Lone Star Siding Solutions

Member appeals and complaints are reviewed under the Blue Shield (Blue Shield of California) grievance process. The grievance process is designed to give Blue Shield an opportunity to fully review and provide a written response to the submitted member concerns and make a determination of any request if necessary. If we are unable to comply with the member's request at the end of our review, we will provide information regarding an Independent Medical Review which may be available through the Department of Managed Health Care. Additionally, the member may request that the grievance be withdrawn by contacting the assigned grievance coordinator as indicated on the Blue Shield acknowledgement letter.

Can you please provide the subscriber ID number?

We thank you for forwarding these concerns to Blue Shield of California (Blue Shield) for review and would like to inform you that the parent(s) of [redacted], have 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. We will provide a copy of our written response to the parent(s) of [redacted] as well as the Revdex.com via U.S. Postal Mail.

This letter is in reference to the correspondence received by Blue Shield of California (blue Shield) on June 4, 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]If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.

I am rejecting this response because: the company did not make a sufficient attempt to resolve this matter. I received a phone call asking to re-submit the claims (I already did three times prior), and there was no follow up of any kind thereafter. This current response is further evidencing the company's practice to purposefully decrease the efficiency of communication with the clients and therefore evade the reimbursement as much as possible. This is unethical and unacceptable.

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on June 4, 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 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], Executive Inquiries CoordinatorGrievance Department###-###-####

I am rejecting this response because: I have not been contacted by Blue Shield since the appeal was filed on Nov 3.  I called and spoke to two representatives today, Nov. 28th and was told that the appeal had been closed because it wasn't filed correctly.  I don't understand how it...

was filed incorrectly since they were the ones that filed it to their back office.  I am beyond frustrated, I just want to speak to someone at Blue Shield that can actually help and not feel like I'm running in circles. This company is horrible.

I am rejecting this response because: I don't need a grievance counselor. Blue Shield already came up with a resolution to the matter that was documented in their Case # [redacted] by their representative [redacted]. The resolution to the problem is for Blue Shield to re-bill me for $1482.95 and to amend my 1095A back to the 4/28/2017 revision. A grievance counselor would only prolong the matter. Why can they not follow through on the solution they already proposed and conclude this matter?I'm happy to write a check for $1482.95 as long as they amend my 1095A back to the 4/28/207 revision that I submitted with my taxes.Regards,[redacted]

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. We will respond directly to Ms. [redacted] as we have not received a signed release of...

information form. We will contact the member shortly.

Re Case #: [redacted]Dear Revdex.com: This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) pn July 1, 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. Our records indicate that Mr. [redacted]'s is enrolled under the Federal Employee Program. As indicated in the member service benefit plan brochure, member complaints and claim processing disputes must be submitted directly to U.S. Office of Personnel Management (OPM) for review and resolution. While we understand Mr. [redacted]'s concerns, based on the benefits and provisions of his plan we are unable to initiate a formal review of his grievance at this time.If you have additional questions regarding this matter, please contact me directly at the telephone number listed below.Sincerely,[redacted] Executive Inquiry CoordinatorGrievance Department([redacted]

Blueshield has changed the name of my plan on the their website but they still not have corrected my id card nor have they correct the payment amount that is actual due for the plan, which is the biggest.  I am always worried that they will cancel the plan for non payment because they do not have it correct.  I even have a Broker whom has spoken with Blueshield on numerous occasions as well as I have.  I have also received bills that the insurance company has not paid anything even though the plan says it covers these said items and I have to continually resubmit them to be taken care of properly.Therefore, the complaint has not be completely taken care of.Thank you for your assistance in this matter.Health & happiness,[redacted], [redacted]

Dear Revdex.com: This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on September 9, 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]

Dear Revdex.com: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 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 April 27, 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 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.

Dear 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]
[redacted]
[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.

Thank you [redacted].  The business has resolved the issues when I told them I was contacting your group.  They took care of everything within 2 hours. Please cancel the complaint.  Thank you!

I am rejecting this response because: this complaint is completed. However, I appreciate the information . I wish I had received it a year ago, but appreciate it being sent now. Thank you

This letter is in reference to the correspondence received by Blue Shield of California (Blue Shield) on June 17, 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, grievance 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] Executive Inquires 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]...

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.