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Business Profile

Medical Plans

CareFirst, Inc.

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Medical Plans.

Complaints

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

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CareFirst, Inc. has 3 locations, listed below.

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    Customer Complaints Summary

    • 135 total complaints in the last 3 years.
    • 41 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.

    Sort by

    Complaint status

    Complaint type

    • Initial Complaint

      Date:10/19/2023

      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.
      When I lost my job in August 2022, I applied for both ******** and Marketplace at the discretion of the ************** representative, unsure of which plans I qualified for, and they told me to apply for both, and I found out I was eligible for ******** in September 2022, so I notified CareFirst. According to the CareFirst representative I was due a portion of refund since I

      Business Response

      Date: 10/27/2023

      Your letter has been forwarded to a CareFirst staff member to investigate and we will be in contact with the complainant directly. Please be assured that we are working as quickly as possible to provide an equitable resolution. 
    • Initial Complaint

      Date:08/14/2023

      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.
      Good morning.Customer Care of ********************** is probably the worst I have ever tried.I have tried to contact Carefirst at the phone on Augut 10th and 11th and today 14th and that's where my Odyssey started. I have been bounced many times (more than 7) from one number to the other, every time restarting with my credentials and the explanation of what I needed. More than 4 hours at the phone, so far for nothing. I have also sent a message in the portal but, after 5 days, no answer except an aknowledge of having received my email.I was simply looking for a "letter of coordination for auto policy" aka "letter of QHC - Qualified Health Coverage" and a letter of "proof of coverage". My husband had his one from **** in 5 minutes. I need it because it aleviates the cost of my auto policy of $284 but apparently nobody in Carefirst is able to understand what it is and if they can provide it. Today my new insurance kicks in and I had to pay the full amount. I am still trying to talk to somebody in Carefirst. :-(. Thank you very much for your help.

      Business Response

      Date: 08/17/2023

      Good morning,

      CareFirst will respond directly to the member. Thank you for the opportunity to address your concerns. 


      ******* R.*******
      She/Her/Hers
      Lead Analyst|Executive Inquiry
      CareFirst BlueCross BlueShield
      ******************************
      **************************************
      w ************|f ************
      **********************************************************************************

    • Initial Complaint

      Date:07/18/2023

      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.
      BLUECROSS BLUESHIELD MARYLAND HAS PUT A GUN TO MY HEAD. I HAVE TO GO ON THEIR plan after the 31st because my medicaid cuts off. (YOU MAY NOT DISCUSS MEDICAID IN AN FASHION IT IS A VERY COMMON TACTIC FOR YOU TO SHIFT BLAME ONTO THEM. ALL MEDICAID OPTIONS SHOULD BE CONSIDERED EXHAUSTED). The deductible is $5000 (NO other plan covers what I need, all other plan options should be considered exhausted). I cannot afford my trikafta at $5000 and I will die without it. I called asking if I can use a copay assistance program at trikafta to cover my deductible. they could not tell me if the copay assistancer would count towards my copay or if It would get stolen by PillarRx (who they said is an entity with Caremark that helps you by taking copay assistance your eligible for and paying out to the insurance company instead of you. It helps by paying a billion-dollar company while I die.

      11 of your agents and Caremark agents went in kill loops directing me to one another for 4 hours. I just wanted to know if the copay assistance counts towards THE DEDUCTIBLE. THE AGENTS RANTED FOR HOURS WHILE REFUSING TO ANSWER THIS IN DESPERATION TO KEEP THE KILL LOOP GOING TILL CLOSE. THE LAST SUPERVISOR DANA REFUSED TO TRANSFER ME UP WHEN SHE DIDNT KNOW THE ANSWER FOR OVER AN HOUR. i EVEN SPECIFICALLY ASKED HER TO CONFRENCE CALL WITH CAREMARK MULTIPLE TIMES AND SHE REFUSED AND INSTEAD SPENT HOURS DOING RANDOM BULLKSHIT TO KEEP THE KILL LOOP GOING. eventually SHE DIRECTED ME TO THE COPAY ASSISTANCE i FOUND ORIGINALLY. She DID NOT HELP. THIS WAS THE ASSISTANCE i WAS ASKING ABOUT.

      THEY HAVE SUCEEDED IN THE KILL LOOP. 4 HOURS AND i FAILED. I WANT TO SMASH MY TEETH IN NOW, I hate myself for being used by your agents. I even told dana I was thinking about hurting myself and she did not transfer up.

      I REALLY THINK IM DEAD AFTER THAT, THERES NO WAY TO GET MY MEDS. I will sue if you use PillarRx to steal my assistance. I also want credit on my premium for this awful treatment.

      Bureau Response

      Date: 07/18/2023

      Kim *******
      CareFirst, Inc. 

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





      Dear Kim *******: 

        

      Better Business Bureau (BBB) received a complaint about your business. BBB understands that there are two sides to every dispute, and we have not pre-judged the validity of this claim. This is your opportunity to address the concerns of your consumer and to rebuild the trust that first brought you together. BBB seeks to help businesses resolve their disputes, whether or not they are accredited with BBB.  The complaint was submitted on 7/17/2023 and was assigned an ID of *********   



      How do I take care of this?

