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Complaint Against a Service United States USA

Florida Blue — prescription run around

Use this company at your own risk!!! I have been trying to get a prescription authorized since April of 2019 when I had to change insurance due to a job change. My GP sent the request multiple times with back up as to why I need the medication. After a few months, I received a letter stating that the request had to come from a specialist. So I made an appointment with a cardiologist who sent in the information. The Doctor let me know that FLA BLUE WOULD FIGHT THIS BECAUSE THEY DON’T WANT TO PAY FOR THE MEDICATION!!! And boy is this true!!! I called Fla Blue back in 10/2019 and was told the prescription was approved and they transferred me to the specialty pharmacy to be filled. And that was a lie – it is now 11/2019 and Fla Blue is saying that the prescription WAS NOT authorized and they NEED MORE INFO FROM THE DOCTOR!! Prior to the change in insurance, I had been on this medication for months through United Healthcare and I don’t understand why Fla Blue is not authorizing it. Be advised that I am filing complaints with the Fla Dept of Financial Services, the Fla Insurance Commissioner and anyone else who can assist with getting me this medication.

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Complaint Against a Service USA

Florida Blue — denied mri but never sent me (patient) notice

According to my physician’s office (a prominent top specialist in Boston) a necessary MRI was denied by Florida Blue (state employee retiree). Florida Blue has not even provided me a letter of denial which they are supposed to do. When I called my doc’s office – they informed me that Florida Blue wants a Peer-to-Peer (I’m sure they are bottom of the pile customer reps). This lack of affording me the MRI is exacerbating my health issues including substantially decreased mobility as well as other issues. Does Florida Blue want the patient to become unable to walk before they will authorize NECESSARY PROCEDURES by top physicians/specialists who know a heck of a lot more than they do. Florida Blue causes direct harm to those they cover and regulatory agencies should investigate them thoroughly. Perhaps they should be sued when a patient’s health declines because they were denied necessary procedures. Patients should keep a record of every call with Florida Blue (date, name, remarks made), all letters received, all denials/approvals. And then send complaints to regulatory agencies as well as legislators. They sure take the premium payments without a problem but when it comes to providing absolutely necessary care they are significantly lacking.

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Complaint Against a Service USA

Florida Blue — tlc dental submits fraudulent claim 3500 dollars when no such work was done

I received my statement Nov 27 out lining what was bill and who billed Florida blue
I noted a billing of 3500 dollars in dental work that was NEVER DONE TO ME i suspect it was TLC dental as they try to get the patient to pay money out of pocket for things and procedures that are covered by the dental plan the particular agency is located on Sheridan street in Dania beach Florida and have had a few arguments with the litte unprofessional office manager who exaggerates service Florida blue has been defrauded out of 3500 but some fake claim and they are doing nothing about it as I do not care but this deducts from my annual dental benefits and reduces what I can have done MY ADVISE TO EVERY ONE AND TO FLORIDA BLUE DO NOT USE TLC DENTAL SERVICES AT ALL THEY AREA MONEY HUNGRY LYING BUNCH OF THIEVES AND DO NOT CARE IF THE INJURE YOU AND WILL LIE TO YOU THEY HAVE DEFRAUDED FLORIDA BLUE OUT OF 3500

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Complaint Against a Service USA

Florida Blue — health ins. monthly $4. auto pay for my son, florida blue deducted $ 712 from my checking.

My name is, hoa v dam, my son philip and I have florida blue health ins. I put his $4. Month payment on my checking account auto pay. Bank contacted me I was bouncing checks in my checking, I said impossible. They showed me how florida blue deducted $ 712. From my checking account because they allege my son didnt send in his yearly income paperwork, and lost his exemption discounts for 2 months. This middle of the night embezzlement caused me to bounce checks and had to work out payment plan with one utility company. Why did i, nor my son get a letter of cancelation if not pay $356. Month. I do not speek 100 percent english, im vietnamese. I attempted many calls to resolve this situation of my money back to me. No luck. If this email doesnt work, I shall see legal help to get a court date. My ins membership information is : vmah19072893 happy holidays, someone with a heart please help me. Hoa [protected]

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Complaint Against a Service USA

Florida Blue — company as a whole /customer service passing buck for doctors who are not in network

Your company is sending out lists of providers who are not really accepting certain plans of coverage and saying they are, THEN telling me it’s the provider’s fault. This is unacceptable. You are passing the buck onto your sick consumers, it’s wrong…You need IN PLACE at very least a department of of employees who are responsible for reviewing in and out of network providers, CONFIRMING week in and week out which providers are INDEED in network and UPDATING your system… otherwise you are simply being neglegent toward your customers…THIS IS NOT A PROVIDER’S RESPONSIBILITY, THIS IS YOURS, REACH OUT TO THE PROVIDERS ON YOUR LIST AND UPDATE IT. IT’S THAT SIMPLE, otherwise you are actually causing your patients much extra stress during a time of illness and need.

