because I am [redacted] and it is a life threatening medication. He said he would call [redacted] to try to get a solution. He called, to no avail they stated that I had to get prior authorization or try another drug????? How can I do that on a Friday at 7:30pm? I asked [redacted] about filing a grievance with the company. He put me on hold again, came back to the line and stated he could basically file a grievance but he didn't know where it would go because I had only been with the plan for a short period of time!! What? I then decided to ask for a Supervisor, he said he would get one and put me on hold. While waiting on hold. The music stopped and low and behold the call was "dropped". I called back and spoke to another rep and demanded to speak with a supervisor. The rep transferred me to [redacted], who was VERY rude to me. Basically told me that [redacted] did not hang up on me the call dropped which was a bunch of [redacted]. I complained to her about my experience and she told me she would file my complaint about service but refused to give me the corporate number.She stated I had to file my pharmacy complaint with [redacted] I called them, they refuse to help me and said I had to file a complaint with [redacted]Desired Settlement: I would like a letter of apology and some type of reimbursement, a member packet mailed to me as well.

Business

Response:

January 23,2014

I am writing in response to your January 6, 2014, correspondence to [redacted], Manager of the Executive Inquiries Department. Your inquiry was written on behalf of **. [redacted], who contacted your agency seeking assistance in resolving her enrollment status with our plan.

As my January 7, 2014. acknowledgement advised, our records indicate that there is no authorization on file for you to receive **. [redacted]'s protected health information. Although that email provided you with a blank Authorization to Release Information form for **. [redacted]'s completion, to date, we have not received the completed document. We are therefore prohibited from disclosing any information regarding **. [redacted]'s protected health information regarding our review to you.

Please be advised that we have responded directly to **. [redacted] with the results of our review, and that we have provided her with a clear and favorable resolution to her enrollment concerns.

**. [redacted], thank you for writing. If you have any additional questions, please contact me at ###-###-####. I will be happy to assist you.

Sincerely,

[redacted], Specialist

Executive Inquiries

Review: Due to multiple billing issues (one month my prepayment would be showing the next month I was two months behind and threatened with cancellation) with my account at the beginning of the year, I prepaid for a vision/dental plan for the entire year, I cancelled my plan as was my right effective June 30th 2014. Since then I have been fighting via phone to get a refund of my prepaid premium which still has not been issued. My last phone call today I was told I was not entitled to any refund, which I have been told repeatedly I have been. Today's interaction with IBX I was told that confirmation number ID[redacted] was assigned to my account. I have waiting several months, and have been unable to purchase replacement coverage due to my funds not being released.Desired Settlement: A refund in the amount of $174.00 AT A MINIMAL as that is what I am due for 6 months of prepaid premium at the rate of $29.00 a month.

Consumer

Response:

Hello, Please be advised that I just faxed this completed form to IBX as well..[redacted]

Review: My name is [redacted]. I am a recent college graduate with a responsible job living on my own in [redacted] Pennsylvania. I take pride in paying my bills on time each month. I am a member of [redacted] Health Plan [redacted] under my mother’s insurance. Premium payments to my insurance plan are regularly made so I am able to receive a physician’s care to maintain my health. On Wednesday, August 14, 2013, I made an appointment with the physician [redacted] at [redacted] of [redacted] for an annual physical. My insurance card was asked for and a co-pay of $40.00 was paid the day of the visit. On Monday, August 19th, I saw the physician [redacted] due to a urinary tract infection at [redacted] of [redacted]. On Tuesday, November 5th, I asked my Primary Care Physician, [redacted], for a referral to an Ear Nose and Throat doctor. A registered nurse named [redacted] responded to my request and informed me that my insurance did not require a referral. Wednesday, November 6th, after a request for a referral from my primary care physician, [redacted] to The [redacted], I saw a physician’s assistant named [redacted] due to a possible ear infection, which caused temporary hearing loss. [redacted] directed me to audiologist to perform a hearing test. A co-pay was paid after being shown my insurance card for $45.00 for this day’s visit. Later that week I scheduled an appointment with the dermatologist, [redacted], for treatment for acne (I did not get a referral for this visit because when I requested a referral for the Ear Nose and Throat doctor a few days prior, [redacted] informed me that my insurance did not require a referral). On December 24th I received a bill from these visits notifying me that the insurance clai** were denied. After calling the [redacted] Health Plan [redacted] customer service center, a man named [redacted] told me I was denied because these doctors were out of the [redacted] PA network and if I had been a part of the Guest Membership program I would not have been denied. As a [redacted] Health Plan [redacted] member, I do not think it is just that I have to pay out of pocket for these doctors visits when I was so misguided. When I went to these specialists, they viewed my insurance card and saw me without a referral but still collected a co-pay. There was never any discussion about being out of network by either specialist office, which could have been remedied by a quick phone call to [redacted]. I have received misguided information on more than one occasion and these health care balances will be financially devastating.

As a responsible consumer who is covered under an active and current insurance plan I should not be responsible for these bills.

Division of [redacted], [redacted]

[redacted], PA [redacted]

###-###-####

[redacted] ([redacted]) [redacted]

[redacted], PA [redacted] — [redacted]

[redacted], PA [redacted]- [redacted]

[redacted], PA [redacted]Desired Settlement: I would like my insurance to cover these charges made by my physicians.

Business

Response:

Dear **. [redacted]:

I am writing in response to your recent inquiry to the Manager of the Executive Inquiries Department, [redacted], on behalf of [redacted]. **. [redacted] indicated her concerns regarding the processing of claims for services that were rendered to her.

Unfortunately, we were unable to identify **. [redacted] in our database as a member of our organization. While we contacted **. [redacted] to request identifying information to initiate our review, we did not receive her response.

In the event that either **. [redacted] or your office can provide identifying information, such as her plan identification number, social security number and date of birth, we will be happy to evaluate the concerns she presented to your office.

**. [redacted], thank you for bringing your concerns to our attention. If you have any questions, you may contact me at ###-###-####. I will be happy to assist you.

Sincerely,

[redacted]

Specialist

Executive Inquiries

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

I am covered under my mother's plan.

My member ID number is [redacted] and my date of birth is [redacted]

Regards,