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Maureen of Needham MA (06/26/08)
In 2006, I filed a claim for testing on my son. He has a medical diagnosis and reason for the claim. It took over 18 months before Blue Cross paid the claim. In that time they tried everything they could think of, with no shame. They never received the claim, they received it but it was missing information, it was deleted by the system (time and time again), it was not a medical condition....it was mind boggling how many excuses they came up with. And not once did they call me to let me know the status, so I had to call and spend days of my time talking to yet another new associate, and find out where my claim was, and why it was rejected again.
Their incompetence truly works in their favor. Unfortunately, I have just had to resubmit a claim for the same test, repeated recently. I sent a cover letter with all pertinent info., and reminded them that they had paid for this in the past. So far it's been a month, and I've made four calls to check on the status, and had four different reasons for it to be denied to far. A new person, each time. Some info. I gave to them during one of my calls was typed in wrong, resulting in it being denied. This whole process kills me. Truly if the bill were small enough, I would pay it and just be mad.
A year and a half waiting for the claim to be reimbursed. Many hours on hold, and talking with different representatives. Even if you get their names, you can't seem to reach the same one twice. Despite our doctors recommendations, I can not bring myself to have my son retested this year, I was still battling with BlueCross, and we could not afford another unpaid claim. And I hate the thought of dealing with these folks again.
Gail of Geneva AL (04/10/08)
My nephew has Neurofibromatosis. Last Dec. he started having severe pain in his legs. My sister took him to be xrayed and doctors found fibroid tumors in his legs. He was put on pain meds. Did not stop the pain. Doctors wanted to put him on Lyrica. BC would not approve this medicine. Doctor sent an appeal letter two or three times to BC. Still nothing. Dept. of Insurance was notified. Still nothing.
My sister even contacted Anthem from the law firm where she works asking them to please allow her son to have this medicine. Nothing......Well, now my nephew was scheduled for a Pet Scan for this morning because the doctors want to rule out any malignancy because the pain meds aren't stopping his pain. He is taking oxycontin and amitrytiline(?)..they have even upped the dosage of oxy. to 15mg. twice a day.His doctor scheduled him for the Pet Scan. When they got to the hospital this morning @ 6:30, they found out BC had denied the test. It is bad enough to have the worry of your child being sick like this but to contend with an insurance company being so heartless is beyond words. My sister never did hear from the appeals to BC in regard to the Lyrica.
Consequences being..a young man weighing 93 lbs. having to endure severe pain just walking when changing pain meds might have helped him. I just hope everyone affiliated with this insurance company in the future when confronted with a loved one with a health problem remembers Aaron and his mother and how they refused to help when they could have so easily.
Donald of Virginia Beach VA (10/26/07)
My Doctor prescribed me Nexium (acid reflux) about two weeks ago and the insurance company is refusing to fill it. I've made numerous phone calls to the insurance company, and they state that it's still under review. They told me that they needed additional information from my Doctor's office before they would approve it. My Doctor has sent them the additional information that they requested on10-19-07 and as of today (10-26-07) they still state that it is under review. I have made about 10 phone calls asking what the status is, and their answer is always It's still being reviewed This is the only medicine that helps with my acid reflux. My Doctor gave me samples, and it worked great.
I've been in extreme pain with the acid reflux and I'm having trouble sleeping at night because of it.
Thomas of Oak Hill VA (09/12/07)
I acquired insurance through Anthem in 12/06. I had many claims which they did not cover, saying they were pre existing. I was told by a doctor that I should have knee surgery, which they said would not be covered for a year. The doctors office said according to their literature it should be covered. Then after approximately 6 months, they dropped me because I had moved. When I signed on with Anthem, a huge reason I went with them was because I was told they would cover me wherever I lived.
Now if I CAN get insurance, I will likely have waiting periods all over again.
I had to pay for multiple bills out of pocket, including a recent injury which requires PT. My knee is still painful.
