Complaints

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

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• 

  Anthem, Inc.

  220 Virginia Avenue Indianapolis, IN 46206-3709

• 

  Anthem, Inc.

  7923 Cullen Dr Indianapolis, IN 46219-1211

• 

  Anthem Blue Cross & Blue Shield

  8990 Duke Blvd Mason, OH 45040-8943

• 

  Wellpoint

  3723 Old Forest Rd Lynchburg, VA 24501-6948

• 

  Anthem, Inc.

  P.O. Box 105095 Atlanta, GA 30348

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:07/07/2025

  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 have been trying for 10 months to file a claim with Anthem to be reimbursed for expenses that I paid out of pocket. I have made several contacts regarding 8 claims from last year. I submitted them the first time sometime in Oct of 2024 - but they were held and denied for "more information" for over 3 months. They never emailed me to say why they were held and if I hadn't checked on them and called, I wouldn't know they were being held. They told me what I needed on the form, however, they failed to mention ALL the things that were missing. I called the provided, got the new receipts, submitted those, again they were held for "more information". Contacted Anthem again, they said i was still missing information even though I was assured the first time that i only needed one thing updated. Resubmitted those and again the claims are being held for "more information". This is the 3rd time in 10 months that I have been trying to get these claims reimbursed for payment! This is a classic "lie and delay and deny" that insurance companies are doing to delay legitimate claims. The deliberately leave out information so you have to keep calling or messaging them to get claims paid. This should be illegal and they need to be held accountable. I had to pay for the services on a credit card a t the time and now I am accruing interest because they keep delaying the claims that I thought I would have the reimbursement by Dec of last year.

  Business Response

  Date: 07/09/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.
  
  

  Thanks

• Initial Complaint

  Date:06/30/2025

  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 have an accident supplemental policy with Anthem and the issue is that i have a lot of claims open to where its in manager review , i have provided all the necessary documentation to show proof of accident doctors notes , some of these claims have been open since October 2024 , the company promotes claims are processed 3 to 5 days , if need additional research up to 30 days , its now June and these claims are still open and now no follow-up, i have called this company 19 times and 19 different callbacks have been placed for management to call me and to this day no response, it seem like claims and Management has ghosted me , i am paying a premium for this coverage and am getting absolutely no service, i had 1 manager that was trying to help but she moved departments (***********) i feel this product is absolutely Horrible and would not recommend to anyone. i am wanting resolution on these claims as i have paid for the *** and provided all documentation to justify claims , needs management follow-up and callback

  Business Response

  Date: 07/01/2025

  Please be advised that member authorization is needed prior to us being able to address the members concerns. Refer to attached letter.
  
  

  Customer Answer

  Date: 07/01/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]
  
  Regards,
  
  ***** ******
  

• Initial Complaint

  Date:06/24/2025

  Type:Product 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.

  Anthem changed my address without my permission or knowledge. I have been attempting to get my address changed back to the correct one for several weeks now, and Anthem is not helping at all. They are sending my checks to the wrong address, and my money is lost. I need my checks re-submitted and my address corrected. I have contacted Anthem, I have emailed every address I can find for Anthem, and have called as many phone numbers I can find without any success.I need this resolved, my address fixed, and my lost checks re-issued with interest.

  Business Response

  Date: 06/25/2025

  If this is a provider complaint, we need the tax id # and NPI # as well as the correct address. If this is a member complaint, we need the complete member ID # with the 3 letter prefix. 

• Initial Complaint

  Date:06/16/2025

  Type:Product 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 enrolled in a health insurance plan through *********************, but due to a major premium increase (3x the estimated amount), I requested the plan be cancelled immediately. ************** confirmed the plan was cancelled effective 1/1/2025, and I was told I would not be charged any premium.Despite this, Anthem has billed me for coverage from 1/1/2025 through 6/1/2025, and they are refusing to issue a refund. I contacted Anthem by phone, and during the call, they directly spoke with Georgia Access, who again confirmed the plan was cancelled as of 1/1/2025.Anthem acknowledged this but is still denying the refund, claiming their system shows coverage through June 1st. I am seeking a full refund for all premiums charged, as the coverage should never have been active beyond the cancellation date of January 1, 2025.