      Your BBB is requesting a written response to this complaint within the next 7 calendar days.  Your prompt and professional response greatly enhances the chance for a successful resolution and will further your reputation as a BBB Accredited Business.  If you received this complaint via email, the fastest and easiest way to view and respond is to the simply click on the “Respond to this Complaint”, link located on the left.  All responses will be copied to the complainant. 



      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      What should I include in my response?

      Please provide an explanation of the events from your perspective and/or a concrete plan for how to work toward a resolution. Remember that the more factual information we have about the case, the easier it is for all parties to develop a full understanding of the situation. 

       

      Please understand that the complaint content and your response may be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.



      What will happen if I do not submit a response and what can I expect to happen next?

      If you do not respond promptly to this complaint, it may be closed as Unanswered.  This may result in a substantially lower rating with BBB, which could adversely influence potential customers. Once we receive your response, we will forward it to your customer and ask them to tell us in writing whether your response resolves their concerns.  If they continue to express dissatisfaction, the case will be reviewed by BBB staff to determine if the remaining concerns warrant an additional response.  The overall standard applied in the review process is: Did the company act in good faith, and do everything that could be reasonably expected, or is responsible for, to resolve the issue?



      We look forward to helping you and your customer work toward an amicable resolution. 

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####


       

      CUSTOMER EXPERIENCE INFORMATION

       

      Customer Information:

      William **************

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

      Daytime Phone: ###-###-####
      E-mail: ******************

       

      The details of this matter are as follows:

       

      Complaint Involves:
      Billing or Collection Issues 

       

      Customer’s Statement of the Problem:



      BLUECROSS BLUESHIELD MARYLAND HAS PUT A GUN TO MY HEAD. I HAVE TO GO ON THEIR plan after the 31st because my medicaid cuts off. (YOU MAY NOT DISCUSS MEDICAID IN AN FASHION IT IS A VERY COMMON TACTIC FOR YOU TO SHIFT BLAME ONTO THEM. ALL MEDICAID OPTIONS SHOULD BE CONSIDERED EXHAUSTED). The deductible is $5000 (NO other plan covers what I need, all other plan options should be considered exhausted). I cannot afford my trikafta at $5000 and I will die without it. I called asking if I can use a copay assistance program at trikafta to cover my deductible. they could not tell me if the copay assistancer would count towards my copay or if It would get stolen by PillarRx (who they said is an entity with caremark that helps you by taking copay assistance your eligible for and paying out to the insurance comapny instead of you. It helps by paying a billion dollar company while I die.

      11 of your agents and caremark agents went in kill loops directing me to one another for 4 hhours. I just wanted to know if the copay assistance counts towaRDS THE DEDUCTIBLE. THE AGENTS RANTED FOR HOURS WHILE REFUSING TO ANSWER THIS IN DESPERATION TO KEEP THE KILL LOOP GOING TILL CLOSE. THE LAST SUPERVISOR DANA REFUSED TO TRANSFER ME UP WHEN SHE DIDNT KNOW THE ANSWER FOR OVER AN HOUR. i EVEN SPECIFICALLY ASKED HER TO CONFRENCE CALL WITH CAREMARK MULTIPLE TIMES AND SHE REFUSED AND INSTEAD SPENT HOURS DOING RANDOM BULLKSHIT TO KEEP THE KILL LOOP GOING. eVENTUALLY SHE DIRECTED ME TO THE COPAY ASSISTANCE i FOUND ORIGINALLY. sHE DID NOT HELP. THIS WAS THE ASSISTANCE i WAS ASKING ABOUT.

      THEY HAVE SUCEEDED IN THE KILL LOOP. 4 HOURS AND i FAILED. I WANT TO SMASH MY TEETH IN NOW, I hate myself for being used by your agents. I even told dana I was thinking about hurting myself and she did not transfer up.

      I REALLY THINK IM DEAD AFTER THAT, THERES NO WAY TO GET MY MEDS. I will sue if you use PillarRx to steal my assistance. I also want credit on my premium for this awful treatment.











      Desired Settlement:
      Store Credit



       
      HIPAA: HIPAA Release was offered and accepted on 7/17/2023.


      Bureau Response

      Date: 07/18/2023

      William **************

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





      Dear William **************:



      Thank you for contacting the Better Business Bureau. This message is in regard to your complaint submitted on 7/17/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 



      Now that I have filed, what is the next step?

      We have forwarded your complaint to the business for their response. We have asked the business to reply promptly, but some disputes may take longer than others to conclude.  Please be patient as we work to ensure that your concerns are addressed. 



      What if I do not agree with the response from the business?

      It is important for both parties to maintain realistic expectations and respond in a professional, fair and courteous manner.  Our goal is for you and the business to be able to work towards an amicable solution. Should this prove difficult, we may offer you and the business the opportunity to participate in binding arbitration.  More information about these options can be found at www.bbb.org



      What happens if a business does not respond?

      BBB will make every effort to obtain a response from the business, but some businesses simply do not ever contact us.  BBB is not an enforcement agency. We cannot force a business to respond. However, failure to do so may result in a negative impact on their BBB rating, which may drive away future customers. BBB can also refer you to other agencies that may be able to assist you, depending on the specific nature of your complaint. 



      Feedback from consumers is vital to BBB. We appreciate your willingness to report this information to us. We look forward to helping you and the business work toward a resolution. Please do not hesitate to contact us with any additional questions or concerns.  



