Complaints

This profile includes complaints for Pacific Blue Cross's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Pacific Blue Cross

  PO Box 7000 Vancouver, BC V6B 4E1

  
• 

  Pacific Blue Cross

  4250 Canada Way Burnaby, BC V5G 4W6

  

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:21/05/2025

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Submitted extended health claim for **** supplies to treat sleep apnea under my organization's health insurance policy. *** is aware of my condition as I have made claims for **** supplies previously. Adjuster denied majority of my claims for supplies that require replacement using arbitrary reasons such as requiring a doctor's note, does not fit within ***'s replacement timeline, or above the allowed amount of ***'s reasonable and customary dollar value. None of this information is available to me as a member of *** either via my policy information nor on ***'s member information website. When inquired I am told that this information is not available to the public and that I should escalate up to ***'s benefits review ************ addition, this is a routine claim for **** supplies (headgear, headgear strap, cushions, filters) which mostly fall under the **** machine vendor's (ResMed) officially published replacement schedule. I have previously escalated a similar case where the adjuster rejected my **** supply replacement claim based on an arbitrary reason (does not fit within ***'s replacement timeline) which was not available to *** members to the *** benefits review committee. The committee ruled in my favor and I was fully reimbursed. This indicates to me that the adjuster's reasoning for denying my claim is in fact not official policy. The lack of transparency and arbitrary behavior of adjusters is also problematic. Needing to escalate to the benefits review committee is also causing needless delays in receiving my reimbursement and is extremely frustrating as I am abiding by all of ***'s guidelines that are available to me when submitting my claim.

  

  Business Response

  Date: 10/06/2025

  Dear Member,
  
  Thank you for your patience as we reviewed your concerns. Your recent claim was assessed in accordance with the provisions of your group benefits plan. Items were reimbursed based on reasonable and customary pricing, and certain components were declined as they fell outside standard replacement guidelines or required additional medical justification. We understand your concerns regarding transparency and past experiences with similar claims, and we acknowledge that needing to escalate for resolution can be frustrating.
  
  At this time, the original decision remains in place unless further supporting information is provided. We remain committed to ensuring fair, consistent, and transparent claims handling, and welcome any additional documentation you may wish to submit for reassessment.

  Customer Answer

  Date: 10/06/2025

   
  Complaint: 23357320
  
  I am rejecting this response because:

  PBC is continuing to reject my claim based on reasonable and customary pricing criteria. Said criteria for what is considered reasonable and customary is not published anywhere on the *** website, in my members profile, or in my benefits information package. While claiming that they are striving for transparency they still do not provide any documentation for the basis of my rejection.

  Meanwhile I have provided the manufacturer's parts replacement timeline and demonstrated that all of my replacement supplies fell within the manufacturer's specified timeline or went even beyond the manufacturer's replacement schedule. I have also said explicitly that this information was provided by my sleep specialist, which would be the medical justification as I am following their medical recommendations in replacing my **** supplies. In addition, this replacement timeline was also used in a previous rejected claim that I had to dispute with ***'s benefits review committee, which ruled in my favor and fully reimbursed me for my rejected claim.

  This is not transparent or consistent behavior from PBC.

  Sincerely,
  
  Jie ** ***

  

  Business Response

  Date: 20/06/2025

  Thank you for taking the time to share your feedback. Were sorry to hear that your experience with Pacific Blue Cross did not meet expectations.
  

  We have reviewed the matter thoroughly and, as a gesture of goodwill, we have proceeded with payment of the claim on a one-time exception basis. Please note that this decision does not set a precedent for future claims. A letter explaining the outcome in more detail will be sent to the member under separate cover.

  If you have any questions regarding your benefits or would like more information about your coverage, our **************** Representatives would be happy to assist you.
  We appreciate the opportunity to address your concerns and remain committed to providing quality service.