  Business Response

  Date: 06/17/2025

  Good afternoon, 

  We were unable to locate the member in our system.  Please provide the member's identification number, including the three-character prefix.  If the member was provided with a health plan identification card, the number will be listed there.

  Thank you, 

  ******** *.

   

   

  Customer Answer

  Date: 06/17/2025

  Attached is the copy of the card.

  Here is the member ID as requested

  Y2W436W22764

  Customer Answer

  Date: 06/18/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  

  See attached for the requested member id 
  Regards,
  
  ****** ***********

  
  

  Business Response

  Date: 06/20/2025

  Please be advised that member authorization is needed prior to us being able to address the members concerns. Refer to attached letter.
  
  

• Initial Complaint

  Date:06/13/2025

  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.

  Athem Blue Cross Medi-*** authorizes a food service called Mom's Meals. They constantly make me go at least a week to a week and a half without this service. I constantly get conflicting information as to whom is responsible for the lasps in service. I'm not going to receive my Foodstamps until 7/8/25 due to paperwork foulups. Both parties offer referrals to local Foodbanks. I don't have a vehicle. I'd have to do this via public transportation. I'm 64 years old. Would they like it if it were their Mother or Grandmother? I'm going to contact my local ************************ and file an Elder Abuse and Neglect case against both parties.

  Business Response

  Date: 06/17/2025

  Good afternoon, 

  We were unable to locate the member in our system.  Please provide the member's identification number, including the three-character prefix.  This information may be found on the member's health plan identification card.

  Thank you,

  ******** *.

• Initial Complaint

  Date:05/28/2025

  Type:Product Issues
  Status:

  UnresolvedMore 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 formally contacting the Better Business Bureau regarding an in-network exception that was denied by Anthem BCBS. The original denial letter concerning my case did NOT address the network deficiency that existed within Anthem BCBS's in-network maternity care providers. After my last appeal, I received yet another denial letter from Anthem BCBS that was so generic I felt the Better Business Bureau should become involved as I am convinced at this point that Anthem BCBS's appeal department does not read nor consider the information I included in my appeals at this point.Thank you for your help and ****************** Number REQ-COMM-******* Authorization Number UM71193312 Please find supporting documentation attached to this complaint.

  Business Response

  Date: 06/05/2025

  Please see the attached response to the members complaint. 

  Customer Answer

  Date: 06/05/2025

  Hello and thank you for your email!

   

  *Has the company addressed the issue of the dispute?

  This company has NOT contacted me after I submitted the complaint to the BBB.
  
  *If not, why?

  I don't believe they have a valid excuse as to why my appeals have not been addressed. I'm receiving a very generic response once my appeals are submitted for consideration.

  
  *Has the company met the agreement they outlined in their response?

  They have not and will not address the concerns in my written appeals.

   

  Thank you for your assistance!

  Customer Answer

  Date: 06/05/2025

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID 23378541, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  
  
  [Provide details of why you are not satisfied with this resolution.]

  Hello and thank you for your email!

   

  *Has the company addressed the issue of the dispute?

  This company has NOT contacted me after I submitted the complaint to the BBB.
  
  *If not, why?

  I don't believe they have a valid excuse as to why my appeals have not been addressed. I'm receiving a very generic response once my appeals are submitted for consideration.

  
  *Has the company met the agreement they outlined in their response?

  They have not and will not address the concerns in my written appeals.

   

  Thank you for your assistance!

  
  
  
  
  Regards,
  
  
  
  Charity Wilkerson

  
  

  Business Response

  Date: 06/12/2025

  Please see attached Follow-up Response. 

  Customer Answer

  Date: 06/13/2025

  Thank you so much for your follow up. Please find the additional information required for the BBB to move forward on my behalf:

   

  
  
  To assist us in bringing this matter to a close, we would like to know your view on the matter.
  
  *Has the company addressed the issue of the dispute?

   

  The company has failed to address my concerns. My last communication from the company was received from April 23rd, 2025.
  
  *If not, why?

   

  The letters are generic and fail to address my concerns listed in the appeal letters. At this point I feel my letters are not opened nor read...
  
  *Has the company met the agreement they outlined in their response?

  They have not.

  Please submit your thoughts via the online system included, or fax, email, or mail within 7 days.
  
