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Business Profile

HMOs

Anthem Blue Cross And Blue Shield

This business is NOT BBB Accredited.

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Complaints

This profile includes complaints for Anthem Blue Cross And Blue Shield's headquarters and its corporate-owned locations. To view all corporate locations, see

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    Customer Complaints Summary

    • 46 total complaints in the last 3 years.
    • 12 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    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.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:07/05/2023

      Type:Customer Service Issues
      Status:
      UnansweredMore 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 denied medical care and I called Anthem today to speak to someone about it. I spoke to a person from member services, which the form you sent for my denial told me to call. After wasting a 1/2 with her she had to route me to someone else and promised me it would be taken care of. Despite her promises, she sent me to the wrong department who then rerouted me back to her department! I don't get paid to sit on hold an HOUR to have nothing done and then transferred right back to the same department who doesn't deal with account holders.I guess the people from out of country could care less about making us happy and Anthem also could care less whether their customers are taken care of or not! Thank you for wasting more of my time, especially since you denied my claim and I am in SEVERE Pain. Jerking me around really makes me feel better.
    • Initial Complaint

      Date:06/27/2023

      Type:Service or Repair Issues
      Status:
      UnansweredMore 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.
      2 years of work-up and diagnostics were disregarded by Anthem BCBS **************************** They sent a denial letter 20 days before a surgery that has been scheduled for 4 months to fix a debilitating issue regarding knees. Career job? Gone. Home life? Severe pain or medicated(and residually very painful). No 38 year old is begging for knee surgery and has documentation to support it. Come on, Anthem BCBS, be better than your bottom line.
    • Initial Complaint

      Date:06/09/2023

      Type:Billing Issues
      Status:
      UnansweredMore 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.
      Went to see my GENERAL Physician in December 2022 because I was sick and needed a strep test. Anthem/Blue Cross DENIED my claim because they claim I need PRIOR approval to see a general physician assistant. I cannot (and should not) get prior approval, to go to my General doctor. There is ONE medical care center in our town. I had to pay $222 to avoid having the claim go to insurance. I had another doctor *********** today either my SAME doctor. My doctors office said I was not approved. After 2 1/2 hrs TRYING to get some help on customer support, I had to eventually give up and cancel my general checkup *********** with my primary care physician. This is absolutely wrong and should be illegal.
    • Initial Complaint

      Date:06/08/2023

      Type:Service or Repair Issues
      Status:
      UnansweredMore 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.
      Dear Anthem Health Insurance,I hope this letter finds you well. I am writing to bring to your attention a discrepancy I have discovered while reviewing the claim records. It appears that my visits to ************************* P have been incorrectly counted as both Chiropractor and Physical Therapy visits. I would like to clarify that ************************* P is a Chiropractor, not a Physical Therapist, and therefore the visits to this healthcare provider should not be categorized as Physical Therapy visits.Please check the attached PDF file for details.
    • Initial Complaint

      Date:05/08/2023

      Type:Billing Issues
      Status:
      UnansweredMore 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.
      On or around the week of March 13th, I called the customer ********************** **** on my wife's claims. She went to the doctor on three occasions, and Anthem did not cover the claims. After going back and forth for about an hour, I was told that they would review the claim and sent it back to the health care provider to ensure that the tests were coded properly. **** told me that it could take a few weeks and that they would send me an email when the results were completed. On or around the week of April 3rd, I reached back out, via the online support, and they advised that the claim was still under review. I was advised that once they hear back from the healthcare provider, then they will let me know their decision on the claim. I spent another hour speaking with them. During the week of April 27th, I reach back out. I had not heard from them and my wife was getting calls from the credit collections. I spent over six hours speaking to a customer rep. **** informed me that their policies state that they cannot send claims to healthcare providers (as I was told they would) and that they did an "internal investigation" and found no issues with the payouts. I repeatedly asked if they reached out to the healthcare provider, to which they kept giving me the runaround and would not answer yes/no. **** reverted back to "our internal investigation found no issues". After spending upwards of ten hours speaking with them with no conclusion to my original claim, I asked to speak to a manager. It's been ten days and I have not received a call. This company is refusing to provide adequate information as to why they would not look into my claim and would not comment further. The customer ********************** was of no help and the company does not help it's insureds when they need it. I am currently in process of cancelling my policy with them, only after five months of service.

      Customer Answer

      Date: 05/05/2023

      The insurance is in my name

      Customer Answer

      Date: 05/08/2023

      My insurance is through blue cross blue shield in Colorado. The insurance is in my name
    • Initial Complaint

      Date:02/06/2023

      Type:Sales and Advertising Issues
      Status:
      UnansweredMore 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 submitted 3 claims last fall under a group policy. These claims were for services that had been covered multiple times by Anthem in the same year. I received mail that these three claims were missing the diagnostic codes. I was able to get new super bills that listed the dx numbers, but after three attempts I have not been able to get Anthem either on the phone nor through their customer ********************** messenger to correct the claims with the updated super bills. I have spent over 8 hours trying to get someone to help me, and each time a representative begins to work on my case, they either end up mysteriously getting disconnected or they tell me they cannot help me because it is a group policy. The bills are for over $600 for which anthem owes me almost $500 back.
    • Initial Complaint

