Carefirst Bluecross Blueshield

BEWARE OF CAREFIRST BLUECROSS BLUESHIELD

PLEASE READ THIS COMPLAINT, AND THEN YOU WILL CHOOSE ANOTHER SUPPLEMENTAL INSURANCE CARRIER

My mother, Eileen Raymond passed away in October 2020 at the age of 97. She had CareFirst for decades as her supplemental health insurance.

I reported her death to CareFirst, Wells Fargo and Westbanco and closed those accounts to prevent any future fraudulent monthly billing.

Care First assured me that I was due a refund for the balance of the month. I told them that my mother's credit card was inactivated. CareFirst said they would send a refund check. Wells Fargo assured me that her credit card was immediately inactivated and there would be no further transactions allowed.

In February I realized I had received neither a refund nor a letter of condolences from CareFirst.

In the following three weeks I made many calls. Each time I was told by the person I spoke with that they would get back with me. I requested to speak with a supervisor with 4 different agents. My requests were denied.

Finally, I was told I had to complain to Wells Fargo.

Apparently, CareFirst sent two refunds of $838.87 and $6.91 to Wells Fargo in December. Wells Fargo told me to contact CareFirst and simply have then rescind their refunds and then send me a check. Further conversations with CareFirst again was just a waste of time.

They have never provided me with any written or verbal response, indicating why they would not send a refund as promised.

How can CareFirst issue a refund to a credit card to a member's credit card after she has passed away, and they credit card has been cancelled? It is their responsibility to issue a refund to the appropriate party.

It is pitiful the way that CareFirst has treated mey mother spent tens of thousands of dollars over 30 years and now they will not send a refund.

Tony Raymond

973 Circle Drive

Baltimore, MD 21227

(410) 247-****

traymond51@***.comChoosehooshoo

I had some testing done. Four separate charges.

Two were approved, two required “lab reports.” Talked to Carefirst to see what they needed, then to my provider, and they faxed a package to Carefirst. My provider sent me a copy with a fax confirmation. Carefirst never received the package. I called again, and was instructed to mail the package to carefirst, which I did.

Explanation of benefits came back, and again, it had a code saying that Carefirst needed lab reports. I called Carefirst again and asked them what they needed on top of what was already sent (including results of lab tests and diagnoses). They said they needed “a lab report with codes on it” and it should be like, five pages. Obviously the rep had no idea what she was talking about.

I asked to talk to someone who could explain what BCBS needed to process the claim. She refused. She acknowledged that she knew no more than I did from the face of the explanation of benefits. It’s this bizarre Kafkaesque situation in which I’m being told that additional information is required, but they’re refusing to tell me what kind additional information they need.

No help at all. So my claim, 13 months later, remains in limbo.

I called Carefirst a few times regarding my claim. Had to wait until 30 minutes until someone was able to talk.

I had an out of pocket claim that is supposed to be processed by Carefirst a few months ago. Apparently it was rejected for rubbish reason, including diagnosis not recognized. To make thing worse I did not even get any notification of the status of my claim and waited for months until remember to call them just to check the status of my claim. First time call on the case was useless, they were saying the diagnosis code do not match their database.

The doctor has been using this for this without any problem. Second call they said the NPI number was unreadable although it was clear and the doctor has served thousands of patients nationwide. After a few calls and getting the doctor talking directly to the Carefirst customer support personnel Carefirst agreed to reprocess it. I thought the issue was resolved, apparently not the case.

I called again after 10 days and realized there was another unreasonable issue - the diagnosis and treatment that the doctor wrote was not clear. After long argument with Carefirst rep after clarification with the previous representative handling the case it as agreed that the claim would be processed and I should receive the notification about explanation of benefits. It looks like I need to file a national complaint and sue this company because their behavior. They just try to avoid paying you and find all reasons and excuses.

If I had a better choice I would go somewhere else. A very very disappointing service!!!!!