      Sincerely,



      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####

      Business Response

      Date: 07/20/2023

      Tell us why here...July 20,2023 


      Better Business Bureau of Greater Maryland Attention: Heather ****** 
      Dispute Resolution & Trade Practices Specialist 
      *** ** ***** **** ***** **** 
      ********** ** ***** 


      RE: BBB File Number* ******** * William **************  
       

      Dear Heather ******: 

      This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  

      CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  

      Please be assured that we are working as quickly as possible to provide an equitable resolution.  


      Sincerely, 

      Danielle ******* 

      Danielle ******** *** ******* 
      CareFirst Executive Inquiry Department 

      Bureau Response

      Date: 07/20/2023

      William **************

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





      Dear William **************:



      This message is in regard to your complaint submitted on 7/17/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 
       

      BBB has received a formal response
      from CareFirst, Inc.. We ask that you review the response and understand that BBB
      is here to assist both parties in reaching a fair and reasonable resolution.


      Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.


      Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.


      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####




      MESSAGE FROM BUSINESS:



      Tell us why here...July 20,2023 


      Better Business Bureau of Greater Maryland Attention: Heather ****** 
      Dispute Resolution & Trade Practices Specialist 
      *** ** ***** **** ***** **** 
      ********** ** ***** 


      RE: BBB File Number: ******** – William **************  
       

      Dear Heather ******: 

      This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  

      CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  

      Please be assured that we are working as quickly as possible to provide an equitable resolution.  


      Sincerely, 

      Danielle ******* 

      Danielle ******** *** ******* 
      CareFirst Executive Inquiry Department 

      Bureau Response

      Date: 07/25/2023

      Kim *******
      CareFirst, Inc. ***** **** *** ***
      ****** ***** ** *****






      Re: ID * ******** * William **************



      Dear Kim *******:



      Thank you for your recent response to William **************. We have not yet heard from the consumer and are closing this case as answered.



      Following our usual procedure, BBB notified the consumer of your response and requested notification of whether or not a satisfactory resolution had been reached.  Unfortunately, the consumer has not notified our office if they are satisfied. BBB has determined that your company has addressed the issues within the complaint; therefore we have closed this case in our files. This matter will appear in your BBB Business Profile as: "Answered - The Business addressed the issues within the complaint, but the consumer did not accept the response, OR BBB has not heard back from the consumer as to their satisfaction."



      The text of your response may be publicly posted on BBB's website. BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language. 
       

      In the event the consumer contacts BBB again regarding this issue, we may reach out to you to review any new or additional information we've received from the consumer. 



      Sincerely,



      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####

      Bureau Response

      Date: 07/25/2023

      William **************

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





      Re: ID * ********* CareFirst, Inc.



      Dear William **************,



      We have not received your response to confirm this complaint has been resolved. Therefore, this complaint has been closed and will appear in the company's BBB Business Profile as: “Answered- BBB has not heard back from the consumer as to their satisfaction with the business's response.” 



      Please know that BBB is always available to discuss your case and review additional information. Thank you for using BBB's Marketplace Services.



      Sincerely,



      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####
    • Initial Complaint

      Date:07/14/2023

      Type:Order 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 had several many problems with Carefirst blue choice. First my husband has switched over his prescriptions to mail in order which care first handles. The 1 prescription they were stating that they are waiting for his doctor then a manager was suppose to override it. Called back today and nothing was done! Then on top of things they need to speak with his provider AGAIN!!! For what? And was wasn't he notified when he needs this prescription!Now my issue is being told information that is incorrect. My doctor sent in reports to have me covered by Wegovy come to find out I am deined but apparently I am not allowed this at all on my plan!!! Why wasn't I told this before she did all this paperwork? They said I need a pre authorization that's what she submitted and she appealed it!My third thing is I am trying to get genetic testing done and again my medical benefits say pre authorization! Apparently my doctor sent over forms for this and care first do not see them. I can't even get the price of what it might cost. Then a representative from care first told me to go ahead with the appointment and I can be billed later after my insurance goes through. WHAT! So if the claim gets denied like my prescription did they I am stuck with the cost? No that is incorrect

      Business Response

      Date: 07/27/2023

      From: ***** *********-*****
      To: BBB of Greater Maryland
      Subject: Respond to Complaint
      Date: 7/27/23

      RE: BBB File Number: 203171100
      Consumer: ****** and ****** *******

      Dear: Ms. ********** style="color: rgb(24, 24, 24); font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Helvetica, Arial, sans-serif, "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Symbol";">
      This letter is to acknowledge the receipt of your correspondence.

      CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau. We will reply directly to the complainant.

      Please be assured that we are working as quickly as possible to provide an equitable resolution.


      ***** *********-Brown 

      ***** *********-*****, Senior Analyst Executive Inquiry 
      CareFirst Executive Inquiry Department 

      Customer Answer

      Date: 07/28/2023

       
      Complaint: 20317110

      I am rejecting this response because: I am not sure what she is referring to as a "valid authorization". Again there were several phone calls put in and multiple representatives telling us different things. The insurance should not need to put a prescription on hold when it was already authorized in the previous month

      Sincerely,

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

      Customer Answer

      Date: 07/28/2023

      There were medical.patches for ****** ******* that he has been using for 3 months now. Each month after the 1st we get a huge run around about the pharmacy having to contact our insurance for approval. This is incorrect. There is no pre authorization for this medication 

      Also I have had several calls trying to get a genetics testing and I just want to know if insurance will cover instead I have had to call so many times for someone to keep saying I need a pre authorization when that's fine but my doctor is not going to call you so what is the cost 

      3rd thing when asking about Wegovy which should be covered by now because of laws changing. But it still is not. The pre authorization popped up again so my doctor appealed it twice and nothing has been done.

