Lone Star Siding Solutions

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to [redacted] within...

30 calendar days. We have mailed an acknowledgement letter to the address on file for Mr. [redacted] with additional information regarding the grievance process as well as direct contact information for her assigned grievance coordinator. Thank you.

We previously responded advising we received the 3rd party authorization form. Additionally, we would like to inform you that Ms. [redacted], has completed our grievance process regarding this specific issue. A response letter was mailed directly to the member on April 28, 2017, addressing her concerns. If the member is dissatisfied with our grievance resolution, she may contact the Department of Managed Health Care for additional assistance. The department has a toll-free telephone number (1-888-HMO-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The department’s Internet Web site http://www.hmohelp.ca.gov has complaint forms, IMR application forms and instructions online.

Blue Shield of California (Blue Shield)'s grievance review timeframe is up to 30 calendar days as indicated in the member's Evidence of Coverage (EOC) booklet. Our records indicate we received [redacted] grievance on August 29, 2016. We have no control over the timeframe in which the Revdex.com complaint stays open.

I am rejecting this response because:  Blue Shield is quick to take a payment from [redacted] NOT [redacted] for this lousy Health Insurance.  NOW they are going to make me wait another 30 days for a response?  Not acceptable.  Please assist - I want my refund of $421.59 back ASAP.  Thank you.

Dear Ms. [redacted],This is in response to the grievance received by Blue Shield of California (Blue Shield) on April 5, 2016, regarding the premium dues on your health plan. You have requested Blue Shield to process the refund for the overpaid premium dues debited from your banking account on January 4, 2016.Your request has been approved. Blue Shield processed a non-refundable credit to your health plan for the next billing period for a total a $198.45.The appeal review was conducted by a Blue Shield Grievance Coordinator with training and experience in processing member grievance.If you have questions regarding this letter, please contact me directly.Sincerely,[redacted] 
[redacted]

Thank you for providing this additional information regarding the member's concerns. We will include the additional information in our review.

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield) for review and would like to inform you that we are currently reviewing the concerns raised in the correspondence submitted. A response will be sent directly to [redacted] within 30 calendar days. Our records do...

not reflect that a signed release of information was submitted with the correspondence sent by the Revdex.com. Unfortunately, without a signed release of information from [redacted], we are unable to provide a copy of the resolution to the Revdex.com.

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on April 5, 2016, concerning a Blue Shield enrollee by the name of [redacted]. The information provided by the Revdex.com included a consumer complaint against Blue Shield. We...

thank you for forwarding these concerns to Blue Shield for review and would like to inform you that [redacted], has not completed the grievance process with the plan. We are initiating a grievance to address the concerns raised in the correspondence submitted. Please be advised that, grievances are resolved within 30 days of the receipt date. A response to the review will be sent directly to [redacted], and a copy of the resolution letter will be sent to the Revdex.com as we received a signed release of information with the correspondence submitted by the Revdex.com. If you have additional questions regarding this matter, please contact me directly at the telephone number listed below. Sincerely,[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory, on the condition that Blue Shield actually sends the promised refund check to me. Having been repeatedly verbally promised resolution before (including one statement that it would be resolved in my favor "in 48 to 72 hours" (BS ref. #[redacted])), I would prefer to keep this complaint open until it is actually satisfied as stated in BS's letter of June 12, 2015.They have given themselves 30 days to send me the check for $1,493.83. I should receive this check by July 11, 2015.Sincerely,[redacted]

Gentlemen:Please stop the pursuance of the subject complaint.With the Revdex.com assistance, on May 2, 2015 I havereceived the payment requested.Again, I would like to express my many thanksfor the Revdex.com fruitful intervention.Sincerely,[redacted]

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). Please note member grievances are reviewed and responded to via US Postal Service, directly to the member within 30 calendar days. Our records indicate this member currently has a grievance under review...

received on June 6, 2017. We will include the additional submitted information in our review.

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). Please note member grievances are reviewed and responded to via US Postal Service, within 30 calendar days. Our records indicate this member currently has a grievance in review received on June 9, 2017, regarding these specific concerns. We will include these additional concerns in our review.

I am rejecting this response because: I am assuming Blue Shield/Cross of California gave their response based on the Authorization for Release of Health Information to the Revdex.com.  I signed the form and faxed it to the Revdex.com of Northeast California in West Sacramento, Fax:  [redacted]

I am rejecting this response because:When selecting Blue Shield as our insurance company, we specifically chose the Silver 70 PPO plan with out of network providers in mind. In making our decision we even told the Blue Shield representative our situation and  intention of using primarily out of network providers who told us nothing about reduced coverage amounts for  out of network providers. The plan stated after the deductible they would reimburse at 50%. There was no way for me to be aware of the  fact that the 50% reimbursement would be off of a significantly negligible allowable amount compared to what  the providers require. I feel that it's deceiving of Blue Shield to hide this information from customers until after  they are already in contract. For instance, I saw a provider 5/18, 6/10, 6/24 which totaled $510 for all three visits.  However, Blue Shield's allowed amount was $198 for those visits. I was therefore reimbursed $96 as opposed to  the $255 I expected.  I would like to be reimbursed for the difference. I have yet to have an explanation as to why this information is  hidden from their customers and why they chose to reimburse at such a lower amount as their acceptable  amount. I feel this is very deceiving to customers. Thank you for your assistance in this matter.

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to [redacted] within...

30 calendar days.

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). Our records indicate the member’s initial grievance review was completed on August 23, 2016. If the member has additional questions or concerns they may wish to contact the assigned grievance coordinator as listed in our response letter for assistance.

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on December 18, 2015, concerning a Blue Shield enrollee by the name of [redacted]. The information provided by the Revdex.com included a consumer complaint against Blue Shield.We thank...

you for forwarding these concerns to Blue Shield for review and would like to inform you that we are currently reviewing the concerns raised in the correspondence submitted. A response will be sent directly to [redacted]. Our records do not reflect that a signed release of information was submitted with the correspondence sent by the Revdex.com. Unfortunately, without a signed release of information from [redacted], we are unable to provide a copy of the resolution to the Revdex.com. If [redacted] has signed a release of health information to the Revdex.com, you may send a copy to my attention via fax at [redacted] or by mail at:[redacted]
[redacted]If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely,[redacted], Executive Inquiry Coordinator[redacted]

You may withdraw this now, they have settled this with me and closed my account with a 0 balance.

I am rejecting this response because: I made my initial request for refund on Feb 13, 2017 and I was later told they had up to 45 days to refund my account, well that time has come and gone and I still have not received my refund and now they want to have 30 more days?  They illegally charged my credit card and it takes up to 75 days to get my refund, are you kidding me???? I want my refund IMMEDIATELY, who do they think they are wanting up to 75 days to refund my account that they charged illegally, do I have to go to the Sacramento County District Attorney's Office for a criminal complaint???  I have my letter from Blue Shield stating my insurance was terminated in Jan. 2017 effective 2/1/17 and they want 30 more days, I don't think so!!!!

Revdex.com:
I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory to me.