Luciano Y

Customer de-service

Customer service is atrocious, it takes me minimum 40 minutes to reach a USA customer representative, aside from reaching either the Filipino or Indian representatives which we know that culture plays the main reason why the quality of service will never be the same as here in the USA NEVER!!!! This happened not only once, in the past 3 years I have called Blueshield of CA many times spending sometimes more than 4 hours just to resolve simple problems every time I called, last year I was given a telephone number by a supervisor that assured me I would only connect to the US customer service, it did work twice, but then it went straight to India, nothing they say its reliable, they never return calls, it doesn't matter if they are representatives or supervisors ITS A SHAME THAT OUR AMERICAN VALUES ARE BEING THROWN AWAY INTO OTHER COUNTRIES FOR PROFIT, IT SICKENS MY SOUL TO BE IN THIS EXPERIENCE FROM ALL THIS GREED.
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Reason of review:
Bad quality
Adam B Ftd

You are better of with every other company

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they have no respect to your health nor your time. they will let you wonder around between dozens of different extensions, wase your time, deny your already approved claims, ask you to go through the ringer every time you ask for anything. do not, i repeat, do not select blue shield. under any circumnstance, as you provider. {{REDACTED}}
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Loss:
$500
Reason of review:
Poor customer service

Preferred solution: Let the company propose a solution

1 comment
Guest

Please return to school and learn how to spell ; creative writing would also be useful.

Ivori Bdc

Disgusted

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I still can’t believe that people are willing to work for these companies. It’s disgusting what they are willing to do to make money. They will make you jump through hoops and then still deny you benefits
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Reason of review:
Problems with payment
Anonymous

Horrible Company!!!

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Blue Shield has done nothing but screw my husband and me since we got our new policy in December. First they mixed our old policy with our new policy when it came to billing and then they decide to automatically withdraw a payment from our checking account WITHOUT OUR AUTHORIZATION!!!! This completely wiped all of our money out and put us in a real emergency situation. When I called to tell them I DID NOT authorize them to do this and demand they cancel the payment and refund the money, they had the balls to say it would take 30 DAYS!!!!! 30 *** DAYS!!!! I told them that, no, that was not an option and that they had better refund it today or tomorrow. You better believe that if they don't do that, we will be filing a lawsuit. Add that to the fact that our policy cost increased by $350 a month (Thanks, Obama) and you have a recipe for a complete disaster.DO NOT ever sign up with Blue Shield of California. They will take you for all that you have.
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Reason of review:
Poor customer service
1 comment
Guest

Unfortunately I have the same problem. It’s disaster. I really don’t know what to do and who can help me in this situation.

Anonymous

A bunch of idiots

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I've been trying to get my son medical insurance because the insurance provider he had pulled out of California & is no longer offering individual coverage. I spoke to a rep last week of December to see about adding medical to my current dental plan I have with BS. Rep took all my son info said it was going to underwriting & I would get a letter in the mail. Following week I received an email stating my application had been returned because I had to do it online. I proceed to apply online. before I submitted it I review it and realized the system had given it a 2/1/18 effective date which was wrong. I called member services & new applications depart. I spoke to several different reps who could not give me a straight answer or solutions how to fix this. Finally, one rep said to submit the application via email along with my supporting documents for "Special Enrollment Period" of 1/1/18. I submitted it last week. I called yesterday & today to confirm my application was received & get status update. After spending over 1 hours being transferred to various representatives no one person could give me a straight answer. Now they are telling me that the only way to apply is via online & they don't know to what department the email I was given goes to. In the meantime, my son remains without medical insurance coverage.
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Reason of review:
Poor customer service

Preferred solution: Let the company propose a solution

Anonymous

Call Center not in America

Blue Shield's call center is in the South Pacific (Manila). I sent in my payment via Visa pursuant to Law, during open enrollment.

Today is the 8th of January and they billed my card and refuse to send the Policy or even the Proof of Insurance card itself. I don't want a lousy card you print off the internet, anyone can make one up or steal it, where in the heck is the Card? Why is the Government allowing these individuals to provide services when they fraudulently refuse to produce proof that you are even insured. I did not get what I bargained for and when you call them, they hang up on you.

Nothing like giving personal information to someone in Manila.

Of course, I am told United Healthcare conducts business in India and the call center is in India, unless the phones are down, then good luck. I thought we were done with outsourcing jobs?Personal insurance information clearly should be conducted here.