      Business Response

      Date: 08/07/2023

      From: ***** *********-*****
      To: BBB of Greater Maryland
      Subject: Respond to Complaint
      Date: 8/7/23

      RE: BBB File Number: 203171100
      Consumer: ****** and ****** *******

      Dear: Ms. ********** style="color: rgb(24, 24, 24); font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Helvetica, Arial, sans-serif, "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Symbol";">
      This letter is to acknowledge the receipt of your correspondence.

      CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau. Yes, CareFirst is providing a response directly to the member when the research is complete this week.

      Please be assured that we are working as quickly as possible to provide an equitable resolution.

      Customer Answer

      Date: 08/07/2023

       
      Complaint: 20317110

      I am rejecting this response because:
      There is validation of this complaint!!! I have spoke to several managers. My number is also listed on the BBB report so you could also call to follow up with details. 
      Sincerely,

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

      Business Response

      Date: 08/25/2023

      BBB Response:

      From: ***** *********-*****
      To: BBB of Greater Maryland
      Subject: Respond to Complaint
      Date: 8/25/23

      RE: BBB File Number: 203171100
      Consumer: ****** and ****** *******

      Dear: Ms. ********** style="color: rgb(24, 24, 24); font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Helvetica, Arial, sans-serif, "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Symbol";">
      This letter is to acknowledge the receipt of your correspondence.

      CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau. We will reply directly to the complainant.

      Please be assured that we are working as quickly as possible to provide an equitable resolution.

      Please be advised I have contacted the member by telephone and sent emails. The inquiry has been answered.

      Will you please ask the member to return my call or email? I can be reached at **************.

       

    • Initial Complaint

      Date:07/14/2023

      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.
      I was scheduled for heart surgery on 7/3/23 but when Medstar surgical center requested pre-authorization the system says I have no coverage?? When I called Carefirst they say I have coverage but request isnt coming through portal?? Carefirst is claiming theres a glitch in the system, my account only. Its is now July 13th and I have called several times, different ***** promises that supervisors will contact me, even told its in an emergency status??? I have NEVER received a call back from anyone. My husband has spoken to multiple people too. This isnt just a knee replacement its heart surgery. UM # ************ Incident # *******. This is unacceptable and I need help resolving or I will have to seek legal help. There is no corporate number, all numbers forward to the same line. Please please help me

      Business Response

      Date: 07/25/2023

      Please see attached response for BBB ********. CareFirst will be responding and working directly with the complainant.
    • Initial Complaint

      Date:07/05/2023

      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 am a member insured by CareFirst Dental. Member ***********************************: 9901 Carefirst mailed by imbursement to the wrong address.I have corrected it via fax on 3/23/2023 and since have received reimbursement for a claim on 06/6/2023.However I am owed for previous claims starting with 6/22/22 for $96.60, 6/30/22 for $153.00 8/01/22 for $40.00 and 9/26/22 for $28.00. I have called numerous times spoken to *****, ******** ***** and office manager by the name of ***** and lastly ******. There have probably been even more. I am a disabled woman with Cancer. My cost of living runs high with the premiums, doctors copays, deductibles and prescription medication and OTC supplements that I need to take. I am being led in the wrong direction and they have not given me correct information as to mailing my reimbursements. I have written logs that I can supply if necessary but it's clear that the money is owed to me.

      Business Response

      Date: 07/13/2023

      July 13, 2023


      Dispute Resolution Specialist
      Better Business Bureau
      Of Greater Maryland
      **************************************************************************

      RE:      BBB File Number:     20273282

      Dear Ms. ******************* letter is to acknowledge the receipt of your correspondence. Thank you for allowing us the opportunity to further review your concerns.

      Your letter has been forwarded to a CareFirst staff member to investigate and we will reply directly to the complainant. Please be assured that we are working as quickly as possible to provide an equitable resolution.

      Sincerely,

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

      ***** *******
      CareFirst BlueCross BlueShield
      Senior Analyst |Executive Inquiry
      ******************************************************************************
    • Initial Complaint

      Date:06/28/2023

      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.
      One of my claims (E*********00) was erroneously denied by CareFirst. The reason for denial was a required 12 month waiting period (that does not apply to me.) When I call in and message within the portal, CareFirst agrees that the waiting period does not apply to me and submitted this claim to be reprocessed. However, it has been over 90 days since my original request via phone for reprocessing (call made on 3/31/2023) and over 30 days since my follow up request via messaging in the online portal (made on 5/26/2023). I've messaged them and called them multiple times and each time, they said it will take another "XX" number of business days with no resolution in sight.

      CareFirst member ID: *********
      Date of service: 1/5/2023
      Claim number: E*********00
      Erroneous Reason for denial: "This service is subject to the member's 12 month Benefit Waiting Period."
      The 12-month Class 3 & 4 waiting period does not apply to existing members with no lapse in coverage prior to 1/1/23. My coverage began 8/2022 and I do not have a lapse in coverage therefore I do not have a waiting period.
      CareFirst agrees that I do not have a waiting period and the claim should be reprocessed however, reprocessing is not taking place.

