Blue Cross California
Reviews and Complaints

So, we got this message from a patient saying we ain't in their network. We checked with an Anthem rep and turns out it's true. But here's the thing, nobody bothered to let us know. And now, when we ask for a disenrollment date, they straight up refuse to give us one. I've been calling different numbers and even tweeting at them, but no luck in getting a date. It's frustrating, to say the least.

On January 1, I started an AARP Medicare Advantage plan. From 1-1-2016 to [protected], a trustee in Hudson, NY handled everything. But on [protected], I found out that premiums were still being paid. The last claim was filed on October 20. At 4:54 PDT on [protected], I talked to K and canceled my policy. K told me that since another policy was paying the claims, not Blue Cross, I should get a refund. The amount I overpaid is $41,150.00. I've been dealing with Multiple Sclerosis for 30 years. After 1-1-2016, AARP Medicare Advantage took care of all the claims, not Blue Cross.

Me and my fam have Anthem Blue Cross for our health insurance from my job at Salinas Valley Radiology. My wife just had a baby and we got hit with a bunch of medical bills. But guess what? Anthem blue cross won't give me the full lowdown on all my claims. They only send these lame summaries that my other insurance company won't accept. And get this, I can't even download the detailed explanations of benefits (EOBs) that show what Anthem isn't responsible for. When I try to call them, it's like talking to a brick wall. I was on hold for a whopping 2 hours until my phone died. I even have a concierge service that my plan covers, but they're useless because Anthem only wants to talk to me, the policyholder. And don't even get me started on their online requests. They're straight-up ignoring me.

Our health provider filed an insurance claim for my wife in September . It's clearly covered (except for the copay) under the terms of our plan at the time. For more than 6 MONTHS, I got on the phone with Anthem nearly 10 TIMES trying to resolve the matter. They claim I had a conflicting plan, but that plan is ALSO WITH ANTHEM, and had been terminated, and they have REFUSED to fix it. Finally, they approved the claim. Then, I heard from my medical provider that Anthem was asking them to RETURN THE MONEY previously paid to them for the claim because it had been approved in error. Anthem is trying to STEAL money behind my back that it already gave to my medical provider. I now see the claim AGAIN listed as "denied". This is easily the worst company I have ever done business with.

I had a mammogram scheduled for August 5, which was a preventative screening. I sent in my order from my doctor with billing code 12.31 to Methodist hospital. I was told by the appointment taker that my order needed to be changed. She gave me the information, and I sent it in without thinking much about it. On the day of the visit, I was told that I had to pay $673. I felt like I was being scammed. I explained that I couldn't afford it and offered to make payments to ensure my health was taken care of. I expressed my concerns to the hospital, and they conducted an investigation. However, they concluded that I was responsible for a bill that my insurance should cover for free. I went to BCBS to seek clarification, but they told me the same thing. I'm really disappointed by this situation, especially since the procedure is supposed to be covered, and I don't have any breast issues. It feels like a complete scam. We pay so much money for our monthly premiums and visits, and yet we are treated this way. It's just not fair how BCBS treats its customers. They did not fulfill their end of the agreement.

Sept. 2021, I went to a medical care facility to get a rapid antigen COVID test for travel. I paid $100.00 directly to the medical office from my own pocket. However, the medical office refused to bill my Medicare and Blue Cross insurance. As the insured, I made sure to submit all the necessary documents to both Medicare and Blue Cross multiple times.

Fast forward to December , I needed another rapid antigen test for travel. I went to a different medical facility and once again paid $100.00 directly to the medical office. Unfortunately, they also refused to bill my insurance, which includes Medicare and Blue Cross Blue Shield. Frustrated, I sent copies of all the invoices, bills, and payment receipts to both Medicare and Blue Cross. Despite my efforts, both insurance providers refused to reimburse me. I submitted all the required documents and proof of payment three times to both parties.

To my dismay, I received Denial Letters from both insurances stating that my claims were denied. They were blaming each other for the situation. Medicare says that Blue Cross should be the one to pay me back, while Blue Cross claims that Medicare should cover the expenses. It's a never-ending cycle of finger-pointing, and I'm caught in the middle without any resolution in sight.

we have provided all the necessary information, we have not received any confirmation or acknowledgment from Blue Cross California. It is quite frustrating as we have been loyal providers for such a long time.

Another issue we have encountered is the lack of clarity and communication from Blue Cross California. We have tried reaching out to multiple contacts, but it seems like we are constantly being redirected or put on hold. It feels like we are just another number in their system, and our concerns are not being addressed.