Roberta of Lyons CO (06/21/06)
For several years my husband and I have had health insurance with Anthem. In January 2006 our insurance agent arranged to have my husband removed from our health insurance as he was switching to Medicare. I paid my premium in January as usual in the beginning of the month. In February I didnt receive a premium statement. Upon calling my agent I was told I would be receiving it shortly. In March I did not receive a statement and once again called my insurance agent. I was told that Anthem would be sending statements out shortly. In April, I didnt receive a statement and called my agent once again.
Within a few days I was told that Anthem said I was being dropped because of nonpayment. I was told, I could reapply which I did. I completed my application and sent it with a check for $287.90. The end of May I received a letter from Anthem telling me that my application was denied. I spoke with my insurance agent and asked him what they do with the check and was told they destroy it.
On June 13th check #3053 in the amount of $287.90 was paid. I called my insurance agent. Anthem said they didnt deposit the check and wanted proof. I sent a letter from my bank with a transaction history statement. Then Anthem said this was not proof enough because the check was processed electronically and I needed a legal document from the bank proving that the check had been cashed. I spoke with a representative from my bank who attempted to get such a document and was told they have no access to this. In the meantime I would like my money back and theyre not giving it to me.
Bonnie of Marion VA (10/01/05)
i have had what i have been told was the best health insurance to be had. i have been paying $2800 per mo. for myself, my husband, my son on a group policy for years with anthem. now, my son has a chronic pain condition with herniated and degenerative discs in his back. After much anguish and taking him to about 7 doctors, i finally found accucare interventinal pain center in milltown new jersey who think they can helf fix the pain problem. after sceduling consultation, paying for mri out of my own pocket and ready for the procedure this next week, anthem tells me they will not cover part of the procedures. Could you please help me understand why i cannot now depend on the insurance co. i believed to be the best, after paying such high premimums for all these years, i cannot get the help for my son that he deserves so much now from this insurance co who promised, represented themselves as the best?
if my son does not have the procedure for his back he must live in total agonizing pain from now on.
Michael of Monroe NY (05/10/05)
I have been trying to submit a medical claim to Anthem for the past 5 weeks. During one phone conversation the represetative stated I should mail the claim form to Empire Blue Cross & Blue Shield at P.O. Box 3877, Church Street Station, NY NY 10008. The claim form came back stating we had the wrong insurance carrier. We again called Anthem and they stated that we should send the form to Empire Blue Cross & Blue shield P.O. Box 5011, Middletown, New York 10940. They now state they have no record that the form was submitted. We are unsure at this time what adress is correct nor how to get reimbursed for $3400 in Medical bills. The representatives we spoke to refused to allow me to talk to a supervisor.
Besides the fact that I am paying approximately four time more for health insurance than last year (2004,) Anthem staff are poorly trained and unresponsive. The doctor required me to pay the bill ($3400) in advance because they will not deal with Anthem. This not the way I expect a Health Insurance Company to work.
Teresa of Perrysville OH (03/29/04)
IN Novemeber of 2003 Anthem Blue Cross and Blue Shield changed pharmacies for my daughters medication. When they changed pharmacies they picked Anthem specialty pharmacies for my daughters medicine. It is a very expensive drug and I guess they were trying to save themselves some money. To date the new pharmacies has not gotten a order right. The medicine bottles are broken when they arrive and they were 5 weeks late getting the meds to my house the first time. This medicine is a life or death thing for my daughter. I talked to servral different people when I called to get the meds and finally have gotten the same person who I can talk to each time. I however still cannot get them to do their job. Each time it is a chore to get the meds and each time there are broken vials. Each time I call they apologize and try to make things right however their excuse is they have no experience in this medication and are trying their best to fill the perscrition. They sent me a sharps container for used needles and I have no way to dispose of it. They just keep telling me they have no idea what to do with it. This is very frustrating and Anthem blue cross is of no help. THe last time I talked to some one there they said sorry but it is cheaper for them the insurance company to use this pharmacy. It may be cheaper for them but it is my daughters life. And to me that is not right.
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