Customer service looks at my plan then sends me lists upon lists of providers who turn out NOT to be in my coverage network…it is of NO good for your employees to be doing this if it is not accurate information. It would be MUCH better use of your labor costs to actually do your homework and update your data base! Pay the same people who send me these inaccurate lists to go find out who is really on the plans.

I currently have pneumonia and the struggle to locate follow up doctors in network has been obsurd. The local providers have actually been the ones to FINALLY inform me which doctors are really covered by my plan, NOT Florida Blue.

As soon as I feel better I will be making a complaint to my local representatives as well as the BBB in hopes of making a change in requirements for the insurance company responsibilities because “That’s not our fault” is a cop out of an answer.

Florida Blue, stop sending your customers lists of physicians you say are covered and are really NOT. This is irresponsible…Do something to clean up your data base and maintain it if you are REALLY trying to provide for your customers.
Thank you,
Rhonda Rudkin

[protected]

Categories
Complaint Against a Service USA

Florida Blue — In 3 weeks I have had 3 big issues, today again here we go.

I called the FL Blue Center in Pinellas Park [protected]). I go through my prompts and the representative answers right away and is nice (I’m thinking what a nice change after the last two (2) calls. She answers my first question and then I wanted to pay my premium on my account and I give her my member number and we were cut off (I’ll giver her the benefit of the doubt). I immediately call back and go through the same prompts as the first call (mind you we are talking 5 min max) approx. 3:10 pm and a recording comes up that was not there before and says if you need immediate service to call this other number. How is that even possible, it was a good number at 3:10 and then at 3:15 it’s not. No one ever wants to help at BCBS. Customer service is horrible!!!
2/26/2020 between 3:10 pm and 3:20 pm –

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Complaint Against a Service USA

Florida Blue — Group blue select coverage member id xjkh32445235

My name is Stacey P. Adams and I can be contacted at [protected]. I believe my employer Marlyn Enterprises of Jacksonville is committing some type of fraud. I was recently found out when I went for a medical appointment by a medical care providers that I am no longer covered by Florida Blue Insurance. I contacted Florida Blue customer service and they refused to give me any information other than the policy was canceled on January 31, 2020. I was never told by the company I work for that my insurance was cancelled. I have proof that my employer deducted money from my paycheck for “Blue Cross Health Insurance” on the following pay periods 12/22/2019-1/4/2020 for $133.00, 1/5/2020-1/18/2020 for $145.99, 1/19/2020 -2/1/2020 for $145.99, 2/2/2020-2/15/2020 for $145.99, 2/16/2020- 2/29/2020 for $145.00 there was no money taken out on our next paycheck but we were told that our insurance was going to be reinstated in 1-3 days. The person I spoke to on the phone said if I could show proof that the money was taken out I would not be responsible for my medical expenses. Because my insurance was not active due to the negligence of my employer and no fault of my own I now have outstanding medical expenses that will not be covered by insurance that I paid for but never received. Please assist on how to proceed.

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Complaint Against a Service USA

Florida Blue — procedure not covered

I am complaining about the fact that my friend had a procedure preformed that was NOT considered “still a experimental procedure”. She has Humana Medicare and her out of pocket for her nerve-releasing surgery was $350 while the same surgery through BCBS is not covered so my cost would be $5000. How can this be ethical to serve someone and let them be allowed to afford a life changing surgery because they are low income but not to allow me to afford the same surgery just because I am not on an insurance for low income people. This seems to me like medical neglect to a certain group of people. Please respond to this email with an explanation how one insurance can say a treatment is considered experimental when another one says it isn’t. My email is [protected]@duvalschools.org Karla Aponte [protected]

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Complaint Against a Service USA

Florida Blue — Lack of Provider Relations Representatives

Since you are no longer providing representatives to assist with provider calls and redirecting all inquiries to Availity, please educate Availity on how to assist us with claims, payments and appeal issues. As instructed, I opened a ticket related to each individual case for the reissuance of ACH payments and Availity responded stating they were simply a clearinghouse and could not assist with my issue. They closed the cases, leaving know further guidance or how to get the issue resolved. WE NEED PROVIDER REPRESENTATIVES!!! Please bring them back. Unfortunately, the only recourse we have is to issue a complaint with the Department of Insurance and local Insurance Commissioner.

Categories
Complaint Against a Service USA

Florida Blue — Customer service (lack of)

I have connected florida blue insurance days.
I can;t get the correct information. I am hung up on, transferred,
Given a wrong phone number. Had to find it my self.

Someone called it was not from tel a doc I asked for.

I am trying to get help f0m tele a doc. No one at lorida xan get me to the right person!

I have sent emails to social media team!