| Date Submitted: | February 6, 2009 |
| Insurance Provider: | Blue Cross Blue Shield in Michigan |
| Coverage: | 7 out of 10 |
| Claims: | 1 out of 10 |
| Customer Service: | 2 out of 10 |
| Cost: | 9 out of 10 |
| Recommend: | No |
| Review: | Just cannot process claims correctly While I have good coverage for the most part, this company simply cannot process claims correctly. They will lose batches of claims we submit, such that we have had to send them registered mail. They will then "find" the original claim forms 6 months later. They will pay for a service one time, then deny it the next - the exact same service with the exact same provider. They will send us a check for a service, then send us a denial for the same service that they paid! The customer service people on the phone know next to nothing. If you ask them something they are reading an answer from a screen, if you ask them to further clarify, they just re-read what they just said. Also, my insurance has Magellan as a carve out to monitor hospital care and I was denied access to a hospital because they refuse to deal with Magellan - it is so draconian. In general the insurance employees who determine what is "medically necessary" have only a minimum of knowledge to make this judgement. These are nurses that are second guessing what doctors are prescribing, just from looking at some paper claims. I would seriously question the judgement of any doctor who would go to work for an insurance company anyway. |
| Submitted by: | Kira 47 year-old :: Female Reviewer :: Lafayette IN |
1 comments for this review
| Comment by: mary From: ames, ia June 14th, 2009 |
No kidding! This company repeatedly failed to correctly process claims sent from Iowa via the blue card system for 2 1/2 years then denied a claim that had been lost in their system since 2/07 because it did not get correctly processed until 4/09. I now have to go through an appeal process. |
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