  The text of your complaint, the company's response and any rebuttal may be publicly posted on BBB website (BBB reserves the right to not post in accordance with BBB policy).  Do not include any information that personally identifies you in your response.  By submitting your response, you are representing that it is a truthful account of your experience with the business.  BBB may edit your response to protect privacy rights and to remove inappropriate language. Your complaint will be made part of the company's BBB Business Profile. If we don't hear from you your complaint will be reflected as "answered".  
  
  We appreciate the opportunity to be of service, and sincerely hope you will contact us for assistance in the future.  
    
  Sincerely,
  
  
  
  Theresa Davis
  Accredited Business Dispute Resolution Specialist
  [email protected]
  Phone: 317-713-6081

  Customer Answer

  Date: 06/19/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  

  My complaint was never address by Anthem BCBS. Not only am I highly disappointed in the company and lack of communication, but I would like to forewarn future families of the lack of regard Anthem BCBS has for them members.

  It is clear that Anthem BCBS only cares about their profit margin. Not the needs of their members.

  
  Regards,
  
  ******* *********

  
  

  Business Response

  Date: 06/26/2025

  Please see attached Follow-up Response. 

  Customer Answer

  Date: 07/01/2025

  Hello and thank you for your reply.
  
  This message is in regard to your complaint submitted on 5/28/2025 against Anthem, Inc..  Your complaint was assigned ID 23378541. We received the business's response to your concerns and you can find the contents of the message below or attached.  
  
  To assist us in bringing this matter to a close, we would like to know your view on the matter.
  
  *Has the company addressed the issue of the dispute?

   

  No, the company Anthem BCBS never responded.

  
  *If not, why?

   

  As I stated in my original complaint, this company never addressed my appeals with valid answers. The replies for generic and lacked investigation per my appeal request.

  Anthem BCBS does not address medical necessities, nor do they consider the network deficiency currently within their network. 

  
  *Has the company met the agreement they outlined in their response?

   

  They have NOT.
  
  Please submit your thoughts via the online system included, or fax, email, or mail within 7 days.
  
  The text of your complaint, the company's response and any rebuttal may be publicly posted on BBB website (BBB reserves the right to not post in accordance with BBB policy).  Do not include any information that personally identifies you in your response.  By submitting your response, you are representing that it is a truthful account of your experience with the business.  BBB may edit your response to protect privacy rights and to remove inappropriate language. Your complaint will be made part of the company's BBB Business Profile. If we don't hear from you your complaint will be reflected as "answered".  
  
  We appreciate the opportunity to be of service, and sincerely hope you will contact us for assistance in the future.  
    
  Sincerely,
  
  
  
  Theresa Davis
  Accredited Business Dispute Resolution Specialist
  [email protected]
  Phone: 317-713-6081
  
  
  MESSAGE FROM BUSINESS:
  
  Please see attached Follow-up Response. 
  Attached Files/Documents

  Customer Answer

  Date: 07/02/2025

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID 23378541, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  
  
  [Provide details of why you are not satisfied with this resolution.]

  Hello and thank you for your reply.
  
  This message is in regard to your complaint submitted on 5/28/2025 against Anthem, Inc..  Your complaint was assigned ID 23378541. We received the business's response to your concerns and you can find the contents of the message below or attached.  
  
  To assist us in bringing this matter to a close, we would like to know your view on the matter.
  
  *Has the company addressed the issue of the dispute?

  No, the company Anthem BCBS never responded.

  
  *If not, why?

   

  As I stated in my original complaint, this company never addressed my appeals with valid answers. The replies for generic and lacked investigation per my appeal request.

  Anthem BCBS does not address medical necessities, nor do they consider the network deficiency currently within their network. 

  
  *Has the company met the agreement they outlined in their response?

   

  They have NOT.
  

