response because: I was clear before: a 30 day time frame is unacceptable in light of the first inquiry on March 7. "up to 30 days, maybe sooner" is equally unacceptable. I will disputed the charge and cancel my health plan if not resolved by March 28.
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: 10106466
I am rejecting this response because: When I wasn't getting any help from Anthem in getting my claim processed, I called the Department of Managed Health Care to see what recourse I had, if any. They told me I first had to file a grievance with with my insurance company and give them 30 days to resolve it. If I didn't get any results, my next step would be to file a complaint with them, which I just completed. I took the proper steps, filed a grievance with Anthem which gave them 30 days to respond, and nothing was done with it. I don't see the logic in taking 2 steps backwards and giving them another 30 days to do what should have been done earlier, or at the latest after I had filed a grievance. At some point the delaying has to stop and a simple claim needs to be processed and a provider has to be paid.
Regards,
Michele Lilley
Complaint: 11422204
I am rejecting this response because: I am a member and the letter from Anthem Blue Cross and Blue Shield stating they may cancel my insurance for non payment had their California address on...
it. My member number is 53[redacted]7.
Regards,
A[redacted]
Complaint: 10088686
I am rejecting this response because: They are not even acknowledging my complaint. They are stating I received...
a written response on 5/14/14 which I already knew. I responded to the letter right away and faxed my proof of coverage immediately. I attached all the information I submitted to them in my previous complaint. I want them to acknowledge why the only refunded $353.33 of the $1,074.80 they withdrew from my checking account. As I mentioned before, if you would like me to provide bank statements showing the charges and my Verizon call logs I can upload them immediately. The response I received from [redacted] from the grievances and appeals department was they would make an administrative exception to cancel you plan effective January 1, 2014 if I could provide evidence that my previous policy was effective January 1, 2014. As you can see in my previous attachment, this documentation was provided. Please note the document sent to me on April 14, 2014 also stated: Once I receive this information, I will have the plan retroactively cancelled and a refund of premiums. This did not happen.
What makes me question their process is the fact that my calls to cancel in January and February were to the same person and she told me to give her the contact information (phone number) for my new insurance carrier so they could verify. I gave her the number and she gave me a confirmation number so I know the policy was cancelled. In March when I noticed I was charged for my premium again, I called in and gave them the confirmation number. The person on the phone said there was no such confirmation number in the system. It wasn't until April 11th that I found out I was getting the run around and needed to fill out a grievance form and fax it in. Please see the email below:
As we now have the member completed health plan ID number, we are initiating a grievance for this member. They will receive a written response within 30 calendar days.
Complaint: 9973334
I am rejecting this...
response because: I was clear before: a 30 day time frame is unacceptable in light of the first inquiry on March 7. "up to 30 days, maybe sooner" is equally unacceptable. I will disputed the charge and cancel my health plan if not resolved by March 28.
Regards,
[redacted]
We are unable to locate this member. Please have the member provider their health plan ID number. Thank you.
[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: 10106466
I am rejecting this response because: When I wasn't getting any help from Anthem in getting my claim processed, I called the Department of Managed Health Care to see what recourse I had, if any. They told me I first had to file a grievance with with my insurance company and give them 30 days to resolve it. If I didn't get any results, my next step would be to file a complaint with them, which I just completed. I took the proper steps, filed a grievance with Anthem which gave them 30 days to respond, and nothing was done with it. I don't see the logic in taking 2 steps backwards and giving them another 30 days to do what should have been done earlier, or at the latest after I had filed a grievance. At some point the delaying has to stop and a simple claim needs to be processed and a provider has to be paid.
Regards,
Michele Lilley
Complaint: 11422204
I am rejecting this response because: I am a member and the letter from Anthem Blue Cross and Blue Shield stating they may cancel my insurance for non payment had their California address on...
it. My member number is 53[redacted]7.
Regards,
A[redacted]
Complaint: 10088686
I am rejecting this response because: They are not even acknowledging my complaint. They are stating I received...
a written response on 5/14/14 which I already knew. I responded to the letter right away and faxed my proof of coverage immediately. I attached all the information I submitted to them in my previous complaint. I want them to acknowledge why the only refunded $353.33 of the $1,074.80 they withdrew from my checking account. As I mentioned before, if you would like me to provide bank statements showing the charges and my Verizon call logs I can upload them immediately. The response I received from [redacted] from the grievances and appeals department was they would make an administrative exception to cancel you plan effective January 1, 2014 if I could provide evidence that my previous policy was effective January 1, 2014. As you can see in my previous attachment, this documentation was provided. Please note the document sent to me on April 14, 2014 also stated: Once I receive this information, I will have the plan retroactively cancelled and a refund of premiums. This did not happen.
What makes me question their process is the fact that my calls to cancel in January and February were to the same person and she told me to give her the contact information (phone number) for my new insurance carrier so they could verify. I gave her the number and she gave me a confirmation number so I know the policy was cancelled. In March when I noticed I was charged for my premium again, I called in and gave them the confirmation number. The person on the phone said there was no such confirmation number in the system. It wasn't until April 11th that I found out I was getting the run around and needed to fill out a grievance form and fax it in. Please see the email below:
Complaint: 9913911
I am rejecting this response because:
30 days?!?! What are these deadbeats doing? This is just as bad as what I...
went through yesterday. Handle it now!
Regards,
[redacted]
The health plan has initiated a grievance for this member. She will receive a written response from the health plan within 30 calendar days.
The health plan has initiated a grievance for this member. The member will receive a response within 30 calendar days.
As we now have the member completed health plan ID number, we are initiating a grievance for this member. They will receive a written response within 30 calendar days.
The health plan has initiated a grievance for this member. He will receive a response from the health plan within 30 calendar days.
This person is not showing as an Anthem Blue Cross member.
Complaint: 11464471
I am rejecting this response because: I've already waited a month. I'm not going to wait another month just to be...
rejected again. Part of my request was that it be handled in a timely manner but I guess you didn't read that part.
Regards,
T[redacted]
The health plan has initiated a grievance for this member. The member will receive a response from the health plan within 30 calendar days.
Our records indicate this member's concerns were addressed by Anthem Blue Cross customer service on 12/29/14.
This member's complaint was resolved by the health plan on 6/9/14 via a telephone call.
Claim was paid in full by Anthem Blue Cross on July 18, 2016.