  Customer Answer

  Date: 23/06/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  Jie ** ***

• Initial Complaint

  Date:01/05/2025

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In October of 2024, I had to be taken to hospital in an ambulance due to an emergency medical event. Once I was recovered a few days later, I submitted a claim to the Pacific Blue Cross travel insurance department. Due to the postal strike, I was denied access to submitting a claim and told to wait until it was over before I would be able to submit. I was denied the ability to send the documents via fax or email and ghosted by the company for several months, despite me calling them regularly. This all took place while the Australian ambulance company was stalling the payments due to the situation. I was finally given permission by *** to send documents via email on the 19th of March 2025, to which I received no contact about aside from a confirmation letter from the company stating that the documents were everything that was requested and that they would fast track my case and I would hear soon regarding the payment. It is now May, and I am being put into collections in ********* through the ambulance company because *** told me not to pay and that they would direct bill them. Every time I speak to ***, I am told that they will call me back (to which I am ghosted) and when I request to speak to a supervisor, I am denied and I am not given a direct line to reach the specific agents through. I am seeking that *** be held responsible to pay their contract obligation and close this case. It is effecting my job, my life and now my ability to stay in ********* as a worker if it gets escalated further. If action is not taken I will be forced to go to news agencies or get a lawyer to settle this claim as my plan is almost in expiry and I worry as I live overseas now that they will continue to push their legal business obligations. Amount owing is in AUD currency.

  

  Business Response

  Date: 08/05/2025

  
  Dear member,
  
  We have completed a thorough review of the call records and documentation related to your claims.Our **************** team made every effort to guide you through the process,including explaining the need for a medical report for the ambulance related expenses and requesting the required documentation accordingly.
  
  Your first claim was processed on a rush basis and unfortunately refused due to missing documentation. For the second submission, the requested documents were submitted, the claim was unfortunately not approved. The explanation of refusal was mailed to the address provided on the claim form. Please note our records show the total submitted was $1,396 not $13,096.
  
  We sincerely apologize for the inconvenience caused by missed follow-up communication. Unexpected staff absences impacted our ability to respond in a timely manner, and we understand how this may have added frustration during an already challenging time.
  
  We value your feedback and remain committed to improving our service. If theres anything further we can do to assist you, please dont hesitate to get in touch.

• Initial Complaint

  Date:08/04/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Pacific Blue Cross - will not pay for my pain medication prescribed by my family doctor, they say it is not covered under my group policy but my doctor claims that it should be covered, I would like them to cover my expense for this medication, I have arthritus in my knees and pain and am waiting for surgery on my knees.This medication should be covered under my group plan ***** My wife's name is ******* ******** that is who the plans main contact is and I am secondary to it my name is ***** ******** I have called blue cross to try to resolve this but have not had any satisfaction please help thanks Pacific Blue Cross phone # ************

  

  Business Response

  Date: 16/04/2025

  
  We are sorry to hear that your experience with Pacific Blue Cross was less than satisfactory in this instance.  We have investigated the matter and unfortunately the claim you have referred to was not paid as the expense is not a covered benefit under your plan. We will be providing you with a letter from our ************************ with further information.

• Initial Complaint

  Date:19/03/2025

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Blue Cross is taking way too long to reimburse my healthcare costs. Even though I will forever require the medical supplies that I order every few months or so, I still have to submit them to Blue Cross for reimbursement. I do this electronically so it gets there immediately. It used to take two weeks to get reimbursement but for the past couple years it has been increasing to more and more days, to the point where the last one was 49 days to process. For my last submission I am well over a month. I use my credit card to pay for the supplies as they are very expensive. And I would hope that I would get reimbursement before my statement arrives. But this does not happen anymore. They keep saying that they are backlogged but as soon as I complain to them they seem to magically get it done sooner. I should not have to complain and I should not be waiting 49 days for reimbursement.

  

  Business Response

  Date: 21/03/2025

  We are deeply sorry to hear of your recent experience with Pacific Blue Cross and recognize that the service you received was not up to the standard we aim to achieve.  Your claim was processed accordingly on March 18, 2025. Thank you for your honest feedback and continued patronage.  Pacific Blue Cross is committed to providing our members with a quality experience and exceptional service and appreciate your contribution to our continued improvement.