  
  
  
  Regards,
  
  
  
  Charity Wilkerson

  
  

• Initial Complaint

  Date:05/22/2025

  Type:Billing Issues
  Status:

  UnresolvedMore 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 the legal Guardian for my niece ******** *******. ******** ******* was receiving ***** services through ************ with an authorization from Anthem. The provider of the ***** services ***** ******** was never paid for April 2025. I was told by ************ that they need to receive a fax from Anthem with the authorization number for services rendered in April 2025. When I call Anthem, they give a run around answer in regard to the authorization #, UM78776045. I was told that this authorization number was from July 2024 through June 11, 2025. However, when Ms. ******** stated that she was not paid for services rendered in April 2025, I called Anthem on multiple occasions. They stated that the authorization is NY0455749 for the month of April (4/1/25 - 4/28/25). They also stated that the service would be converted from ***** to PCA effective (4/29/25 - 6/11/25) with Evergreen (the care company) under the authorization number UM78776045. However, up to this point Ms. ******** has not been paid for the services ******** is receiving.

  Business Response

  Date: 05/27/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.
  
  

  Thanks,

  Paige 

  Customer Answer

  Date: 05/27/2025

  The member's ID number is ************.

  ******** *******

  DDB - 10/4/2013

  Customer Answer

  Date: 05/27/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]

  The member's ID number is ************.
  
  Regards,
  
  ****** *****

  
  

• Initial Complaint

  Date:05/13/2025

  Type:Customer Service 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.

  number ************ calls me up every day at least ten times a day never leaves a message for me last call was at 2:01 pm today and i awnser it this way because some people like spam risk callers hang up and not call again because they really think that they called that but this one keept laughing so i flat out told her to quite calling me and hung up im sorry i dont care if i am inrolled with them or not they should never call me unless i call and request a call back other then that it better be in writing or you will never get me to respond to you if you are really wellpoint then thats what you have to do to get my attention

  Business Response

  Date: 05/14/2025

  May 14, 2025
  
  Better Business Bureau (BBB)
  Attention: ******* *****
  *******************
  12th Floor
  ******************
  VIA: BBB Portal
  
  
  Member: ****** ********
  Re: ****************
  ******************** File No.: 23305863
  
  Dear BBB:
  
  This is in response to your correspondence dated May 13, 2025, regarding the above referenced member.
  
  Due to federal laws pertaining to the **************** Portability and Accountability Act (HIPAA)and the Protected Health Information (PHI) portion of it that went into effect April 14, 2003, we cannot relinquish information without proper authorization.  Therefore, we will be addressing the concerns in question and responding directly to ****** ********.
  
  I trust that the information provided will aid in resolving your concerns and want to thank you for the opportunity to assist you. Should you have any additional inquiries, please do not hesitate to contact me at **********************************************************************.         
  
  Thank you for your concern.
  
  ******** ********
  Grievance Analyst I
  Medicare Complaints, Appeals & Grievances

  Customer Answer

  Date: 05/15/2025

  They are still doing it it's in my phone and the numbers too so you just lied

  Customer Answer

  Date: 05/19/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]

  They are still doing it it's in my phone and the numbers too so you just lied
  
  Regards,
  
  ****** ********

  
  

  Business Response

  Date: 05/28/2025

  May 28, 2025
  
  Better Business Bureau (BBB)
  Attention: ****** ********,Complaint Analyst
  *******************
  12th Floor
  ******************
  VIA: BBB Portal
  
  
  Member: ****** ********
  Re: Scam Calls
  BBB File No.: 23305863
  
  Dear BBB:
  
  This is in response to your correspondence dated May 19, 2025, regarding the above referenced member.
  
  Due to federal laws pertaining to the **************** Portability and Accountability Act (HIPAA)and the Protected Health Information (PHI) portion of it that went into effect April 14, 2003, we cannot relinquish information without proper authorization.  Therefore, we will be addressing the concerns in question and responding directly to ****** ********.  
  
  I trust that the information provided will aid in resolving your concerns and want to thank you for the opportunity to assist you.  Should you have any additional inquiries, please do not hesitate to contact me at **********************************************************************.         
  
  Thank you for your concern.
  
  ******** ********
  Grievance Analyst I
  Medicare Complaints, Appeals & Grievances

  Customer Answer

  Date: 05/29/2025

  They never called and if they did they must have really hit a nerve that day too cause a lot of them try and argue with me when I tell them all the time not to contact me 

  Customer Answer

  Date: 05/30/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]

  They never called and if they did they must have really hit a nerve that day too cause a lot of them try and argue with me when I tell them all the time not to contact me 
  
  Regards,
  
  ****** ********

  
  

• Initial Complaint

  Date:05/12/2025

  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.