      Business Response

      Date: 07/03/2023

      In absence of authorization and order to safeguard protected health information, CareFirst will be responding directly to the complainant.

      Customer Answer

      Date: 07/09/2023



      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 am however, dismayed that it took me writing to the BBB to finally get the business to respond and resolve my longstanding issue. 



      Sincerely,



      Meiping ****

    • Initial Complaint

      Date:06/07/2023

      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 had Carefirst insurance with a previous employer that would not expire until the end of May 2023. I started working at a new employer and signed up for a new policy since the old one was to expire on May 31st 2023 from the previous employer. On May 22nd 2023 i signed up for my new policy that would begin on June 1st 2023. On June 5th i found out that my new policy was voided because a payment was never made. So instead of having some type of grace period to make a payment, they voided my new policy immediately. I did not receive and emails, texts or phone calls from anyone that a payment was due immediately. I was waiting for some form of billing documentation to come in the mail from Carefirst and nothing ever came. If i did not call Carefirst on June 5th 2023, i would never have known my insurance was voided. I made a payment over the phone on June 5th 2023 to activate this account. I had to take my daughter to the doctor's on June 6th for an ear and eye infection. The doctor's office informed me today that my insurance was not currently active and i would have to pay out of pocket. I contacted Carefirst and they told me it would be possibly up to 48 hours for my policy to be activated while the payment was still processing. This doesn't work for me. If I was notified that the payment was due before June 1st, I would have paid it and none of this would have happened. Also, not activating the account immediately after I paid on the phone, doesn't work for me. I was a 7 year long member and only switched to a different group number. My member ID is exactly the same. I should have had a 90 day grace period to make payment instead of them voiding my new policy immediately.

      Business Response

      Date: 06/08/2023

      From:              Donna ***************
      To:                   BBB of Greater Maryland
      Subject:           Respond to Complaint
      Date:                6/8/23

      RE:                   BBB File Number:  ********
      Consumer:       *******, Kenneth

      Dear: Ms. ******,

      This letter is to acknowledge the receipt of your correspondence. 

      CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau. We will reply directly to the complainant. 

      Please be assured that we are working as quickly as possible to provide an equitable resolution.

      Sincerely,


      Donna ***************
      Senior Analyst, Executive Inquiry
      CareFirst BlueCross BlueShield
      **** ** ******* ******
      ********** ******** *****
      W ###-###-#### | F ###-###-####
      carefirst.com

    • Initial Complaint

      Date:06/06/2023

      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.
      My office provides outpatient physical therapy in Baltimore, MD. We hired a new therapist over a year ago and filed for credentialing as soon as she was hired. We also credentialed with many other insurance companies and have gotten credentialing in a timely manner. Carefirst has not issued my therapist credentialing but shows on their website that she is apart of Carefirst. Our claims have been denied and I have been cosigning all of her notes which is taking up a significant part of my time. My complaint is that we have numerously tried to contact carefirst via phone, email and online portal and have received absolutely nothing. We have not been able to contact a live person on the phone for the past 6 months. We had a previous complaint over a year ago with a different issue and needed to file a complaint, in which at that time, Carefirst contacted us, gave us a liason to get in touch with and as soon as our issue was resolved, that individual's number stopped working. I have a small office so I understand I don't affect carefirst too much but I am still trying to run my business efficiently and should get help with this issue in a timely manner. My office has been trying to get in touch with Carefirst for over 3 months. I would like Carefirst to contact my office and resolve this issue immediately and give us a liason with a direct number that will work for future problems.

      Bureau Response

      Date: 06/06/2023

      Kim *******
      CareFirst, Inc. 

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



      Dear Kim *******: 

        

      Better Business Bureau (BBB) received a complaint about your business. BBB understands that there are two sides to every dispute, and we have not pre-judged the validity of this claim. This is your opportunity to address the concerns of your consumer and to rebuild the trust that first brought you together. BBB seeks to help businesses resolve their disputes, whether or not they are accredited with BBB.  The complaint was submitted on 6/5/2023 and was assigned an ID of *********   



      How do I take care of this?

      Your BBB is requesting a written response to this complaint within the next 7 calendar days.  Your prompt and professional response greatly enhances the chance for a successful resolution and will further your reputation as a BBB Accredited Business.  If you received this complaint via email, the fastest and easiest way to view and respond is to the simply click on the “Respond to this Complaint”, link located on the left.  All responses will be copied to the complainant. 



      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      What should I include in my response?

      Please provide an explanation of the events from your perspective and/or a concrete plan for how to work toward a resolution. Remember that the more factual information we have about the case, the easier it is for all parties to develop a full understanding of the situation. 

       

      Please understand that the complaint content and your response may be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.



      What will happen if I do not submit a response and what can I expect to happen next?

      If you do not respond promptly to this complaint, it may be closed as Unanswered.  This may result in a substantially lower rating with BBB, which could adversely influence potential customers. Once we receive your response, we will forward it to your customer and ask them to tell us in writing whether your response resolves their concerns.  If they continue to express dissatisfaction, the case will be reviewed by BBB staff to determine if the remaining concerns warrant an additional response.  The overall standard applied in the review process is: Did the company act in good faith, and do everything that could be reasonably expected, or is responsible for, to resolve the issue?