Furthermore, the website of Blue Cross California is not user-friendly at all. It is difficult to navigate and find the information we need. The layout is confusing, and it takes a lot of time to locate the specific forms or documents we are looking for. It would be much more convenient if they could improve the website's design and make it more accessible for providers like us.

In terms of claims processing, we have experienced delays and errors. It often takes a significant amount of time for our claims to be processed, and when they are, there are frequently mistakes in the reimbursement amounts. This creates additional work for us as we have to go back and forth with Blue Cross California to rectify the errors.

Overall, our experience with Blue Cross California has been disappointing. The lack of communication, the difficulties with their website, and the issues with claims processing have made it challenging for us to continue providing quality care to our patients. We hope that they can address these concerns and improve their services in the future.

My healthcare plan has a $7850 Out of Pocket Max. It took me several calls to Anthem BCBS to even get this basic information about my healthcare plan agreed to. I have over $35,000 in medical bills from my COVID hospital stay in February . Anthem BCBS has not processed the provider bills correctly. A big example is the hospital bill for the service dates of 2/14-2/23, with a total bill of $34,889.08. Anthem is saying I should pay $10,916.12. According to my $7850 Out of Pocket Max, this statement should not require me to pay more than $7850. Additionally, because I have already separately paid doctors and other bills this year, the amount I should have to pay on this bill is only about $5000. Anthem BCBS takes my calls, but I spend an hour explaining the whole situation every time I call in. They always say they are going to do something, but they never follow through. They also do not call me back with updates. I have to call them back to find out that they have done nothing. I need BCBS to take action to avoid the Provider collections process.

Sept. 2021, I went to a medical care facility to get a rapid antigen COVID test for travel. I paid $100.00 directly to the medical office from my own pocket. However, the medical office refused to bill my Medicare and Blue Cross insurance. As the insured, I submitted all the necessary documents to both Medicare and Blue Cross multiple times.

In December , I needed another rapid antigen test for travel and once again went to a medical facility. I paid $100.00 directly to the medical office. Unfortunately, the medical office once again refused to bill my insurance, which includes Medicare and Blue Cross Blue Shield. I made sure to send copies of all the invoices, bills, and payment receipts to both Medicare and Blue Cross. Despite my efforts, both Medicare and Blue Cross refused to reimburse me. I submitted all the required documents and proof of payment three times to both parties.

It's frustrating because Blue Cross says Medicare should pay, while Medicare says Blue Cross should reimburse me. Neither insurance company is willing to pay. I have received denial letters from both insurances, with each blaming the other. As the insured, I am entitled to be reimbursed the $200.00 that I paid out of pocket. I pay thousands of dollars each year for medical coverage to both Medicare and Blue Cross Blue Shield, yet they continuously deny my legitimate and justified claims. Medicare even stated that Blue Cross is responsible for reimbursing me as the insured.

The medical facility where I had the procedures done was Sand Canyon Urgent Care located at 23521 Paseo de Valencia, Laguna Hills, CA 92653. My insurance provider is BlueCross BlueShield, and my member ID is R51055795. The issue at hand is the reimbursement of the $200.00 that I paid out of pocket for two COVID-19 rapid antigen tests. I need this money to be reimbursed directly to me.

I have sent all the invoices and paperwork three times to both Medicare and BlueCross Blue Shield. I also filled out multiple claim forms and sent them to the BC/BS Claims Department. However, I only received denial letters in response. When I called BC/BS, they told me that the claims were "In Process," but they continue to lie. BC/BS needs to take responsibility and pay me the $200.00 that I am owed.

First...we've been providers for Anthem Blue Cross for over 30 years, operating under the name D *** & ***, PTRS with a DBA of Campbell Physical Therapy & Sportscare. We recently made some changes, including a new name, TIN, and business NPI. Our new name is Campbell's Premier Physical Therapy, Inc. Our new tax ID # is 87-2*** and our new business NPI is 15***834. However...we're still in the same location with the same therapists and contact information. We had to restructure the business on paper when we dissolved the partnership. I went to Anthem's portal and updated all the information in the Provider Management portal. I made changes in Availity and submitted all the required forms. We've contacted multiple people to ensure our business is contracted under our new name. Unfortunately, even though we started the process almost 4 months ago to avoid delays, we're still listed as a non-contracted business. I've made numerous phone calls and filled out duplicate forms, but the issue remains unresolved. Anthem doesn't provide a phone number for providers, so I haven't been able to speak to anyone directly. The people I've contacted via email or online haven't followed up with me. This situation is severely impacting our ability to bill our patients' claims. I'm not sure what else to do except to take more extreme measures, unless someone can help us resolve this. Our revenue is being greatly affected, especially during this COVID season. Since there's no phone number available, I hope someone will reach out to us by phone or email to provide assistance.