  Customer Answer

  Date: 24/03/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ****** *******

• Initial Complaint

  Date:28/02/2025

  Type:Order Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Supposedly *******, is my sales person, who since 2021 I have never spoken to, and I was unaware he was to connect with me, as he was not the person who set up my account. I called the **************** line many times, and was transferred, she was emailed to connect, I left voice message and eventually when I called back mailbox is ******* rates per employee at Blue Cross have gone up from time to time, however this time it was much more than ever expected. I also never received any notification at anytime of the increase. I had just connected with them last month about a refund that was required on the account, and nothing was mentioned to ***** an employer, we pay the whole bill and do not have or employees pay partial costs, if they had, and I did not let them know the insurance on their paystub was going up, I am sure I would be in trouble with Employment ************ per the documents that were uploaded we were paying $85.22 per single person, and this has now gone to $105.40 per single person which is an increase of $20.18 per single ********* per the documents that were uploaded we were paying $203.20 per family, and this has now gone to $252.54 per family which is an increase of $49.34.The directly deposit the funds out of our account, and if I was to do a stop payment that would affect the livelihood of our employees. Why were we not given any notice, therefore if I wanted to change companies I had a chance to do so, now I am stuck having to pay this bill or tell our employees they have no coverage. This is absurdly wrong, and extremely hard on a non-profit/charity organization.

  

  Business Response

  Date: 05/03/2025

  Dear Member,

  Thank you for sharing your feedback with us. We value your input and appreciate the opportunity to address your concerns.

  Our Account Executive has reached out to you to discuss the products and services we provide. During this conversation, we understand there was a miscommunication regarding the responsibility for presenting the renewal details. As a resolution, the Account Executive offered to defer your renewal until May 1st and to apply a concession on the health and dental renewal rates. We are pleased to hear that you have accepted this offer and that it is appreciated. If there are any further questions or concerns you may have, or if you require any additional assistance, please dont hesitate to reach out. Your satisfaction is important to us, and we want to make sure your needs are met.

• Initial Complaint

  Date:18/02/2025

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was diagnosed with hearing loss and require hearing aids. The audiologist office checked with Pacific Blue Cross to see if I had any coverage. I was told I was covered for $2000 per ear. I checked again myself to double check before purchasing the hearing aids. I then needed to send the paper receipts to pacific blue cross as they dont process these claims online. I did so and pacific blue cross rejected my claim. Im absolutely disgusted and disappointed - its clear that covered and they are my primary insurer.

  

  Business Response

  Date: 24/02/2025

  We are deeply sorry to hear of your recent experience with Pacific Blue Cross and recognize that the service you received was not up to the standard we aim to achieve.  We have taken immediate action to address the concerns you have brought forth and have approved your claim.

  Thank you for your honest feedback and continued patronage.  Pacific Blue Cross is committed to providing our members with a quality experience and exceptional service and appreciate your contribution to our continued improvement.

• Initial Complaint

  Date:27/01/2025

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  We submitted a claim for our Health Spending Account on January 14 by placing in the drop box at their ******* location, as the guidance by their ***************** as it would be processed faster. It is January 27, we have yet to receive notification that the claim was even received and yet to receive notification it has been processed. When we spoke with ***************** they have informed us that they are only processing claims submitted on January 8 and that it would be another couple week. The Health Spending Account is monies allocated by my employer for costs up and above the insurance. In this case we had to paid $608 above our insurance and want to claim it on our Health Spending Account. ******************** does not have an online location to do this, so we are forced to submit a paper claim. It is ridiculous that a company as large as Pacific Blue Cross does not put **************** at the front and ensure that they have enough staff to process a key portion of the business which is claims.

  

  Business Response

  Date: 10/02/2025

  
  Thank you for your feedback regarding your recent **************** experience with ******************** (PBC).  At PBC, we are dedicated to ensuring the utmost satisfaction of our customers with our products and services. We sincerely apologize for the delay in processing your recent claim, which may have inconvenienced you. Rest assured; we are taking immediate steps to address the issues you raise. Your Health Spending Account claims were processed on February 6th, 2025.Please visit member portal for details. We appreciate your patience and understanding during this process. Your feedback is invaluable as we continuously strive to improve our services

  Customer Answer

  Date: 10/02/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  

  I do hope that Pacific Blue Cross takes the necessary steps to ensure that they have enough staff to process in a timely manner. This is not the first time and each time it is the same excuse - they are busy and received heavier submissions and we are working hard to catch up. 
  

  there should be zero reason to be weeks behind.  If effects people. 
  