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Loss:
$395
Cons:
  • Difficulty contacting a knowledgeable rep
  • Fraudulent behavior
  • Customer support
Reason of review:
Fraud

Preferred solution: Let the company propose a solution

Anonymous

Blue Shield of California

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I tried asking someone in customer service about a deductible that my boss wanted me to find out about and the woman named Krissy in Customer Service got my information including my contact number in case we get disconnected and when she asked for my email I was looking for the email associated with the account and she hung up on me. I thought at first we were disconnected but she never called me back so I called back and had to go through the operating system until she answered again and I told her that she had hung up on me and said "mm-hmm" and hung up again! I called a third time and I made sure to let her know that I knew her name and said "krissy, I was just on the phone with you!" then she proceeded Don't know which Country the operators are located in but she was incredibly rude and should be taught manners.
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Cons:
  • Customer service
Reason of review:
Poor customer service
Anonymous

Horrible customer service

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Asking for a US REPRESENTATIVE., They cancelled my phone call (call center) Blue Shield of California uses call centers
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Reason of review:
Poor customer service
Anonymous

In my opinion they regularly commit fraud

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They make you spend as much time as possible on things. Their execs should be in jail.
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Reason of review:
Poor customer service
Anonymous

Declined medication

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Blue shield is declining my meds all of the sudden. I am on suboxone and withdrawing due to blue shield. This can be deadly if you just stop taking the meds. They womt allow me to talk to my case manager and they wont allow me to escalate.
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Anonymous

RIP OFF

$630.00 premiums, over $6,000.00 deductible, Blue Shield KNOWS they have this all figured out to where they end up NOT paying a penny for anything....all this is, is a screw over to people, taking our money...giving us NOTHING. My so called "FREE" annual, can't find ONE Dr. in our area to provide this service!!!!! When I call Blue Shield asking for those providers, call those providers, they do not give/offer such service...15 of them in my area. I need a new car, our finally gave out, if I was not FORCED to pay BLUE SHIELD this type of money....I could get a car.... If I could get on welfare, I would get cash, food stamps, medical, dental. low rent...on and on, but NO, my husband is 80, yes, EIGHTY, out working in this heat to pay Blue Shield for NOTHING!!!!!!!
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Reason of review:
I liked being kissed when I am being screwed...(not listed on here)
Anonymous

Decided to not cover previously paid claim

Starting in September 2016 my orthopedist gave me the Synvisc series of 3 injections after pre approval from Blue Shield of Ca. Now, 5 months later I received a letter from Blue Shield that the coverage for this claim has been rejected so I am getting ready to fight it, rather than pay another $1500 for these injections.

After paying $543 a month for insurance, it is like pulling teeth to get this company to pay for anything. When they do, most of what I pay does not go towards my $875 deductible. I am sick of this insurance company. I will get Medicare soon and will switch to UHS Supplemental in hopes they will pay better on claims.

We are mandated to have coverage, at a huge price, then they don't want to pay claims. This insurance must be great if you don't need it.

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Reason of review:
Problems with payment
Mallorie Gpd

Stay Away from Blue Cross Blue Shield-Even Providers Have Complaints

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More than 2 years later, the same is still occurring. I have been on the phone 6 hours of my day checking on 10 claims that have been past due for almost a year. They have no answer so they send the claim back for reprocessing. Now their new excuse is due to a system migration we are behind on processing. No! Not the providers problem! No! Not the patients problem! I can't seem to understand how they can remain in business. All customer service representatives are now in the Philippines and they have NO CLUE WHAT THEY ARE DOING. My constant question to them...how long is this one going to take? They don't provide you with the correct information and calling on 1 patient led to 4 different answers, being hung up on, and waiting 30 minutes for a supervisor that still didn't know what she was doing. It's disgusting to think that people pay with their hard earned money to be bunked by these thieves. It's no wonder the North Carolina Department of Insurance issued an investigation against Blue Cross Blue Shield of North Carolina, along with the class action law suit they are facing. It's Blue Cross Blue Shield across the board that is the problem. Do yourself a favor, stick with Aetna, Cigna, Healthnet, any other carrier aside from Blue Cross or Blue Shield.
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Cons:
  • Being lied to and hung up on because i asked for a supervisor
  • Nonpayment of claims
  • Lack of average processing of claims
Reason of review:
Problems with payment

Preferred solution: Replace your Customer Service Dept with people we can understand and are qualified to perform the job. Hold your claims department accountable for numerous mistakes. Make supervisors accountable for not "escalating" claims that are pending for a year.

