Usacomplaints.com » Health & Medicine » Complaint / Review: Blue Cross Blue Shield of North Carolina - Will not respond to a valid claim. #916290

Complaint / Review
Blue Cross Blue Shield of North Carolina
Will not respond to a valid claim

In 2011 while working outside I experienced dizziness, disorientation and was light headed. I went in the house and after resting for a bit took my blood pressure (BP). The upper was over 190.

I called the BCBSNC 24 hr nurse help line and after talking with me the nurse insisted I go directly to the emergency room. However, being an individual that detests hospitals, and feeling better I elected to wait until the following morning and contact my primary care physician.

On explaining the events of the previous day and what my BP currently was, I was directed to go directly to the emergency room.

I did, all the tests for stroke, etc., were negative, and I was referred to a cardiologist who subscribed BP medication and subsequently brought my BP down.

Everything is good, right? Not!

Now I start getting bills from the emergency room doctors billing group for $1000 plus change. Since I had a EOB from BCBSNC say although the doctor was out of net work, the visit was covered due to emergency, I didn't pay any attention to the bill assuming sooner or later the insurance would pay.

Six months later the doctors billing group sent notification that they were sending it to collections. I then called them to find out they had not received payment. I called BCBSNC and was told they had initiated a payment voucher and sent it to me so it was my responsibility.

Guess what, no voucher! I called back and asked for a copy of the check voucher. The customer service representative for BCBSNC came back on the phone and admitted she could not locate a copy, or a record of my having been paid. She then transferred me to the BCBSNC finance group. I again asked for a copy or a record of the voucher. I was told it would take time as they would need to search the hard copies (isn't it the digital age?).

Weeks went by still no response, no copy and no record. So, I drafted a letter requesting BCBSNC to provide me with a copy or record, or initiate a payment voucher so I could pay the doctor and sent it registered mail. They got it. I've got the receipt. Still no payment voucher or documents that they paid the claim.

So, I'm now paying the $1K bill and another $25K that they denied on other claims. Swell. Great insurance. With BCBSNC I really hope I don't get diagnosed with something serious. These guys will bankrupt me.

Get everything in writing folks, and even then read those EOB like a legal form.

This company is slippery.


Offender: Blue Cross Blue Shield of North Carolina

Country: USA   State: North Carolina   City: Durham
Address: PO Box 35 Durham NC
Phone: 18887227441
Site:

Category: Health & Medicine

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