  Sincerely,
  
  ****** ********

• Initial Complaint

  Date:06/01/2025

  Type:Product Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Hello,I continue to have problems with having Pacific Blue Cross process and pay out claims that I have been manually submitted. For example, I submitted a receipt for an item in April 2024 and it was only processed and paid out in October 2024. That is beyond acceptable.Additionally, and rather frustratingly, the issue most of the time stems from Compounded Preparations and Medications that I have previously had. The pharmacy can only produce a pseudo-*** for the preparations/medications, because Pacific Blue Cross refuses to give them the *** under which they approve the medication manually. And yet, these are the same Compounded Preparations and Medications that I have had for years!! I have even sent Pacific Blue Cross with every submission a letter from the same doctor telling them why this medication is needed. Yet every single time, I have to submit it manually and wait months and months and months to be reimbursed.This is no longer acceptable. And trying to get it resolved with Pacific Blue Cross never leads anywhere.Pacific Blue Cross owes me payment on the following claims:Claim ID ********* - $48.55 Claim ID ********* - $54.78 Claim ID ********* - $48.55 TOTAL AMOUNT OWED - $151.88 I would like to have these claims paid within 5 to 7days.I would also like to have Pacific Blue Cross provide me, or my Pharmacy, with the proper *** codes so that the Pharmacy may bill Pacific Blue Cross directly.Thank you for your assistance!

  

  Business Response

  Date: 08/01/2025

  Thank you for bringing your concerns to our attention. We understand the frustration caused by the delays in processing your claims, and we sincerely apologize for any inconvenience this has caused. Regarding compounded preparations and medications, pharmacies can currently submit compound claims electronically, and the relevant information is outlined in the Pharmacy Fee Guide. However, many pharmacies choose not to submit these claims electronically because the reference guide advises them to verify ingredient eligibility before submission. We are aware of the complexities surrounding compounded medications and are working to improve this process.

  In the meantime, we have reviewed your pended claims, and they will be processed within the week. We appreciate your patience as we resolve this matter, and we will continue working to ensure a smoother experience for you in the future. If you or your pharmacy have any further questions about billing compounded medications, please feel free to reach out to us directly ************.

  Customer Answer

  Date: 08/01/2025

   
  Complaint: 22774314
  
  I am rejecting this response because I have asked multiple times to receive the appropriate DINs from Pacific Blue Cross for the medications and compounds in question. 
  

  I am not in a position to wait months on end for hundreds of dollars of medications that Ive had for years, and then chase Pacific Blue Cross for the payment. Pharmacy asks for the ***** Pacific Blue Cross says they should know what they are. 
  

  These are LONG-STANDING prescriptions that have to go through this EVERY single time, and I am tired of it. 
  

  Kindly provide SPECIFIC pseudoDIN for pharmacy billing of the medications and compoundings in question and submit them via a response here. 
  

  In addition, I would like written confirmation that the pended claims will be reviewed and paid by no later than end of business Monday January 13, 2025.

  
  Sincerely,
  
  ****** *****

  

  Business Response

  Date: 14/01/2025

  Thank you for bringing your concerns to our attention. We understand the frustration caused by the delays in processing your claims and sincerely apologize for any inconvenience this has caused.
  Regarding compounded medications, pharmacies are able to submit compound claims electronically, as outlined in the Pharmacy Fee Guide. However, many pharmacies choose not to do so because the reference guide advises them to verify ingredient eligibility before submitting claims. We are aware of the challenges with compounded medications and are working to improve the process.
  We have reviewed your pending claims, and they will be processed within the week.
  We truly appreciate your patience as we resolve this issue, and we are committed to making the process smoother for you in the future. If you or your pharmacy have any further questions about billing for compounded medications, please feel free to contact us directly at ************.

  Customer Answer

  Date: 14/01/2025

   
  Complaint: 22774314
  
  I am rejecting this response because it is a copy-and-paste response from the previous response, and does not in any way respond to the requests for the **** requested. 

  I have spoken to the pharmacy and they can NOT bill directly as the Pseudo**** required for these medications are not available in the pharmacy guide.