4 comments
Guest

Same thing....HOURS on hold....THEN I get the Phillipines, I asked to be transferred, what did I get, disconnected. I have had a claim for months, I pay over $500.00 a month, my deductible is over $8,000.00. Going to FACE BOOK, see what others are saying...I need to get rid of Blue Shield!!!!

Guest
reply icon Replying to comment of Guest-1283748

The only thing I have found that may be helpful is filing a complaint with either the Department of Managed Health Care of the Department of Insurance. It depends on what state the plan was created in or something to that nature.

For instance in the state of California. I will usually file my complaint with the Dept of Managed Health Care and they will let me know if they have jurisdiction over the plan. Seeing my original post and looking back at how much I've learned is exhausting. We still continue to have issues with them to this day, but what I did notice, that was interesting is that the Department of Managed Health Care actually provides a break down on the number of complaints filed by providers each year.

I was surprised and a bit frustrated to see the numbers were so low because I know there are tons of providers having the same issue and I don't think this tool is being utilized to the full extent.

As long as you have issued the provider dispute or member grievance, you should be able to file a complaint with an outside agency not affiliated with the carrier. Hope this helps a bit.

Guest

Yes, I agree completely. They are at the bottom of the heap and there is no one to complain to because when you hold for a worthless supervisor, you listen to their ridiculous music for half an hour and then they hang up on you. Providers should refuse to accept Blue Shield or Blue Cross patients and perhaps BS/BC would take these complaints more seriously.

Guest
reply icon Replying to comment of Guest-1276821

We have threatened to no longer service Blue Cross members and their representative actually said this would probably be best. Yes, that is exactly what he said.

They don't care about the members, they care about you paying your monthly premium and denying as many claims as possible. Just recently Anthem tried to buy out Cigna and it was blocked by a federal judge. The purchase price....$54.2 billion! With denying claims as much as possible and servicing members and providers from a country that reads from a script and does nothing to resolve issues that actually aren't even employees of Anthem, it's no wonder they have so much money to purchase other companies.

It's not because they have amazing customer service and everyone wants their services, it's because of their internal process that allows them to reap the benefits and them not advising you of their full process of appeals and so on. They are not here to help members or providers, only themselves.

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Anonymous
map-marker San Jose, California

Don't buy B.S. EPO/PPO products

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I am a medical doctor, a hematologist, saw patient on an emergency request by the patient's hospital primary care MD. B.S.

refused to pay on the basis of lack of prior authorization and I was not a contract provider, but where to get prior authorization at night? They are not available at but MD are always working. Not enough MD's sign up with them anyway. I am billing the patient now.

The patient now paying double, to B.S. and to me. Next time I will not see their patients. I would ask the other MD what insurance first before I hear the story as I hate to deny care in an emergency situation.

I hope it will not be you, the B.S. patient.

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Cons:
  • Lack of services covered
Anonymous

Blue Shield Of California - Review in Insurance category

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I enrolled with blueshield CA only because I met the age requirements on my parents insurance and was kicked off. I called to buy insurance with blueshield and they told me to go online. Note I am a high risk pregnancy and need to see a doctor in 4 weeks for a surgery to save my baby's life's or my baby dies. I express this to blueshield so they can start my coverage at the beginning of next month and not 2 months from now. They said no problem as long as I have proof. When I called back I was transfer 24 times to 24 representatives that didn't know how to do their job or help me all they said was hold on let me transfer you. 1 hour and 45 mins on the phone only for them to hang up on me. Their customer service sucks! Now they are saying they can't move my coverage? Umm okay then refund me my money so I can go with someone else. I will not be doing business with them again. Who pays for medical coverage that can't start for 2 months from now?
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1 comment
Guest

When you apply after the 15th day of the month, your insurance will start on the 1st day of the 2nd month. This requirement applies to all qualified insurance plans - it is not a Blue Shield rule.

What you need is an insurance agent to take care of you and explain how all of this works.

It does not cost you anything to use an insurance agent to eliminate all these frustrations. Lori 818.518.8895.