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Complaint Against a Service United States

Florida Blue — customer service

I was given a prescription for a medically necessary device by my doctor in November of 2018. I had to pay out of pocket for this device. I submitted the medical claims form for reimbursement in December of 2018. My doctor also submitted a claims form on my behalf.

Over the ensuing 11 months I have contacted FLA Blue no less than 6 times, each time FLA Blue has instructed me to submit more information. Each time I complied. I was told after each interaction with a customer service representative that I would be contacted regarding my reimbursement. They never contacted me. I always had to call them to follow up.

Finally, 1 month ago, I called for the 7th time and this time someone in customer service, Shamika, told me that FLA Blue had mistakenly sent a check to my doctor for the reimbursement of my medical device even though it clearly showed by my receipts that I submitted that I had indeed paid for the device. I was instructed to contact my provider and tell them that they have to send the check back before I get reimbursed.

I contacted my provider and told them this request by FLA Blue. He got me in touch with the billing dept. and the contact person there told me that I need to get the check #, date of check and amount of payment. I have spent so much time on the phone with FLA Blue, countless hours in total more than 40 hours on the phone trying to get this issue resolved. I have no way of getting this information. I will have to call FLA Blue AGAIN, and then speak with someone who will tell me that they will look into it.

I am a physician and I am appalled at the horrific customer service provided by FLA Blue. I am truly disgusted by the unwillingness and/or inability of FLA Blue to straighten their ERROR, not mine.

I am not sure what to do at this point. I am worn out by this process. It should not take almost a year to resolve a claim nor should the onus be placed on the claimant to resolve a mistake made by FLA Blue.

If I could cancel my policy, I would. Unfortunately, I can’t.

David Zamos, MD