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1.0 128 Complaints
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Florida Blue Complaints 128

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K
3:25 pm EDT
Verified customer This complaint was posted by a verified customer. Learn more

Florida Blue requesting peer to peer review of a claim.

My doctor and I have been trying for months to set up a peer to peer review of a denied claim and florida blue has made it impossible. I have made multiple phone calls, sent messages through the florida blue website, and had several chat sessions. They have not responded to any of the messages, none. The phone and chat responses are to have the doctor call the provider line. He has tried twice but it does not allow him to request the peer to peer. The automated system asks for date of service, and when he enters it, the systems responds that there is no claim for that date of service (actually there are 6) but it will not let him proceed, nor is there a way for him to speak with a person. My doctor says the claim was for a legitimate medical service and that if he could speak with a peer, he is sure they would agree. All we are trying to do is set up a peer to peer reviews, but the system will not allow it.
If the results of the peer to peer were not in my favor, then I could accept that. But florida blue not following there own policy and their customer service representatives being unable or unwilling to help find a way to set up the peer to peer is very poor. All we are asking for is a phone call for a peer to peer review and all we get is a dead end and the runaround.

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joeinslw
US
Sep 22, 2018 9:38 am EDT
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Good for you, keep the pressure up, & make sure your facts are correct and true, it's the only way to get Florida Blue to change and accept their mistakes. They did it with me when they sent me a bill from a Doctor that Florida Blue paid nothing, Zero was paid, the Doctor expected me to pay the balance, but the Doctor or Florida Blue didn't know that there is a law signed into effect in April of 2016 which does not allow balance billing. I had to do my own research and in fact it's in their own policy which they missed.
It seems with Florida Blue a patient must do their own research, because the people you talk to on the phone do not have the correct knowledge or information, it's easier for them to say no to a patient, so don't take no for an answer if you feel you are correct, because most times you will be.

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S
7:35 am EDT

Florida Blue address change

I am trying to change my address for the last 7 month. it has been changed at the market place that long already, but it seams like nobody is competed enough to call the market place and have them confirm the change. I keep contacting customer service about it. Half the time I am getting emails saying, that they have not received a note from the market place about my change yet (they should just call them and confirm it) and the other half I don't get an answer at all. I am just wondering, if I already have a problem with such a minor thing, what would happen if there would be a major issue.

not happy

maren shaw

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Sweet Nook
US
Aug 27, 2023 8:52 am EDT
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I meet criteria for Wegovy medication and yet am being denied coverage.

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Notatthistime
New Port Richey, US
Jul 22, 2023 5:29 pm EDT

None wants to do business with this provider.

They have poor communication skills and no Doctors office anywhere near me want to accept this ins. They have an outdated data base of doctors that will accept it it, as most won't.

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Maria Camm
Pompano Beach, US
Jan 23, 2023 6:46 pm EST
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New Directions has failed to provide an SCA or Authorization despite promising to do so. It has been nearly 3 months. Fl Blue is required to provide continuity of care but New Directions has intentionally blocked provider from being able to bill due to no fault of the provider.

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7:37 am EDT

Florida Blue dental insurance

I have had a dental policy with the above since December 2015. They deduct the premium from my account every month, however, I am unable to access my account online to print the premium payments to submit for reimbursement from my healthcare reimbursement account. I have contacted them numerous times over the months to try and gain access or a printout to no avail. There is no place on their website to email a complaint, very disappointed in this provider.

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Florida Blue
US
May 19, 2016 8:25 am EDT

Hello, sorry for the issues you are experiencing, Can yo please email us at socialmediasupport@floridablue.com with your full name and policy information for additional help? Thank you.

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6:42 am EDT
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Florida Blue health insurance payment refund

I was paying for my bcbs health insurance directly (my company did not have hi at the time). When my company then started to offer hi I had to sign up as the direct payment was being paid by them and I was told they would be discontinuing and I would have to choose once of the insurances they were offering. The first week in feb 2016, I was told that the insurance would be starting as of feb 1. I called florida blue immediately to cancel the insurance (feb 8) and they said they would issue a refund of my feb payment. I have just called and they said I am not entitled because at the time I cancelled they had received the payment and the term date was already set for feb 29th. I asked why was I not told that at the time. My husband did the same thing with his aetna payment and received a prompt refund. The person I spoke to said there is no way I will get a refund no matter what I do. The reference number is [protected] person jazma b. It is simply shameful - I said why would I pay for 2 health insurances - I called as soon as I knew that the company insurance started feb 1 and they assured me of the refund. I am being punished because I pay my bills on time - she said you should have just not paid. I would like to get my refund. How can you help me?