  I had procured Anthem ***** insurance though the Maine *********** market place earlier this year, at which time I had set up auto-pay. After having my baby in February my family qualified for MaineCare as of April 1, 2025, at which point the Anthem **************** I had purchased was canceled, or so I thought. On April 28, 2025 they deducted my now greatly increased premium of $625.26 from my bank account, our previous premium had been $46/month. I reached out to them on April 30, 2025 to get an explanation and a refund. The representative agreed that the insurance had in fact been canceled on April 1, 2025 and she was submitting a request for a refund. She said that the refund would take 3-5 business days to process. I have since received conflicting notices from Anthem, one saying that our coverage had been terminated effective April 1, 2025, and just this past weekend I received a bill, dated May 2, 2025, for an addition $192.16 and a notice that I am in a ***** period because of an unpaid balance (dated May 1, 2025). As of today I still have not received the refund for the $625.26 that they wrongfully withdrew from my bank account. This all prompted me to call to see what they heck was going on and the representative that I spoke with today (May 12, 2025) told me that the claim for refund was still process and was unable to give any estimate on when I might get my money back. I requested that she escalate the claim because thats an unacceptable resolution and was told that she had put a note on my file for the representative who had initially put the claim through but that was all she could/would do. This company had essentially stolen my grocery money for the month and are refusing to give it back. I am livid.

  Business Response

  Date: 05/13/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.

  Thanks,

  ***** *. 

  Customer Answer

  Date: 05/18/2025

  Attached is a copy of my digital insurance card from anthem so the representative is able to locate my files

  Customer Answer

  Date: 05/19/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]

  Attached is a copy of my digital insurance card from anthem so the representative is able to locate my files
  
  Regards,
  
  ***** *****

  
  

  Business Response

  Date: 05/19/2025

  Please be advised that member authorization is needed prior to us being able to address the members concerns. Refer to attached letter.
  
  

  Thanks,

  ***** *. 

  Business Response

  Date: 05/19/2025

  Please be advised without member consent, see previously sent letter, we cannot address the members concerns. 

  Thanks,

  ***** *. 

  Customer Answer

  Date: 05/29/2025

  The Form Anthem Requested

  Business Response

  Date: 06/02/2025

  See attached decision letter.

  Customer Answer

  Date: 06/02/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  They absolutely did remove $625.25 from my bank account on April 28, 2025 which was only remedied after I reached out directly to my bank to resolve the matter because Anthem customer service proved to be utterly useless on both occasions that I tried to resolve it thought them. Furthermore I am still receiving notices from Anthem that my premium, for a policy that was canceled affective 4/1/2025, that my premium is past due. Where the bank has taken care of the financial end of things, an apology and a permanent stop on the harassing and inaccurate account statements would rectify the situation in my eyes.
  
  Regards,
  
  ***** *****
  

  Business Response

  Date: 06/05/2025

  Please see attached decision letter.

  Thanks,

  *****

  Customer Answer

  Date: 06/06/2025

  Better Business Bureau:

  I have reviewed the response made by the business in reference to complaint ID ********, and find that this response/resolution is satisfactory to me  
  
  
  

  Regards,

  ***** *****

• Initial Complaint

  Date:05/07/2025

  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.

  RE: Denied coverage for preventive care (annual screenings)Insurer: Anthem Blue Cross Member ID: ********* Case number: REQ-COMM-******* To Whom it May Concern: I would greatly appreciate assistance with the following matter.On March 5, 2025 I visited my primary care physician for an annual physical at which time she ordered laboratory studies, as she has done every time I've had an annual exam. Prior to getting my blood drawn, the laboratory admission clerk ran an estimate of the costs based on my insurance and coverage which she estimated to be $0. However, when I received the *** from Anthem, they said I owed $296.18 for a complete metabolic panel and **** 2 lab panels they didn't cover because they were not considered preventive care. This came as a surprise since all of my insurance carriers, for decades, have fully covered these labs annually. When I contacted a representative at Anthem, she said they weren't covered because they didn't have one of the following codes: 07V, 07X, or 07Z. When I contacted ****** Health, they confirmed that the information they submitted to Anthem was correctly coded as ************* an RN for ************************************** Nursing academia for 17 years, I am shocked that a complete metabolic panel and a *** would not be considered preventive care and denied coverage for the following reasons: A Complete Metabolic Panel includes: Glucose (screens for pre-diabetes and diabetes), Sodium (screens for endocrine, kidney, and adrenal gland disease), Potassium (screens for endocrine and kidney disease), Calcium (screens for kidney, parathyroid, and thyroid disease), Phosphorus (screens for kidney disease), Creatinine and BUN (screens for kidney disease); while a *** (complete blood count) screens for blood dyscrasias, infection, bleeding disorders, and anemia. After all, these labs are screened annually as the standard of care.I am seeking reimbursment of $296.18 for labs that should be covered as preventive care.

