Anthem Blue Cross Blue Shield
reviews and complaints

I work in the medical field and have been coming across a large number of patients being denied for replacement cpap machines by blue cross blue shield of minnesota despite their machines being 5 years old and the reason they are denying is because despite the 5 year replacment rule patients are also reqired to provide documentation that states their current machine is broken and cannot be fixed. This is not ok its recommended that cpap machines be replaced every 5 years regardless of their condition patients should not be forced to use old or malfunctioning machines until they completely stop working if they pay for insurance they should be getting the equipment or medical supplies that they are entitled to a doctor prescribed tehm a replacement cpap every 5 years for a reason. I personally suggest mot using bcbs as your insurance provider because patients often have to fight for an extended period of time just to get medical treatments that are necessary

My mercy primary dr. Sent me to mercy windham qickcare because I woke up with face neck and throat swollen struggling to swallow and they sent me to emergency room at mercy hospital now anthem refuses to pay anything because they say it was out of network even though its still mercy care I talked with them they refuse to pay I did not choice this location I was sent by primary dr. Because of an emergency now they say I have no choice but pay or there sending to collection to ruin my credit the acc#[protected] now demanding payment of 300 dollars its like highway robbery with out a gun is there no help anywhere this is just dead wrong and has caused me and my family to cancel all doctor appointments from now on we will wait till we are rushed to the emergency room there should feel nothing but ashamed by these insurance companies an the workers that push these harmful policies the one thing your good for is taking our premiums then denying coverage so we all die a slow painful death

I requested that you review my claim because you charged back part of your payment to Wellstar Health on my behalf. I received outpatient surgery on 7/27/2022 at Atlanta Medical Center. I received prior approval from you that the charges and facility would be coveredin full. You paid the bill but later took back part of that payment. I was not notified of the chargeback until Wellstar Health began billing me for the chargeback in April 2023.

I filed an appeal but you refuse to review it based on a 180 calendar year restriction. Had I been informed of your chargeback i would have filed an apeal sooner.

Please review the claim/appeal and pay the remaining balance of $6,343.48 to Wellstar Health because the surgery and facility was preapproved and authorized by you.

Sincerely,

Thresa M. Palmer

564 Heather Drive

Lithia Springs, Ga. 30122

#404.276.9838

My Primary Care Physician was somehow flagged as "out of network," but I don't believe that is true. They automatically assigned me (a 77 yr, old male) to a pediatrician who allegedly practiced 18 miles away from my home (and didn't). I have contacted the Dr., his office manager, the insurance company 3 times and this is still not resolved. I am now on hold wasting another hour of my time waiting for them to check records and report a status.

My employer has offered Anthem- BCBS health insurance policies for may years now. I have been going to Central Missouri Dermatology for quite sometime as well. They offer a great serve to our commuinty. However recently I found out that Anthem-BCBS has not offered them a Full contract! Thus resulting in this group being out of network. I am dishearted by this decision. Not only have I been going for year check ups other family member have as well. Which is a bonus that I do not have to go through there life history as well. Now I am expected to find someone else that is in network that is as good!

This is not a complaint regarding a doctor. This a complaint regarding Anthem insurance. I have been a member of Anthem insurance since December 1, 2023, when I changed jobs from one company to another. My current contractor only offered Anthem Blue Cross/Blue Shield. I take a prescription medication, Amlodipine Besylate 5 mg tablet to control my blood pressure. Since switching over to Anthem from my previous insurance provider, my prior physician on another health insurance program, provided approval for my medication monthly. Today, I realized I only had one of my pills left and I had not identified a new physician with Anthem, so I contacted Anthem to request how I could get my medication. I was told that I would need to select a physician in the Anthem system to prescribe my medication. I was told that after identifying a physician to prescribe my medication, it would take 1 week to 2 weeks before I would have my prescriptions filled. I when I told the Anthem lady with whom I was speaking, that I needed my medication, she told me that I probably should call my current physician and maybe he could prescribe the medication for me. I told the lady I was speaking with that he could no longer prescribe my medication because I was no longer a member of the insurance company for which he was under.