      We look forward to helping you and your customer work toward an amicable resolution. 

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####


       

      CUSTOMER EXPERIENCE INFORMATION

       

      Customer Information:

      Marina *****

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

      Daytime Phone: ###-###-####
      E-mail: ************************

       

      The details of this matter are as follows:

       

      Complaint Involves:
      Service Issues 

       

      Customer’s Statement of the Problem:



      My office provides outpatient physical therapy in Baltimore, MD. We hired a new therapist over a year ago and filed for credentialing as soon as she was hired. We also credentialed with many other insurance companies and have gotten credentialing in a timely manner. Carefirst has not issued my therapist credentialing but shows on their website that she is apart of Carefirst. Our claims have been denied and I have been cosigning all of her notes which is taking up a significant part of my time. My complaint is that we have numerously tried to contact carefirst via phone, email and online portal and have received absolutely nothing. We have not been able to contact a live person on the phone for the past 6 months. We had a previous complaint over a year ago with a different issue and needed to file a complaint, in which at that time, Carefirst contacted us, gave us a liason to get in touch with and as soon as our issue was resolved, that individual's number stopped working. I have a small office so I understand I don't affect carefirst too much but I am still trying to run my business efficiently and should get help with this issue in a timely manner. My office has been trying to get in touch with Carefirst for over 3 months. I would like Carefirst to contact my office and resolve this issue immediately and give us a liason with a direct number that will work for future problems.











      Desired Settlement:
      Contact by the business



       


      Bureau Response

      Date: 06/06/2023

      Marina *****

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





      Dear Marina *****:



      Thank you for contacting the Better Business Bureau. This message is in regard to your complaint submitted on 6/5/2023 against CareFirst, Inc..  Your complaint was assigned ID ********* 



      Now that I have filed, what is the next step?

      We have forwarded your complaint to the business for their response. We have asked the business to reply promptly, but some disputes may take longer than others to conclude.  Please be patient as we work to ensure that your concerns are addressed. 



      What if I do not agree with the response from the business?

      It is important for both parties to maintain realistic expectations and respond in a professional, fair and courteous manner.  Our goal is for you and the business to be able to work towards an amicable solution. Should this prove difficult, we may offer you and the business the opportunity to participate in binding arbitration.  More information about these options can be found at www.bbb.org



      What happens if a business does not respond?

      BBB will make every effort to obtain a response from the business, but some businesses simply do not ever contact us.  BBB is not an enforcement agency. We cannot force a business to respond. However, failure to do so may result in a negative impact on their BBB rating, which may drive away future customers. BBB can also refer you to other agencies that may be able to assist you, depending on the specific nature of your complaint. 



      Feedback from consumers is vital to BBB. We appreciate your willingness to report this information to us. We look forward to helping you and the business work toward a resolution. Please do not hesitate to contact us with any additional questions or concerns.  



      Sincerely,



      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####

      Business Response

      Date: 06/07/2023

      June 7, 2023 


      Better Business Bureau of Greater Maryland Attention: Heather ****** 
      Dispute Resolution & Trade Practices Specialist 
      *** ** ***** **** ***** **** 
      ********** ** ***** 


      RE: BBB File Number: ******** – Marina *****  
       

      Dear Heather ******: 

      This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  

      CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  

      Please be assured that we are working as quickly as possible to provide an equitable resolution.  


      Sincerely, 

      Danielle ******* 

      Danielle *******, Sr. Analyst 
      CareFirst Executive Inquiry Department 

      Bureau Response

      Date: 06/07/2023

      Marina *****

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



      Dear Marina *****:



      This message is in regard to your complaint submitted on 6/5/2023 against CareFirst, Inc..  Your complaint was assigned ID *********  
       

      BBB has received a formal response
      from CareFirst, Inc.. We ask that you review the response and understand that BBB
      is here to assist both parties in reaching a fair and reasonable resolution.


      Please review their response to your complaint and advise us of your position in the matter within 5 calendar days. If we do not hear back from you, BBB will assume you are satisfied and will close your complaint as answered.


      Please be sure to indicate whether the business' response is satisfactory or not and how you would like to proceed in this matter.


      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####




      MESSAGE FROM BUSINESS:



      June 7, 2023 


      Better Business Bureau of Greater Maryland Attention: Heather ****** 
      Dispute Resolution & Trade Practices Specialist 
      *** ** ***** **** ***** **** 
      ********** ** ***** 


      RE: BBB File Number: ******** – Marina *****  
       

      Dear Heather ******: 

      This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  

      CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  

      Please be assured that we are working as quickly as possible to provide an equitable resolution.  


      Sincerely, 

      Danielle ******* 

      Danielle ******** Sr. Analyst 
      CareFirst Executive Inquiry Department 

      Customer Answer

      Date: 06/07/2023



      Complaint: ********



      I am rejecting this response because:



      Sincerely,



      Marina *****

      Bureau Response

      Date: 06/13/2023

      Kim *******
      CareFirst, Inc. 
      ***** **** *** ***
      ****** ***** ** *****





      Dear Kim *******:



      This message is in regard to a complaint submitted to the BBB about your business on 6/5/2023 by Marina *****.  This complaint was assigned ID *********



      Why am I receiving another letter regarding this complaint?

