Lone Star Siding Solutions

Dear Mr. [redacted] This is in response to the grievance Blue Shield of California Life & Health Insurance Company (Blue Shield Life) on November 2, 2015, regarding an erroneous debit on your financial account ending in “0050”. You have requested that Blue Shield Life return the payment to you as soon as possible. Your request has been approved. After reviewing your account with the Billing Department, it was determined that an incorrect debit was deducted from your account. An overdraft for the amount of $11,016.00 was returned to your account on November 23, 2015. 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]

I am rejecting this response because:  Blue Shield claims they have sent a grievance packet to my son (insured) but we have not received it yet.  Again, they are quick to debit my debit visa card but will not return my money $421.59.  Money spent for unworthy insurance coverage.

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on July 20, 2015, concerning a Blue Shield enrollee by the name of [redacted]. The information provided by the Revdex.com including 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 916-350-7405 or by mail at:P.O. Box 5588El Dorado Hills, CA 95762If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely,[redacted], Executive Inquiry Coordinator(916) 350-7168

Dear Revdex.com:This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on July 16, 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 [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 resolves 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 any additional questions regarding this matter, please contact me directly at the telephone number listed below. Sincerely,[redacted], Executive Inquiry Coordinator

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on December 21, 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 [redacted], has already been through our grievance process regarding these concerns. Her grievance was reviewed and responded via written correspondence. Additionally, our records indicate she has exercised her right to a second level of grievance to be reviewed by our regulating agency the Department of Managed Health Care (DMHC). Therefore, we will not initiate an additional review of this member’s concerns at this time.If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely,[redacted]
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to my concern, and although I believe it is ridiculous to have to wait 30 days just to get resolution, I find that this resolution is satisfactory to me.

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.

Hello [redacted],Blueshield has not reached out to me in any way. I believe that they do not want to contact Me in order to allow my policy to lapse so they can cancel it again! Thanks,[redacted]

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 Ms. [redacted] mailing address
with additional information regarding the grievance process as well as direct
contact information for her assigned grievance coordinator. Thank you.

Revdex.com:
Thanks very much for your assistance with this matter. I have reviewed the response made by the business in reference to my concern, and find that this resolution, if satisfied per my conversation with [redacted] in grievances, will suffice.  The credit has still not posted to my account at this time, however, so I can't confirm whether we are squared away at this time.Best,[redacted]

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on June 22, 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 [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 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]., Executive Inquiries CoordinatorGrievance Department[redacted]

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]...

and [redacted] within 30 calendar days. We have mailed an acknowledgement letter to the mailing address on file with additional information regarding the grievance process as well as direct contact information for their assigned coordinator. Thank you Tell us why here...

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 Ms. [redacted] mailing address with additional information regarding the grievance process as well as direct contact information for her assigned grievance coordinator. Thank you.

I am rejecting this response because: Please keep this complaint open until we have a resolution.  To date, we have, or are trying to, discontinue the Blue Shield EZ pay due to the difficulties from April through September.  We have instead initiated electronic payment through our own bank, Bank of America.  Payments have been made up through November 1 on our part.  In addition, I am being told by Blue Shield that they wrote off, or credited, part of our bill, which we never asked for.  Despite this, we are receiving notices that our account in is arrears and in danger of cancellation.  The last letters were received on Thursday, October 12.  I see that the Customer Service office is trying very hard to assist us, but apparently communication with another branch of the company is poor/nonexistent.  I have asked repeatedly for a statement, and see no reason why I am unable to receive a premium statement.  We have little confidence, based upon historical actions of this company and the fact that we have already been incorrectly cancelled once, to assume that we will not be cancelled again.  To emphasize, this account was never lacking funds for any of these electronic payments attempted.  We would be happy to provide proof if required.  The Customer Service department has not contested our statements. incorrectly  Blue Shield already indicated (on the State level complaint) that the problem has been fixed, when in fact it has not.  Please leave this complaint open until I can see a track record - not receiving arrears notices, cancellation warnings, or cancellations.  Please understand we are only three weeks out from an actual, real cancellation which was RETROACTIVE to June 1.  Any assistance from Revdex.com in this matter is appreciated. A partial list of conversations concerning [redacted]’s attempts to set up EZ Pay    Verbal, March:            Per Blue Shield, et up EZ pay when you get back from vacation.  There will be no problems.4-10-17                       Per Blue Shield, EZ Pay set up immediately.5-22-2017                   Per Blue Shield verbal, EZ Pay has been set up.5-22-2017                   Per Blue Shield, email stating EZ pay has been set up.7-17-2017                   Per Blue Shield verbal – EZ pay has been set up and withdrawals have been made to cover the months of May, June, and July.  Confirmation [redacted]7-28-2017                   Per Blue Shield, letter stating that EZ Pay will withdraw four months May, June, July, August.8-11-201                     Per Blue Shield EZ Pay set up confirmed. “I will keep an eye on your account to be sure the amount deducts.”  Inquiry# [redacted]8-17-2017                   Per Blue Shield, email thanking for setting up EZ Pay.8-17-2017                   Per Blue Shield, email confirming auto payment update.9-6-2017                     Per Blue Shield, [redacted] (Lodi office) states that he will straighten out and there will be no problems whatsoever.  Subsequent calls to [redacted] not returned.9-11-2017                   Per Blue Shield, [redacted] states that [redacted] is paid up through September. Confirmation [redacted]9-6-2017                     Per Blue Shield, cancellation warning that full payment of $776 must be made by Sept. 30.9-12-2017                   Robert mails a check for $776.00.9-16-2017                   Per Blue Shield, policy cancelled retro to June 1, 2017.

I am rejecting this response because: we are in need of inmeidate medical treatment and your office is providing the wron verification. I cannot wait on a grievance. A call was placed to blue shield on January 4th and the reference number is [redacted]. A call went to covered California on 1/9/17 case delete number [redacted]. Case number [redacted] and red number [redacted]. A call to blue shield on 1/23/17 case #[redacted]. 12/30/17 blue shield case number [redacted] and reference number [redacted]. You need to place me on the silver 94 along with my son [redacted]. Effective 1/1/17. [redacted] has had orders for physical therapy since 1-4-17 and cannot obtain services because we cannot afford to pay the co-pay of the gold plan. On 1-4-17 [redacted] N from Blue Shield verified Silver 94 PPO plan effective 1-1-17 but blue shield keeps verifying to the medical offices that we are on the gold plan. The inquiry number for that call is [redacted]. We are paying for a plan but we can't get services because you are verifying the wrong coverage. It is not my responsibility to file a grievance. You MUST fix this immediately as we are in need of medical treatment. My blue shield ID number is [redacted]. Please call me and fix this immediately. My number is [redacted]. Thank you, [redacted]

We responded to the Revdex.com on August 26, 2016, regarding this member's complaint and an acknowledgement letter was mailed directly to the member on August 26, 2016, advising we would initiate a grievance review to address his concerns. A final resolution letter was mailed to the member on September 15, 2016.

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.
I will be faxing you the signed form on Tuesday, November 22, 2016.  Thank you.  [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, 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.

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

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. Our response will be sent directly to [redacted] within 30 calendar days.