Independence Blue Cross

Good afternoon:
We will be issuing a response directly to the member in this case as there is no HIPAA authorization on file allowing us to correspond with your office. If you have any questions, please feel free to contact me at ###-###-####. I will be glad to assist...

you.
sincerely,
Scott Y[redacted]
Executive Inquiries

Dear **. [redacted],
 
New Roman">Re:         [redacted]
File No:   [redacted]
 
I am writing to acknowledge our receipt of your April 28, 2014, letter to the Manager of the Executive Inquiries Department, [redacted].  We appreciate your writing to alert us to your concern(s). 
                            
We will respond to your letter shortly once we have looked into the matter you raised.  Should you have any questions, please call me at ###-###-####. I will be glad to assist you.
 
Thank you.  
 
Sincerely,
 
 
[redacted]
Specialist
Executive Inquiries

Great, you got insurance, and now you want to use it, right? Wrong. Unless you are looking for a general practitioner, you will have to call around blindly hoping to find the specialist that will accept your insurance.
Independence Blue Cross's website is awful, every specialist I was trying to get "could not be found" in either of the 3 zip codes I tried. I tried to submit a help request to me, and got a shady email asking for personal information without any links or contact information (so for all I knew it could very well be a scammer). There was no recourse for contacting them.
I've given up using their service. Luckily I am changing jobs soon who will have a different provider, because I was getting absolutely nothing from IBX. Constant back pain and digestive problems and no specialists within their network. It is absolutely ridiculous. They even consider a molar implant to be "cosmetic", so now I can't chew food on the right side of my mouth without destroying my gums.
If you were unlucky enough to get IBX as your insurance provider, be prepared to work extra hard to find doctors, and be prepared for them to shaft you on any care you need with the exception of regular checkups.
Worst insurance company ever.

I am writing to acknowledge and respond to your February 16, 2016,...

email to Detra D[redacted], Supervisor of the Executive Inquiries Department.  You contacted Ms. D[redacted], on behalf of [redacted], who contacted the Revdex.com (Revdex.com) regarding a copayment amount we applied to her son’s claim. We received the Authorization to Release Information form that accompanied your inquiry. Unfortunately, upon review, we determined that the form has not been completed correctly. [redacted] signed under both the Member Signature and the Personal Representative Information fields. Since the Personal Representative Information field should only be signed when an individual has been designated by the member to be their personal representative, [redacted] only needed to sign under the Member Signature field. Having signed both fields has rendered the document invalid, and we are unable to disclose the member’s protected health information to you under the federal Health Insurance Portability and Accountability Act, known as HIPAA.        I can tell you that prior to receiving your inquiry, this matter was presented to our plan by the Pennsylvania Insurance Department, and has been reviewed and resolved. Rather than delay our reply, please be advised that we have corresponded our findings directly to [redacted]. [redacted], we thank you for bringing this matter to our attention. Sincerely, Yvonne P[redacted], Lead Client Services RepresentativeExecutive Inquiries

From: [redacted] <[redacted].com>Date: Thu, Sep 24, 2015 at 7:09 PMSubject: Complaint ID [redacted]To: [email protected] Whom It May Concern:The business I filed a complaint with took care of the problem and I received the refund check in the mail...

yesterday for the proper amount. However, even though the issue was solved; I feel like it should never have gone as far as a it did to get resolved! I should have never needed to go as far as filing a complaint with the Revdex.com nor with the NAIC. The customer call center at IBX has always been a source of extreme frustration, deep lack of information and full of confusion on the parts of all people involved. Any time I ever called their customer care line to deal with any type of issue, I was always put on hold, sent from one person to another. More often than not I would have to ask to speak to a supervisor because the person I was dealing with at the time did not have the information I needed, or was ill-equipped to deal with what I needed help with. In my experience as a customer with this company, the whole call center needs a complete overhaul. From the bottom on up! Scratch that, the whole company needs to be re-evaluated, and overhauled. I am so thankful and grateful that I am no longer a customer of theirs to be quite frank. Sincerely,[redacted]

[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]
 Complaint: [redacted]
I am rejecting this response because:
Again, I do not have [redacted] insurance (I am not sure why this error has been so persistent). My claim was submitted under the [redacted] PPO (ID [redacted]), for which the copy for a [redacted] provider should be $0. As IBX repeatedly has pointed out, [redacted] Hospital is a [redacted] provider. Therefore my copay should be $0 once IBX understands that I have a [redacted] PPO plan and DO NOT have [redacted] as my primary insurance. 
In addition, Mr. Y[redacted] continues to fail to return any of my calls regarding this issue to try to resolve the matter outside of the Revdex.com, which I find to be disappointing and unprofessional behavior. 
Regards,
[redacted]