      We recently received additional correspondence from the consumer in the above-referenced case.  The information has been reviewed by your consultant and we believe this information warrants some additional remarks from your company.



      How do I see the new information?

      If received via email the fastest and easiest way to view and respond to the complaint is to use the link on the left.



      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      What should I include in my response to the consumers rebuttal?

      Please respond to the additional information that has been provided by the consumer.  If you have not already done so, please submit copies of supporting documents to your BBB using the contact information at the bottom of this correspondence.  Please understand that the complaint content and your response will be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.



      In the interest of time and good customer relations, please respond within 5 calendar days.




      How many more times will I have to respond to this complaint?

      We appreciate the response you have already provided and our goal is to minimize back-and-forth communication.  The new information provided by the consumer may have brought up new concerns that your BBB consultant felt needed some clarification.  By providing this information, you are allowing BBB to develop a more complete picture of the situation and how to move forward. 



      Generally, resolving a complaint requires both parties to move from their current position to a middle ground. In your response, please state your position and if possible indicate what steps can be taken by both parties to resolve this matter. If necessary, the BBB will offer its mediation and/or arbitration services to bring a close to this matter.



      We look forward to your prompt attention to this matter.

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####



      MESSAGE FROM CONSUMER:






      Complaint: ********



      I am rejecting this response because:



      Sincerely,



      Marina *****

      Bureau Response

      Date: 06/26/2023

      Kim *******
      CareFirst, Inc. 
      ***** **** *** ***
      ****** ***** ** *****





      Dear Kim *******:



      This message is in regard to a complaint submitted to the BBB about your business on 6/5/2023 by Marina *****.  This complaint was assigned ID *********



      Why am I receiving another letter regarding this complaint?

      This is a reminder that you have not responded to the consumersadditional correspondence in the above-referenced case.  The information has been reviewed by your consultant and we believe this information warrants some additional remarks from your company.



      How do I see the new information?

      If received via email the fastest and easiest way to view and respond to the complaint is to use the link on the left.



      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      What should I include in my response to the consumers rebuttal?

      Please respond to the additional information that has been provided by the consumer.  If you have not already done so, please submit copies of supporting documents to your BBB using the contact information at the bottom of this correspondence.  Please understand that the complaint content and your response will be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.



      In the interest of time and good customer relations, please respond within 5 calendar days.




      How many more times will I have to respond to this complaint?

      We appreciate the response you have already provided and our goal is to minimize back-and-forth communication.  The new information provided by the consumer may have brought up new concerns that your BBB consultant felt needed some clarification.  By providing this information, you are allowing BBB to develop a more complete picture of the situation and how to move forward. 



      Generally, resolving a complaint requires both parties to move from their current position to a middle ground. In your response, please state your position and if possible indicate what steps can be taken by both parties to resolve this matter. If necessary, the BBB will offer its mediation and/or arbitration services to bring a close to this matter.



      We look forward to your prompt attention to this matter.

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####



      MESSAGE FROM CONSUMER:






      Complaint: ********



      I am rejecting this response because: see attached



      Sincerely,



      Marina *****

      Bureau Response

      Date: 07/10/2023

      Kim *******
      CareFirst, Inc. 
      ***** **** *** ***
      ****** ***** ** *****





      Dear Kim *******:



      This message is in regard to a complaint submitted to the BBB about your business on 6/5/2023 by Marina *****.  This complaint was assigned ID *********



      Why am I receiving another letter regarding this complaint?

      We recently received additional correspondence from the consumer in the above-referenced case.  The information has been reviewed by your consultant and we believe this information warrants some additional remarks from your company.



      How do I see the new information?

      If received via email the fastest and easiest way to view and respond to the complaint is to use the link on the left.



      If you received this complaint via Postal Mail, you may respond online using the link below or respond by mail using the address above.

      To access/respond to this complaint online:

      Go to: ****************
      Enter the following code: **************

      What should I include in my response to the consumers rebuttal?

      Please respond to the additional information that has been provided by the consumer.  If you have not already done so, please submit copies of supporting documents to your BBB using the contact information at the bottom of this correspondence.  Please understand that the complaint content and your response will be publicly posted on the BBB web site (BBB reserves the right to not post in accordance with BBB policy). Please do not include any information that personally identifies your customer. By submitting your response, you are representing that it is a truthful account of your experience with this consumer. BBB may edit the complaint or your response to protect privacy rights and to remove inappropriate language.



      In the interest of time and good customer relations, please respond within 5 calendar days.




      How many more times will I have to respond to this complaint?

      We appreciate the response you have already provided and our goal is to minimize back-and-forth communication.  The new information provided by the consumer may have brought up new concerns that your BBB consultant felt needed some clarification.  By providing this information, you are allowing BBB to develop a more complete picture of the situation and how to move forward. 



      Generally, resolving a complaint requires both parties to move from their current position to a middle ground. In your response, please state your position and if possible indicate what steps can be taken by both parties to resolve this matter. If necessary, the BBB will offer its mediation and/or arbitration services to bring a close to this matter.



      We look forward to your prompt attention to this matter.

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####



      MESSAGE FROM CONSUMER:






      Complaint: ********



      I am rejecting this response because: Attached is the HIPPA release form.