      Date:02/02/2023

      Type:Product Issues
      Status:
      UnansweredMore 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.
      My husbands insurance provider changed at the beginning of 2023. We switched from United Healthcare to Blue Cross Blue Shield of Colorado. During the initial enrollment period I was not given an option to choose my preferred primary care physician. However, I called my PCP to ensure they accepted BCBS of ** and she confirmed she was in their network. When we received our insurance cards they had some random doctor listed as our PCP. I attempted to go online and on their Sydney app to get my PCP updated before an upcoming appointment with my PCP. I only ever received error messages saying I had to call in to make that change. During my first call they stated it had been updated and that it would be reflected online and a new physical card would be mailed. I checked a week later online when the new physical card came and was still showing the old unknown PCP and even online it still showed the incorrect PCP. I called again the day before my doctors appointment to have it updated again. This time they said they updated it and even called my PCPs office to say they updated it. However, again a new card and the online profile still shows the unknown doctor. So I called for a third time just to get the same run around and to my surprise they assigned my PCP to my husbands profile and did not update mine. ***** considering he has never gone to my PCP and he never requested the change to PCP. Since my PCP requires her name to display on the card I am unable to receive health care due to these issues. BCBS is literally preventing me from being able to see my doctor. This needs to be fixed now since I have more upcoming PCP appointments this year.
    • Initial Complaint

      Date:01/04/2023

      Type:Order Issues
      Status:
      UnansweredMore 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.
      Anthem claim number ************* for 4/2022 out of network services was submitted 6/8/2022 & approved 7/25/2022 for $825 but has not been successfully paid to the patient (me), on my submitted claim form.Anthem states that the check was mailed and cashed. Both myself and my provider (***************) have notified Anthem that neither one of us live or work at the address Anthem mailed the check. And that the check should be made out to the patient (me, *******************). We believe it was fraudulently cashed. The address Anthem says the check was made out to *************** and was mailed to: *************************************************** have tried to call and resolve this over the phone with Anthem's representatives 11 times since 6/2022.I have also been advised by my provider (Dr) that at this time I can request interest since it has been more than 60 days.Multiple calls (8/26/2022, 9/12/2022, 10/5/2022) stated that a 'new check" was being reissued.My following calls (11/10/2022, 12/2/2022) I requested direct deposit & confirmed my direct deposit since no mailed check had arrived.It is now my understanding that these Anthem representatives were submitting the request, but the Anthem payment department has been denying the payment because their system has it as already been paid. It has NOT been paid to me. The most recent denial is dated 12/7/2022 stated to be a "redundant" claim. It is not redundant. It has NOT YET been successfully reimbursed.I pay my Anthem health premiums on time; I expect Anthem services to be rendered (in this case, accurate reimbursement) in a timely manner.
    • Initial Complaint

      Date:10/27/2022

      Type:Service or Repair Issues
      Status:
      UnansweredMore 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.
      On July 18 2021 I was emptying my camper sewage black/gray water when I turned around and slipped on pavement that had raw sewage on the ground and broke my ankle it was a compound fracture bone sticking out and my foot was facing the opposite direction. I could not walk or move my leg so I called an ambulance they took me to ******************* hospital at **************************************************** Colorado 80122-2602 Once I arrived they took me directly into the ** where DR ******* *********************** told me they would have to do Emergemcy surgery ASAP because it was an open fracture and the raw sewage I had fell in could cause an infection that I could die from if not cleaned out ASAP and then treated with antibiotics. I had the surgery done immediately they cleaned out the wound but they could not fix the broken ankle at the same time because I was under anesthesia too long. They kept me in the hospital and he did another surgery two days later during this time I was on antibiotics. DR ******* *********************** did the second surgery also repairing the broken ankle. Blue Cross and Blue Shield paid all the bills to the hospital but I cannot get them to pay the ** **************************** ***********************. This was an emergency surgery done in ********* emergency room and should be paid I did a dispute with Blue Cross and Blue Shield and they said it was not an emergency. I have pictures of my ankle pointed the opposite direction with the bone sticking out obviously it was an emergency. **************** had to bill it from his practice Panorama orthopedics and spine Center but that is not where he did the surgeries he was the attending Emergency room DR at ******************* Hospital that did my surgery. The insurance company says he is not in network but he does not need to be if it was an emergency and clearly this was an emergency. I have tried to explain to the insurance company that he was the ** doctor that it was not done at his practice the bill is $10,982.69 please help
    • Initial Complaint

      Date:10/07/2022

      Type:Billing Issues
      Status:
      UnansweredMore 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 started a new medical and dental plan with anthem on October 1st. On September 30th I received an email to make a payment. I made a payment but it was only for the amount of my medical plan. I called Anthem to try to pay my dental bill over the phone. They said I was all payed for both my medical and dental plan that started on October 1st. I went back and forth with the rep as I believed I still needed to pay my dental. After an extended period of time of him insisting the payment that I made was for both my medical and dental and that there was nothing for him to accept payment for I had no choice but to let it go. Today, I received an email saying my account was past due. I called anthem again. I had a different rep this time but they again insisted that I was all paid up for both medical and dental for the month of October. Multiple times I said I received this email and I'm showing I owe in my account...what's going on. The rep again continued to insist that I didn't owe anything. This time, however, I wouldn't give up this easily. Eventually, after an hour plus the rep tells me that I do indeed owe money and that it is late.

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