November 24, 2014
Dear [redacted]:
Thank you for providing our office with the completed HIPAA authorization form, which allows us to respond to your office. I am writing in response to your November 21, 2014, letter to the Manager of the Executive Inquiries, Detra D[redacted]. The purpose of our letter is to inform you that a refund of $252.55 will be issued to [redacted] shortly.
The balance of our letter will summarize [redacted]’s concerns and explain the circumstances surrounding [redacted]’s account.[redacted]’s concerns [redacted] contacted the Revdex.com (Revdex.com) about the status of her premium refund. [redacted] cancelled her [redacted] coverage effective April 30, 2014, a premium payment of $252.55 was deducted from her account. She made several contacts with our office to obtain her refund but was unsuccessful.
Our findings our records confirm that [redacted] contacted our office via email on September 10, 2014, about the cancellation and refund of her account. Unfortunately, due to human error, the refund request was never processed. We apologize that this occurred. As a result, our Billing Department submitted a request to refund $252.55 to [redacted] will receive this refund shortly.[redacted], thank you for bringing this matter to our attention. If you have any additional questions, please contact me at ###-###-####. I will be happy to assist you.Sincerely,Sylvia B

I have had a horrible experience with this company this year. It mirrors what others have said on Yelp: http://www.yelp.com/biz/independence-blue-cross-philadelphia
I called because they improperly sent me a refund check for two months of premium. I wanted them to void the check because it was a mistake. I paid 12 months of premium early. The first premium was paid by credit card the next 11 were paid by direct payments from my checking account. They had me on the phone for 2 hours without resolution. They wouldn't transfer me to a supervisor. There was no access to the website to resolve the issue and no available time to speak with a representative in the evening or on the weekend. I don't have 2 hours to waste on their mistake EVER nevertheless during the work week. This may be the worst customer service experience I've ever had.

[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]
 Complaint: [redacted]
I am rejecting this response because:
there is no information in the business response in how they plan to resolve the problem.  I am fine with them contacting me directly but need to know hoe they have resolved the situation.
Regards,
[redacted]

August 5, 2015Our Supervisor of the Executive Inquiries Department, Detra D[redacted], has requested that respond to your July 19, 2015, correspondence regarding [redacted]. The purpose of this letter is to inform your office that we have responded directly to **. [redacted].
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 (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.
As we have not received an authorization form from your office with [redacted] naming you and your office as an authorized recipient of his PHl and to prevent any unnecessary delays, we have directed our response to [redacted], we appreciate your office bringing [redacted]'s concerns to our attention.
Sincerely,
Rafael *. D[redacted]Specialist, Executive Inquiries Department

Re:         [redacted]                                                      Dear Ms. [redacted]:    ...

   I am writing to acknowledge our receipt of the May 2, 2016, correspondence you addressed to Detra D[redacted], Supervisor of the Executive Inquiries Department. As you are aware, 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. The written approval, called an “authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule. Our records indicate that there is no authorization for you to receive this member’s protected health information or PHI. As a result, we cannot disclose any information regarding our member. Please have Mr. [redacted] complete the attached Authorization to Release Information form. Once the document has been completed please forward it to my attention. Ms. [redacted], thank you for your patience while we resolve this matter. Should we finalize our review before the completed authorization form is received, we will respond directly to Mr. [redacted]. Sincerely,          Yvonne M. P[redacted], Lead Client Services Representative Executive Inquiries

Good Morning:
I am issuing a response directly to [redacted], in this case as we do not have authorization to disclose his protected health information to your office. If you have any questions, please contact me at ###-###-####. I will be glad to assist...

you.
sincerely,
Scott Y[redacted], Specialist
Executive Inquiries

November 6, 2015
Dear [redacted],
I am writing to respond to your recent letter to the Manager of the Executive inquiries Department, Detra D[redacted]. The purpose of our letter is to inform you that as of October 26, 2015, our investigation is still underway regarding [redacted]'s...