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Florida Blue
US
May 19, 2016 8:27 am EDT

Hello, sorry for the issues you are experiencing, Can you please email us at socialmediasupport@floridablue.com with your full name and policy information for additional help? Thank you.

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R
4:12 pm EST

Florida Blue customer service

I have been on the phone with florida blue representatives for the last week starting on january 19th. Rebecca miller was the one and only rep to date that seemed to know anything and helped me get all my health insurance paperwork squared away.

She told me that I should call florida blue back in 3-5 days to follow up on my account status, that I should be active and coverage should be for the month of january. She quoted me the dollar amount for my monthly payments and what my tax credit would be.

Since then it has been a nightmare. I have spoken to mr. Claudio, shy, rhonda and rebecca, none of whom have been any help and as of today my account is still inactive! I have paid for january and february and still have no active account. I can not fill a much needed prescription and have bills from a procedure that are coming to me because of this mess bcbs has created.

I am totally dissatisfied with bcbs and hope that someone that knows something and has the authority to do something will call me back and get this mess straightened out!

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elfin
jupiter, US
Nov 17, 2020 2:13 pm EST

florida blue lacks customer service. reps never have your info. constantly have to give it. you are tramsfered many times and hung up on.
If you get a rep, they talk over you they don;t listen. Keep, asking you for info.

the phone system is a maze. If you call to new. you are connected to someone who ha to transfer you,

after giving you info again! ripm over very premiums, wih no service!

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R
7:47 pm EST

Florida Blue florida blue hmo

I received my acceptance letters and new florida blue "blue care" hmo cards to be in a new plan which I am not clear about & after my doctors visit today I went to my normal pharmacy here in duval county fl. At my pharmacy I learned that even though I have paid for the new policy (that I was confused about when I thought I had to change & really want my original ppo florida blue select plan back), the "system" is not recognizing me or any coverage at all. When my awesome pharmacist called blue cross/blue shield of florida, she worked diligently to find a solution as I am not the first patient to come in with this serious problem. No less, I left without being able to get medicines for which I must have to remain stable as my health is critical and I sit waiting until the morning to learn what is going on and why I cannot have my former plan back with the same copays as before. I suffer brain traumas along with neurological disorders that impair my cognitive thinking in certain situations so the plan that I selected was not the plan that I wanted to be in! Blue cross blue shield of florida has received my payments as all are current but the systems not allowing me to access the health coverage at all! This is a very, very serious problem affecting more people than I alone. I believe that the big wigs at blue cross blue shield must address with a swiftness lest they suffer claims of damages from patients like me (a middle aged disabled [claim pending any day now] who are suffering needlessly because the disorganization of this florida blue madness and the "marketplace enrollment" confusions amuck. Sad & serious in florida, h

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3:34 pm EST
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Florida Blue rate increase

Received notice that my current health insurance premium was being raised from 835.00 per month to 1448.00 per month for me and my family coverage effective 1/2/15.
Not sure how many folks can afford of $613.00 per month ($7356 per year) increase - please help me understand.
Called company and said it was due to health industry costs... Called fla dept of financial services consumer division to complain and they said bcbs rate increase had been approved by state (deemed reasonable)! Are you kidding me?
In addition no major health costs for my children and I never once went to doctor in 2014.

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JKWilliams
JKWilliams
US
Jan 07, 2015 6:26 pm EST

Just remember one thing: The doctors, nurses and techs are making the same money they made 20 years ago - some, less, some as a result of doing twice as much work. That's a fact. So, where is this money going?

Take a walk sometime through a community hospital and note how many administrative people you see wandering around. With a little effort, you can spot them. Do you realize they now greatly outnumber the people working with actual direct or even indirect patient care? Do you realize that they are paid (each one of them) an average of over $60, 000/yr - some well over $100, 000? Also look at the physical facility. Many (not all, but quite a few) hospitals and clinics have been turned into something looking like a 5 star hotel or a space age air terminal - and yes! you pay for that! You also pay for everybody else's health insurance because today, by law - it all for one, one for all.