      Sincerely,



      Marina *****

      Bureau Response

      Date: 07/18/2023

      Kim *******
      CareFirst, Inc.


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





      Re: ID # ******** - Marina *****



      Dear Kim *******:




      Thank you for your cooperation in responding to the above consumer's complaint.



      We forwarded your response to Marina *****. The consumer notified our office that they are not satisfied. BBB has determined your company has addressed the issues within the complaint; therefore we have closed this case in our files. This matter will appear in your BBB Business Profile as: “Answered - The Business addressed the issues within the complaint, but the consumer did not accept the response, OR BBB has not heard back from the consumer as to their satisfaction.”




      The text of your response may be publicly posted on BBB’s website. BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language. In the event the consumer contacts BBB again regarding this issue, we may reach out to you to review any new or additional information we've received from the consumer.




      We appreciate your cooperation in addressing this matter and hope we can be of service to you in the future.



      Sincerely,



      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-####

      Bureau Response

      Date: 07/18/2023

      Marina *****

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



      Dear Marina *****,



      This message is regarding Complaint ID # ********- CareFirst, Inc.



      Your complaint is closed for one of the following reasons:



      We understand you are NOT satisfied with the business's response, and have noted your dissatisfaction in our files.  While we were unable to reach your desired resolution, the business has provided your Better Business Bureau (BBB) with its position.  This matter is now closed in BBB files, and will appear in the company's BBB Business Profile as: "Answered - the business addressed the issues within the complaint, but the consumer remains dissatisfied."



      OR



      We have not received your response to confirm this complaint has been resolved. Therefore, this complaint has been closed and will appear in the company's BBB Business Profile as: “Answered- BBB has not heard back from the consumer as to their satisfaction with the business's response.”


      If this is the case, please reply to this email and for the complaint to be reopened so you can submit a response to the business. After your request is processed, you will receive an email asking for your response with a link to the complaint.



      Please note, the text of your response may be publicly posted on BBB's website.  BBB reserves the right to not post in accordance with BBB policy, and we may edit your response to protect privacy rights and to remove inappropriate language.



      We appreciate the opportunity to be of service, and sincerely hope you will contact us for future pre-purchase information. 

      Sincerely,


      Heather ******
      Dispute Resolution Specialist
      *************************

      Phone: ###-###-#### MESSAGE FROM BUSINESS:



      June 7, 2023 


      Better Business Bureau of Greater Maryland Attention: Heather ****** 
      Dispute Resolution & Trade Practices Specialist 
      *** ** ***** **** ***** **** 
      ********** ** ***** 


      RE: BBB File Number: ******** – Marina *****  
       

      Dear Heather ******: 

      This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  

      CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  

      Please be assured that we are working as quickly as possible to provide an equitable resolution.  


      Sincerely, 

      Danielle ******* 

      Danielle *******, Sr. Analyst 
      CareFirst Executive Inquiry Department 


    • Initial Complaint

      Date:06/06/2023

      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.
      On January 1st, 2023, I started a dental policy for my family of 5 with Carefirst BCBS of MD. After receiving dental work, my Daughter's claim was denied for an unknown reason. Upon inspection of the plan, I must have accidentally listed her birth year incorrect, which was causing the issue. On 4/19, I began messaging Carefirst about the issue with the simple request of changing the birth year to the correct date so the plan could I was laying for could be utilized. Case number C23-0015946889 was created to document. I was told to fill out a member change form, which I did. It was faxed, with confirmation and no change was ever made. After 7 subsequent messages, they stopped responding and I began calling. In or around May 1, 2023, I was told by customer service to fill out another form and fax it in. I did. Again, no change. A couple weeks later, I was told to mail a different form, which I did through certified mail (proof available if needed). I waited the 10 days as specified and still no change to her birthdate.With bills piling up, I finally decided to simply cancel the current plan effective May 31 and re-sign up for the plan effective July 1. Cancelation firma were submitted and I signed up for a new plan online. In June 1, I received mail stating that since I had canceled my policy, I could not sign up for a policy for a period of 1 year. Leaving me without a dental plan and stuck with the bills that they should have covered during the time her policy was active.After waiting in hold for at least 39 minutes per call for 5 phone calls trying to correct this, sending multiple faxes and even a certified piece of mail, this just shouldn't have happened. I even sent personal messages to 3 VP level employees at Carefirst asking for assistance (proof available upon request).I request assistance with having someone at Carefirst acknowledge this customer mistreatment and allow me to re-sign up for a policy. Thank you.

      Business Response

      Date: 06/08/2023

      June 8, 2023 


      Better Business Bureau of Greater Maryland Attention: ******* Pigott 
      Dispute Resolution & Trade Practices Specialist 
      ***************************************;
      *********, MD 21201 


      RE: BBB File Number: 20139732  James Marchesi  
       

      Dear ******* ******: 

      This letter is to acknowledge the receipt of your correspondence regarding the above referenced file.  

      CareFirst requires a valid Authorization Form for Information Release to provide your office with specific details regarding the complaint. Because we do not have that authorization on file, we will reply directly to the complainant.  

      Please be assured that we are working as quickly as possible to provide an equitable resolution.  


      Sincerely, 

      ******** Griffin 

      ******** *******, ***************************************************** Inquiry Department 

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