concerns. She will receive a written response shortly.As you are aware, 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.
Should [redacted] wish to designate you/the Revdex.com to be the recipient of her PHl, please have her complete the enclosed Authorization to Release Information Form. To be considered valid, all required categories must be fully completed. The instructions are located on the back of the document. Please return the completed form to. Independence Blue Cross, Executive Inquiries Department - Tedra F[redacted], [redacted] Philadelphia, PA [redacted].
[redacted], thank you for writing. If you have any additional questions, please contact me at ###-###-####. I will be happy to assist you.
Sincerely,Tedra F., Specialist.Executive Inquiries

Good morning [redacted]:
I am writing to acknowledge our receipt of the case# [redacted]. We ave resolved this case; however, there is no authorization on file allowing me to communicate our findings to your office, which involves the member's protected health information. Please...

advise if you would like me to respond directly to the member in this instance.
Sincerely,
[redacted], Specialist
Executive Inquiries

December 4, 2015
Dear [redacted].
Our Supervisor of the Executive Inquiries Department, Detra D[redacted], has requested that l acknowledge your recent correspondence regarding [redacted]. The purpose of this letter is to provide your office with an authorization...

form.The federal Health Insurance Portability and Accountability Act, known as the HIPA Privacy rule 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.
As such, we have enclosed an authorization form so that [redacted] could complete the form naming you and your office as an authorized recipient of her PHI so that we can provide your office with our response upon the conclusion of our investigation.
[redacted], should you have any additional questions, regarding this matter, please contact me at ###-###-#### and I will be glad to assist you.
Sincerely ,
Rafael D.
Lead Client Services Representative
Executive Inquiries Department

November 20, 2015
Dear [redacted]:
I am writing to acknowledge and respond to your November 11, 2015, correspondence to Detra D[redacted], Supervisor of the Executive Inquiries Department. Your inquiry was written on behalf of [redacted], who contacted your office regarding her...

efforts to have an outstanding claim issue resolved.Our review As you are aware, 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, The written approval, called an "authorization”, must contain certain required elements for us to consider it valid under the HIPAA Privacy rule.
Your inquiry did not include our Authorization to Release Information form, and our records indicate that there is no authorization on file from [redacted] for you to receive this member’s protected health information or PHI. Having completed our review, rather than delay our response, please be advised that we have corresponded our findings directly to [redacted].
[redacted], thank you for bringing [redacted]'s concerns to our attention, and for allowing us the opportunity to be of assistance.
Sincerely,Yvonne P.
Executive Inquiries

[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]
 Complaint: [redacted]
I am rejecting this response because:
**. [redacted], I have tried to contact you several times by phone regarding this matter but you have not returned my calls.
If, as you say, you 'are monitoring the processing of **, [redacted]'s claims to ensure that we are processing his claims correctly when we initially receive them,' why was my recently submitted claim for services received in April denied in the same fashion as all of the others?
Regards,
[redacted]

[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]
 Complaint: [redacted]
I am rejecting this response because:
See attached hippa form.
Regards,
[redacted]

[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]
 Complaint: [redacted]
I am rejecting this response because:
The representative from Blue Cross has failed to properly investigate, or provide satisfactory answers. 
My premium was raised from $484.78 to $557.02 in January 2015.  This represents a 15% rate increase as approved by the Pennsylvania Insurance Department. It was properly billed, and paid, at this rate for January and February. Suddenly in March the rate was again raised to $659.  I contacted Blue Cross and was assured it was a billing error and would be corrected. It was not.  I then contacted the Executive offices and was again assured it was a billing error.  I have been assured by 4 different people at Blue Cross that the rate is $557.02 and that my billing would be corrected. This has been an ongoing issue causing me great distress, frustration, and loss of time as I struggle to get Blue Cross to correct their fraudulent billing. Because of this we discussed a credit of $557.02 as compensation.
It is insulting that the representative from Blue Cross has once again failed to conduct a proper investigation. The response they provided is unacceptable.  I want a complete explanation to why their employees have consistently confirmed the rate is $557.02 and the extra rate increase in March was in error and would be corrected. The Pennsylvania Dept of Insurance approved a 15% increase, yet Blue Cross is charging me a 36% increase. I request written evidence to show that the Insurance Dept approved them to pass on a 36% rate increase.
The level of incompetence of Blue Cross employees is astounding.
Regards,
[redacted]

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.]
Revdex.com
IBC has sent me a check via [redacted] overnight and resolved the matter thanks to [redacted] at [redacted]. 
Regards,
[redacted]