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Customer Service Runaround from BCBS West Virginia

Update by user Apr 04, 2017

They are terrible at dealing with appeals. Customer service staff is either purposely trained to frustrate you or woefully under-trained.

Original review posted by user Apr 03, 2017
I had to fill 2 prescriptions before they were out b/c my son was traveling somewhat unexpectedly. I paid full price and then called them the next day. I was told to submit a reimbursement request to Express Scripts, they would reject it and then I would get instructions to appeal. 1. 1st letter from Express Scripts gives me no option to appeal except contacting their Civil Rights Coordinator 2. Civil Right Coordinator is dismayed that there were no appeal instructions and promises to resolve by talking to Customer Service 3. 2nd letter from Express Scripts has a Q&A, where it says to call the number on the back of your card to appeal (not making this up) 4. Call number on back of card on a Friday, 2.5 hrs later and after speaking with 4 different people from BCBS in addition to 2 different people from Express Scripts, I am told I must speak with Appeals Dept at BCBS, which is closed. 5. Last BCBS person tells me he'll call me at 9:30a on Monday. 6. At 12:30p on Monday, I initiate the call as no call came at 9:30a. 7. 2.5 hrs later, after speaking with 3 different people from BCBS (only 1 was from the Friday group) and 3 different people from Express Scripts (all different people from Friday), I am told that I must submit the appeal in writing. It is important to keep in mind that EACH TIME you talk to a different person, they are asking for DOB, Address, and call back number for security purposes. This only adds to the frustration. They all ask if it is OK to leave a message as well. I will find someone in that organization to hear this story as I feel abused.
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ID
#1029236 Review #1029236 is a subjective opinion of poster.
Location
Parkersburg, West Virginia
Reason of review
Poor customer service
Loss
$770
Preferred solution
Let the company propose a solution

Therapy Coverage Review

my 82 year old mother after having Blue Cross for 50 years broke her hip and the hospital could only put her in a nursing home for one month because Blue Cross will not pay for any more time in therapy or nursing care.they sent her home with an open wound in her hip and only three weeks of therapy to walk on a broken hip
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ID
#565872 Review #565872 is a subjective opinion of poster.
Location
Davis, West Virginia
Reason of review
Not as described/ advertised

DONT DO IT! CALL YOUR STATES ATTORNEY!!!

I have had BCBS since feb. I received a letter in the mail saying I had to pay 80.52 or my insurance would be canceled. So I did. I also paid some money on the current months premium as well. I owed less than one months premium, and they canceled the insurance. When I called and spoke to three different managers, no one was willing to help me. Less than 30 days before they dropped me, I was given a possible diagnoses of breast cancer and melanoma. NO ONE at the company cared. We had also just met out family deductible as well. Whatever you do, don't do it.
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1 comment
#899458

Yes agree call another insurance company. Sorry they gave you so much trouble don't let them eat up your positive energy.

ID
#556786 Review #556786 is a subjective opinion of poster.
Location
Martinsburg, West Virginia
Loss
$10000
Preferred solution
Let the company propose a solution

Bluecross Blueshield of west virgina

My husband and I a need proof of insurance certificate to give to my insurance company before having surgery. We have waited a month for the certificate to arrive and then when we received it, the letter had only my daughter's name on it. A large company like this should have competent individuals doing their job. We pay a lot of money for health insurance and should receive excellent customer service. I work in an Oncology office and I see first hand how insurance companies effect our patients and it is ashamed that an incompetent individual in an insurance office can make their lives miserable. I say do YOUR *** JOB. To the companies that keep letting these individuals work for them, grow some balls and fire them when you know they are worthless. Quit paying for them to be ***, taking smoke breaks, and coffee breaks. I have to make another phone call to wait on another frickin letter when they didn't do their job the first time.
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1 comment
#553334

This is supposed to be one of the best ones? Then we're in deep trouble people!

Two years ago, BCBS approved a surgery, then afterwards reneged - now I owe thousands of dollars to the hospital and surgeons (read their "disclaimer" about pre-certification and beware). Three months ago I broke my back and pelvis. The doctor wanted to perform immediate surgery to relieve the pain and help the vertebrae heal because I have severe osteoparosis. The night before surgery, the insurance company called and denied the pre-certification.

I appealed and they denied the appeal. I am still in a back brace and in severe and constant pain. Shame on you, BCBS!

I've been paying your premiums for 23 years and this is what I get? Beware, beware, beware!

ID
#339909 Review #339909 is a subjective opinion of poster.
Location
Gate City, Virginia

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