Blue Cross Blue Shield of Florida
Carla Gartrell, Member Appeal Associate Refused to pay a claim even though they authorized the visit

I took my wife to the Sarasota Memorial Hospital Urgent Care Center in Sarasota, after she was stung by a wasp. Before going there, I quickly checked the Blue Cross Blue Shield of Florida website to make sure the care center was an approved facility under our plan. It was.

The insurance company paid the bill submitted by the urgent care center, but would not pay the attending physician's bill, informing us he was not on our plan. How in the world is a patient who is close to going into shock from an allergic reaction to a wasp sting supposed to interview the employees, of an approved facility, to see what their employment status is? Apparently, this physician was a subcontractor to the hospital and not a direct employee. He was the only physician on duty at that time.

I followed the appeal process twice, all the time being reassured by Blue Cross Blue Shield of Florida employees that it was a mistake and it would be corrected. Not so. The last letter we received on March 7th said the appeal process is over and they're not paying and gave us a phone number and extension to ask any questions we may have, but the extension does not work. I had to spell out the name of the signatory to the letter and all I get is her voice mail and she will not return my calls after four messages.

Beware customers of Blue Cross Blue Shield of Florida that just because you are being treated in an approved facility, that they refer you to, the nurses and/or doctors there may not be on your plan. Pretty tricky isn't it?

Company: Blue Cross Blue Shield of Florida
Country: USA
Address: 532 Riverside Drive
Phone: 8889058783
Site: bcbsfl.com

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