| Date Submitted: | November 12, 2009 |
| Insurance Provider: | Blue Cross Blue Shield in New Jersey |
| Coverage: | 5 out of 10 |
| Claims: | 1 out of 10 |
| Customer Service: | 1 out of 10 |
| Cost: | 5 out of 10 |
| Recommend: | No |
| Review: | Pre-existing Condition Headaches Since I was not previously covered by insurance, I've had to deal with a "pre-existing condition clause" for the first year of coverage. This has been an incredible headache! I had a test done, and BCBS didn't pay because they "had to determine whether it was related to a pre-existing condition." However, they did NOTHING to collect needed information. When the service provider began sending me threatening letters, I called to find out why the claim had not been processed. They just told me they needed more info, and that they would send a questionnaire to my doctor. Why didn't they do that in the first place? I've had to call in several times to check progress. Three times I was told they would send a questionnaire, but my doctor has never as yet received one. We finally decided to fill out a generic questionnaire and fax it to them. I have had to do ALL the footwork to make sure this claim is being processed. Meanwhile, the provider has continued to threaten to send me to collections, and all BCBS has to say about that is: "They can't do that to you." Well, I'm not going to wait around and see if they do! Horrible service, nothing done without me making them, and even then, no sign they've done anything except put me off. Maybe after the first year goes by and this clause expires, I will start to see some better service, but I doubt it! |
| Submitted by: | ladyrach 34 year-old :: Female Reviewer :: New Providence, NJ |
2 comments for this review
| Comment by: HovaG From: LaCrosse, WI June 11th, 2010 |
I am currently dealing with this same situation! to a "T"! I became aware a month ago that BSBC stopped payments to my provider back in April. I called to question BCBS and ask why they were not processing payments. Their response, "We need more information from your provider. We sent a request a month ago." I immediately contacted my provider, who stated that no information was ever requested & submitted the claims as required. After many phone calls being the "middle-man", I finally spoke with a BCBS representative who said she would request that the paperwork be faxed to my provider. My provider has not yet seen this paperwork. At this time, I have spoken with the financing department for my provider & requested that I be set on a payment plan until this matter is resolved. I was advised by the BCBS representative that, "This will take some time." I do not see a light at the end of this tunnel... what steps would you recommend I take in order to expedite the process? |
| Comment by: HovaG From: LaCrosse, WI June 11th, 2010 |
I am currently dealing with this same situation! to a "T"! I became aware a month ago that BSBC stopped payments to my provider back in April. I called to question BCBS and ask why they were not processing payments. Their response, "We need more information from your provider. We sent a request a month ago." I immediately contacted my provider, who stated that no information was ever requested & submitted the claims as required. After many phone calls being the "middle-man", I finally spoke with a BCBS representative who said she would request that the paperwork be faxed to my provider. My provider has not yet seen this paperwork. At this time, I have spoken with the financing department for my provider & requested that I be set on a payment plan until this matter is resolved. I was advised by the BCBS representative that, "This will take some time." I do not see a light at the end of this tunnel... what steps would you recommend I take in order to expedite the process? |
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