janice b Gyj

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Verified Reviewer
| map-marker Portland, Oregon

Total right knee replacement

poor,poor insurance care after a total knee done on my daughter just close to a month ago and cannot get proper physical therapy and they wont correspond to what doc wants.Are you askilled doc in orthopedics and have you had a tkr done lately.The knee is freezing and you are the cause FIX IT.I am her Mom and and old ortho nurse and this is very wrong.

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User's recommendation: connect with insurance before surgery to see what they do or don`t do.

Anonymous
map-marker Portland, Oregon

Denial of treatment

Regence Bluecross Blueshield Of Oregon - Denial of treatment

My 39 yr old daughter has Wolff-Parkinson-White syndrome which is an extra electrical pathway between your hearts's upper and lower chambers which causes rapid heartbeat and can lead to death. She also has Dystonia....which causes muscles in the body to contract and spasm involuntarily.

They cause this mother of "4" sever migraine headaches. The "normal" treatment for Dystonia CANNOT be taken by a patient with WFW Syndrowme. If this is NOT treated she will develop tremors that cannot be reversed.

REGENCE BLUE CROSS OF OREGON, THROUGH UPS UNION....WILL NOT COVER THE PROCEDURE. If anyone reading this plea.....can help please contact her at 541-990-**** The comments on the Dystonia page are by her neurologist.

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Cons:
  • Rejection of medication to save my life
Reason of review:
Not as described/ advertised

Preferred solution: Deliver product or service ordered

1 comment
Guest

I'm very concerned with current insurance coverage issues due to my daughter being ill for 25 years -- we've endured such horrible physician input throughout these years and hearing this about the coverage I currently have makes me even more angry . .

. and nervous. One of my major diabetes meds was changed in the formulary two months after I signed up for Regence coverage . .

. making me feel like it was a bait and switch situation probably over money coverage (since the med I had been taking for quite some time was great) and the new drugs they suggested have NOT worked.

So sorry you and your daughter are going through all of this -- it's hard enough to deal with the day to day issues of caregiving and these additional frustrations are so uncalled for! Sorry for all of this ignorance on their part!

Anonymous
map-marker Portland, Oregon

Terrible, expensive, denial of procedures and care.

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Had to have my own private insurance after husband retired. Had BX OF TEXAS THEN.

NOW 1000 MONTH 10000 BEFORE THEY PAY ANYTHING, HAVE MS, asthma, ect. They took 3 moths to ok MS med. I'D been on for 3 years. They denie medication and tests for my diseases.

So far paid about 3.00 on one prescription. Pulmonologist concerned about spots in lungs. Deny CT scans.

Dealing with this company has caused stress and increased decline in health. Terrible!

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Reason of review:
Poor customer service
Anonymous
map-marker Portland, Oregon

Regence Blus Cross Blue Shield Customer Service

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Customer Service at Regence Blue Cross blue Shield is awful. I realize the need for them to ask providers to use the website, which I do because of the terrible interactions I have when I do call, but when something isn't clear on the website, a call to customer service is warranted however that is when the customer service representatives are rude and not helpful at all.

The first thing out of their mouths is always, have you looked it up on the website. Yes I have, couldn't find what I needed so I needed to call. I obviously don't want to subject myself to the rudeness so I avoid calling but when there is a need to call its rude every time.

If the representative isn't rude then the call gets transferred to "somebody else" several times only to be transferred back to the original number I called. You need to get better customer service and not be so rude EVERY SINGLE TIME.

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Loss:
$16
Cons:
  • Customer service
Reason of review:
Poor customer service

Preferred solution: Let the company propose a solution

Anonymous
map-marker Redondo, Washington

Refusal to Cover Benicar

With my prior insurance, I was cleared, after much screwing around with other medications, for Benicar use through (I believe it was) 2049 (which for me is my lifetime). Now, REgence refuses to cover my Benicar...

Please stop refusing my Benicar. I take Benicar because it works for me, no other reason. Please respond quickly; lack of proper medication is causing me undue discomfort. Thank you.

Sent via Regence webform on 08/28/2016.

If I messed around with another's medication the way Regence is messing around with mine, and the patient died, I would go to prison for homicide. If I die, I hope someone pounds a burning steak through Regence's heart.

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Reason of review:
Problems with payment
Anonymous
map-marker Lindon, Utah

Blue Cross Blue Shield pre-authorization for medications leaves me 2 months without medications.

I tried to fill a Nuvigil prescription on the last week of September and was told by my pharmacy that they will need to get a pre-authorization before they can fill my prescription. It usually takes about 2 weeks but this time after a month I still had no medications and the pharmacy gave up.

I had an appointment the last week of October with my physician who sent another prescription and I received a letter from Blue Cross Blue Shield of Utah stating that I am pre-authorized. My doctor called in the prescription right after our appointment and my pharmacist called me leaving a message that there will be a delay on my prescription. I assumed they meant that they were out and will get supplies later in the week. After a week I called the pharmacist for an update and was advised that they weren't out of stock, they were awaiting pre-authorization from my insurance company.

I called Blue Cross and the person told me that the pharmacy doesn't know what they are talking about and that I am pre-authorized for the prescription. I sent a letter and days later someone from Blue Cross contacted me to tell me that the person who entered in my pre-authorization entered in the wrong dates and they fixed it. Finally after 2 months my pharmacy called to inform me they have my prescription ready for pickup! Anyone know of an alternative to Blue Cross Blue Shield in Utah?

This isn't the first time I've had problems with their pre-authorization. A couple of years ago I was without Nuvigil for 6 weeks.

Luckily I am not reliant on Nuvigil to the point that I cannot function but still take it due to daytime sleepiness and falling asleep easily. Other than their pre-authorization I really don't have much complaints about Blue Cross Blue Shield.

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Reason of review:
Poor customer service
Anonymous
map-marker Eugene, Oregon

Denying claim payment is happening to me too!!

Ha! Denying claim payment is happening to me too!!

My daughter (3 years old) fell and hit back of her head at my friend's house on March 30th. She vomit twice that day, so I took her to the emergency room that night.

Today (4 months later), I got statement that Blue Shield won't cover any of it, and I need to sue my friend where it happend!

This is an accident (I was there too very close to her) and nobody can't predict or prevent that will happen.

So if my 3 years old fell from her back of her head on the street, and had to been taken to the hospital, do I have to sue the city?

This statement is ***.

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Loss:
$500

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