I do not take my medication just to take medication! I have to take it because of my blood pressure. I would think that since I pay Anthem for insurance coverage, someone at Anthem would have a little more concern for my health issue. I am disappointed in how the non-concern of the woman I spoke with and I hope this is not the norm for Anthem's health care service.

Will not give my pregnant wife Health Insurance until I can provide proof,I am covered under TriCare which I do not qualify for anymore. They made her pay for the healthcare plan and do all of the information, then told her I need to provide proof of Healthcare. Which to me defeats the purpose of getting healthcare with anthem. My wife makes too much to get medicaid, and is pregnant. I feel this practice is wrong.

Denial of coverage of medical equipment during COVID. It was unavailable from any of the approved providers. Due to the risk to my husband's life, I was forced to buy it from a provider who was NOT in network. It cost $3000 and was an approved item. Rather than pay me what they would have paid an approved provider, they paid me a whole $25 for that claim. That tells you what kind of a company this is. Supply chain issues, COVID issues and two years almost of denials as I worked my way through the system and I am out $2975 on a covered piece of equipment. No common sense what so ever. I never expected to get the whole 3000, but I did expect to get what they would have paid the provider.

Anthem does NOT care about the patient, just the contract.

When I switched to anthom, I was told I would get all my meds the same as I had then. Now they sayi cant have my brand name as I had, but this oblong genric pill. Me and my doctor want what I had for the past 20 years. It is not the same, and I find the round pill is easier for me to swallow. Calling you people on the phone totally sucks, takes way way to long, cant hear, and the folks u have are not to professinal or proficent in their jobs. Some young collage kids. Ill be swithching back to the carrier I had before, had no problems [protected] home after 5 george medrek

We were lied to by a agent about our otc cards being used at wal mart. And my ent was not on the list.
Was told wal mart was availabe online with your co. It is not. Now it can't be used in store, the on line only option is itotal waste, overpriced off brand items, no meats no vegatables. $175.00 of wasted money from the govt. Per person. In your scam. I have filed with bbb mo. Attourney general and state ins regulations.

I have been in pain for 20 years and my doctor has recommended a procedure that will finally relieve this pain it would involve removing the deep scar tissue that is the root of the problem with a procedure that has a cpt code that is covered with my plan! But someone behind a desk at anthem has decided that it's not medically necessary to relieve me of this pain and had decided that I should continue to live with it. How is it possible that a procedure that is covered by a plan that I pay for can be turned down by someone in the back office? When my doctor requested a peer to peer review so they could answer any questions they might have about the procedure they were turned down by the peer to peer department because they said my authorization was turned down so they will not even listen or review my case. I thought the reason for the peer to peer team is to help with this process, but to not even give my doctor a chance to explain why I need the procedure that is part of my benefits is completely cold and heartless. The notes on the request clearly state that the patient is in pain and has been for over 9 years! My only recourse is to file an appeal... Basically, blowing me off. If they will not speak to my doctor when requested why should I have any faith that some suit will read my appeal and grant my procedure. It is not fair to make me pay for insurance and a service that they do not provide. I really feel like this company is a scam. I used to have cigna and never had any issues with them, but now that my husband has changed companies we got stuck with anthem. My next letter will be to the company to request that all their locations change providers from anthem and offer a company that actually cares about their members.

I received a card with $200 loaded on it. I verified the balance at [protected]. It said the card was ready to use. The card was declined everywhere that I tried to use it. I tried to use it with and without the PIN. I thought maybe the card was defective so reported it damaged. The automated line said the card was canceled but they would not send a new card. Now I am out $200! I tried to call member services for my insurance as instructed and they do not know anything about this program or how to re-issue my card.