  PBC continues its unwillingness to provide information on the **** needed to have these medications billed directly. 

  I will no accept a response from PBC that does not include the Pseuo**** required, as I have been asking for them for over a year. 

  
  Sincerely,
  
  ****** *****

  

  Business Response

  Date: 28/01/2025

  Thank you for allowing us the opportunity to address the concerns raised by member ****** *****. We deeply regret any frustration caused by the delays in processing the claims and understand the impact it has had.

  Regarding the issue of compounded preparations and medications, we want to clarify that pharmacies do have the option to submit compound claims electronically. The detailed information about this process is outlined in the Pharmacy Fee Guide. However, it is important to note that many pharmacies opt not to submit these claims electronically, as the guide advises them to verify ingredient eligibility prior to submission, which can lead to additional time and steps in the process.

  We are fully aware of the complexities associated with compounded medications and are committed to working towards streamlining this process. In the interim, we have thoroughly reviewed the pended claims in question back in January 7th 2025.

  We truly appreciate Mr. ****** patience as we work to resolve this matter. Our goal is to continuously improve and provide a smoother experience for all our clients moving forward. Should there be any additional questions or concerns regarding compounded medication billing, we encourage the member or their pharmacy to reach out directly to us at ************.
  

  Thank you for your attention to this matter.
  

   

  Customer Answer

  Date: 28/01/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ****** *****

• Initial Complaint

  Date:03/01/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Canceled account for December 31st., verified it was on file. Payment was due on the 5th and it has been taken out as of the 2nd of January 2025. December payment taken out November 27th. The later was reversed. Called in and asked for them to do the same and got told we don't do that , they will mail a cheque sometime. Unacceptable response.Need assurance this will not happen again and the charge reversed.

  

  Business Response

  Date: 13/01/2025

  Dear Member,

  Thank you for reaching out with your concerns. We take your inquiries seriously and want to provide an update regarding the status of the account. The plan has been cancelled effective December 31, 2024, and a refund of $156.00 will be mailed to the updated address as requested. This cheque is scheduled to be sent by January 14, 2025. Unfortunately, we are unable to process direct payments to the members account at this time, which is why the refund will be issued via cheque. While we understand this may not be the ideal solution, we are following the established process for refunding overpayments.

  We recognize your frustration and want to assure you that we are continuously reviewing our processes to improve the experience for our members and minimize similar situations in the future.
  If you have any further questions or need additional assistance, please dont hesitate to reach out.

  
  

  Customer Answer

  Date: 14/01/2025

   
  Complaint: 22763500
  
  I am rejecting this response because:

  This is the second time I have been told a cheque is in the mail. As per our conversation the cheque was to be couriered to me on the 14th.  Not doing so would be a breach of our verbal agreement. Your explanation makes no sense , and I , a senior on a fixed income have been caused hardship. 
  Please allow this complaint to stand until it is fully resolved.
  
  Sincerely,
  
  ********* *******

  

  Business Response

  Date: 14/01/2025

  Dear Member,
  We wanted to inform you that the email has been sent out as requested. We apologize for any inconvenience caused and appreciate your understanding.
  Thank you!
  Kind regards,
  

• Initial Complaint

  Date:12/12/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am attempting to get reimbursed for two transactions, both from May 2024. This is my second attempt to file both claims. The first one was denied on December 10 for foot orthotics because they requested a prescription from a doctor indicating the medical reason they were needed. When I click View beside attached documents I can see the prescription including the medical reason. Its right there.attached to the document and he claim is still denied. Another claim was denied on December 9, saying they had already paid it. The same claim was denied in July because the receipt wasnt attached. They are saying it was paid. I am out $1500 since May even though I am covered for both expenses.

  

  Business Response

  Date: 18/12/2024

  Dear member. We at Pacific Blue Cross sincerely apologize for the delay in processing your recent claims. After review, your orthotics claim has now been processed.  As for the denied claim in December, we determined it was a duplicate claim.  Please visit member portal for details.  At Pacific Blue Cross, we are committed to providing exceptional service and a quality experience to all our members. We appreciate your patience and understanding during this process. Your feedback is invaluable as we continuously strive to improve our services.