  Business Response

  Date: 05/14/2025

  Please see attached response for the member's complaint. 

  Customer Answer

  Date: 05/15/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  Anthem is only asking for an authorization form to discuss my complaint. The authorization form has been sent to Anthem and has been uploaded here allowing representatives at the Better Business Bureau to discuss this matter. Nothing about the bill has been addressed nor resolved. It remains my position that the labs that Anthem has refused to cover are preventive in nature and should be covered under my Health plan. The appeal is still active and has not been resolved. 
  
  Regards,
  
  ****** ******-*******
  

  Business Response

  Date: 05/22/2025

  Please see attached follow-up response. 

  Customer Answer

  Date: 05/27/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]
  
  Regards,
  
  ****** ******-*******
  

  Customer Answer

  Date: 05/27/2025

  I reject Anthem's response as it is a blatant lie that my labs were ordered as diagnostic. You can see in the highlighted text in the attached document, that my PCP ordered these labs as routine health maintenance. Also attached is my correspondence with my PCP about being billed by Anthem for these labs and she clearly responded that she was surprised since she put them in ******** system as routine health maintenance, i.e. preventive care. 

  Business Response

  Date: 06/04/2025

  Please see attached Follow up response. 

  Customer Answer

  Date: 06/05/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  Anthem's response is unacceptable and just another example of an insurance carrier trying to get out of paying what they are responsible for. Once again, the patient (me) is not responsible for billing codes and should not be in the middle of a dispute between coding by the health care provider versus what codes the insurace carrier will accept for preventive services. I have provided multiple documents indicating that the visit was an annual physical with the intent of all services, including labs ordered, to be preventive. In fact, in my original statement I mentioned that the admin clerk in the lab ran an estimate against my insurance using the codes that my provider entered and I was told it would be $0 for ALL of the labs and venipucture performed. No one ever mentioned that the facility where I had my blood drawn was associated with a hospital which doesn't make any sense since there is not a ****** hospital within miles of this location. Trying to get the codes changed by ******************* to reflect the codes that Anthem will recognize should not be my responsibility as it is entirely out of my control as the patient.  In my complaint and the subsequent rebuttals, I have provided correspondence from *** **** who said that she entered the codes as preventive and an insurance carrier has never denied covering these labs before. I have been seeing the same provider for years and having my labs drawn at the same facilty, which is an outpatient lab located in the same office complex as my health care provider as well as multiple others. In fact, my prior insurance carrier, *****************, ALWAYS 100% covered the annual exam and the same labs that Anthem is refusing to reimburse. This experience has been an abomination! If Anthem wanted to resolve this dispute, they would work with ****** Health to find codes to cover these labs! I am at the point that if this dispute cannot be resolved, I will be contacting 7 on Your Side, a local media outlet that helps consumers like me by investigating and broadcasting stories like mine. In addition, I am considering changing insurance carriers as my experience thus far has been an outrage considering that I have only used the carrier once since I signed up through Covered California in January 2025. 
  
  ****** ******-*******
  

  Business Response

  Date: 06/16/2025

  Please see attached Follow-up Response. 

  Customer Answer

  Date: 06/16/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  Once again, this response is unacceptable. Despite Anthem's claims that they are not responsible for what is submitted by the ***, they have the ability to recognize through all of the documents provided that this visit and its subsequent lab work was preventive in nature and intended as such. At this point, I will be contacting my attorney who is standing by to file a lawsuit in this matter. 
  
  Regards,
  
  ****** ******-*******