Of course if you ever get treated for something, you'll see essentially the same equipment they used 10 yrs ago (with few exceptions); a hoard of computers (which are no option - nope - required by law! and that's a whole big mega-expensive tech department, you understand), and, of course, your pharmacy bill, you'll see very often is "whatever price they care to charge." (a topical steroid I use went from about $80 a bottle to [get this] $325 a bottle in 5 years - same stuff you understand)

Just don't ever get the idea its doctors, nurses, med techs, or radiology techs or physical therapists soaking you to finance their lush lifestyles. Nope. You are paying all the others I described above. I like to call them "cling ons."

And then, of course (another destination for that all too common Business grad) the layers and layers of bureaucrats and their paper shufflers at the BCBS office which of course require the same manpower employed by each and every provider - just so they can make sure they get paid.

It has been observed that between 18 and 25 business grads are now needed for every MD. or RN. So, you see, you're lucky it's just $1400 a month.

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8:13 pm EDT
Verified customer This complaint was posted by a verified customer. Learn more

Florida Blue refund

I canceled my heatlh insurance policy by the required deadline and was still charged the full amount the next month. I contacted bcbs customer service and they admitted to the wrong doing. They transferred me to the billing department and they also admitted to the wrong doing and submitted a form so I can get a full refund. They said it would take 7 to 10 business days. I never received it. It's been about 6 months now and I contact the company about every 2 weeks and the billing department keeps giving my excuses as to why I have not received a refund. I have heard (they sent it to the wrong department (twice), there was an error in your address, they approved the refund it will take some time to have it send out etc. Etc. It is no longer an issue of them making a mistake. It is now a major issue of integrity.

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_____________
US
Aug 15, 2018 1:39 pm EDT

They r so dumb and can't speak English when u call. I'm sure this is the only job they can get is to answer the phones at the 800 number!

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Mae Rust
US
Sep 11, 2012 9:23 am EDT

I visited Florida Blue one time. I called them before coming and asked the prices. The numbers they told me are absolutely different from the sum I received with the bills. I paid $100 more! I can’t afford myself so expensive services. But I had no choice and I paid.

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Florida Blue
US
May 19, 2016 8:26 am EDT

Hello, sorry for the issues you are experiencing, Can you please email us at socialmediasupport@floridablue.com with your full name and policy information for additional help? Thank you.

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Johnnys1968
US
May 01, 2016 7:43 am EDT

I have been with Florida Blue for 3 years and have been on the same medicine for 7. Five months into my policy this year When I went to Target to get my HIV medication I was informed tat my doctor would now have to justify the medication that has worked best for me. I will run out of medication before the review process is over and how is it half way through my policy the rule get to change for Florida Blue

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Kolluru
US
May 19, 2015 10:45 am EDT

Hi,

I have the exact issue with Florida Blue. The same story, it has been 6 months, called them once in a week. Reported to the local Florida blue center at Tallahassee. They never follow-up. Waiting for the refund. They do not have any responsibility over customers.

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Overview of Florida Blue complaint handling

Florida Blue reviews first appeared on Complaints Board on Aug 1, 2014. The latest review NationsHearing was posted on Jun 28, 2024. Florida Blue has an average consumer rating of 1 stars from 128 reviews. Florida Blue has resolved 0 complaints.
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  1. Florida Blue Contacts

  2. Florida Blue phone numbers
    +1 (800) 352-2583
    +1 (800) 352-2583
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    +1 (877) 352-5830
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    Florida Blue Centers
    +1 (800) 926-6565
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    Medicare Members
    +1 (800) 267-3156
    +1 (800) 267-3156
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    Agent Contact Center
    +1 (866) 946-2583
    +1 (866) 946-2583
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    Employers & Benefit Administrators
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    Physicians & Providers
    +1 (800) 955-2227
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    Group Sales
    +1 (877) 465-1125
    +1 (877) 465-1125
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    Individual and Family Plans & Medicare Plans
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  3. Florida Blue emails
  4. Florida Blue address
    4800 Deerwood Campus Parkway, Jacksonville, Florida, 32246, United States
  5. Florida Blue social media
  6. Laura
    Checked and verified by Laura This contact information is personally checked and verified by the ComplaintsBoard representative. Learn more
    Jul 14, 2024
  7. View all Florida Blue contacts

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