The phone call was Friday, September 9, 2022

My husband is paying $63.00 a week out of his paycheck. When he discovered that he had health issues the insurance said they would not cover his treatment until the deductible is paid.

They wanted $400.00 up front. With the complete deductible of $800.00 for any further procedures

What is being expressed is the money is more important than the person.

Complaints Board,

My name is Dana D Nafus, I am a retired firefighter, from the El Dorado County Fire Protection District, in Camino, California. I have been trying to make contact with the benifits person for over a month. The first week I left a message/voicemail to please call me back. I have some questions I need answered on my health plan.

I have been stoned walled as I said for over a month, no contact of any kind. I worked for them from 1983 to 2004, seen lots of sloppy management. I feel this is a new high in sloppy.

The fire dept address is 4040 Carson Rd, Camino, CA. The phone number is 530/644/9630. My phone is 530/626/1451, I'm at 6300 El Dorado Street, El Dorado, California. Thank you.

They are deducting $153.64 each week from my paycheck, I am still paying for routine doctor visits and prescriptions. That is nearly $8,000.00 per year. I think that this excessive amount being deducted from my paycheck each week when I am still getting bills from health care providers and paying co-pays and for my prescriptions. It is a total rip off.

I work for a provider and we deal with getting retro authorizations through the AIM Portal. I have been having this problem for over a year (2021 & 2022) When ever getting these authorizations after the procedure has taken place causes problems with BC paying the approved procedures.

I have had to fight for month's to get an authorized procedure paid for. I have the authorization number and even send a copy of this authorization but I continue to get denials saying that I need to submit this to AIM. I have also had to on several occasions appeal these and still get denied.

I have called AIM on trying to figure out what the problem is and according to the reps I talk to from there they said as soon as they approve or deny a procedure the information is uploaded to Anthem BC. I have talked to your reps on many occasions on why this seems to be a problem and I never can get a straight answer. I have asked to speak with a supervisor but never get transfered. It just does not seem right that these authorized procedures are not getting paid in a timely fashion it should not take months to get these paid once they have been approved. Any help would be useful in getting this problem taken care of.

I am Kendall Phillips, I am the Director of Accounting and TRU Community Care in Lafayette, CO. We have been getting odd contract denials when if comes to our billing. Our billing team has spent hours on the phone trying to get information and explanation but one service member says one then and another says another. It is like the system does not have the same information. We have tried to get a contracting representative, but to no avail. In fact, no one calls us back. Our concern is that we have no recourse and this is on purpose. We have asked, called, emails, and talked to representatives who gave wrong information, so we are considering going to the insurance commission about this company. Please contact me at [protected] if you would like to help resolve this issue before we contact the commission.

I know this letter is not going to help, but after having Blue Cross insurance for over 60 years, I believe I have been treated very unjustly.

Blue Cross has denied paying for a surgery I needed due to severe shoulder pain, where I had a hard time sleeping and couldn’t raise my arm above my shoulder. I did not want to have surgery but had to if I wanted to be able to function with activities I normally do.

I had a similar issue with my right shoulder years ago and Blue Cross covered the surgery, which doesn’t make since that they would not cover the same thing on my left shoulder.

I went to the surgeon who suggested injections first which I did, then suggested therapy, which I did, including therapy at home since it was during the epidemic, none of this helped. Therapy just put me in more pain every time I did the exercises they recommended.

My surgeon said they had preapproved the surgery, (I don’t have proof of they did, only what they have told me). If this was preapproved, how can it all the sudden be denied, leaving me with a bill for the surgery.

You probably do not care, like most insurance companies you make money not covering expenses if any way possible.

The last letter you sent me said my only other course of action is to seek legal action if I didn’t agree with you refusing to cover the surgery. Not sure if I can afford an attorney but seems like that is what you are telling me to do.

Member ID 801M79748

Case Number APP-COMM-830009

Michael Limbers

I cant get money back for my claim and no one will talk to me. When I call,Im just left on hold.

James Daloisio