Business Profile

Health Insurance

Blue Cross and Blue Shield of North Carolina

This business is NOT BBB Accredited.

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Complaints

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

Customer Complaints Summary

88 total complaints in the last 3 years.
19 complaints closed in the last 12 months.

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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.

Initial Complaint
Date:10/06/2022
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.
BCBS of NC has yet to update our nursing home contract, which is now causing billing issues and bills to be denied. We started on this update in January 2022.

BCBS assigned a random person not in contracting to help with the process but it still is not completed.
Our nursing home bills are still not paid.
Business Response
Date: 10/07/2022
Thank
you for the referral. We will reach out to our member and address any questions
or concerns.
Initial Complaint
Date:10/06/2022
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.
We cancelled the policy on September 7, 2002. This is the information for the policy* ***** * ********
Subscriber ID ************
DOB 04/09/1969
When we cancelled the policy on September 7, 2022 we were told we would get a prorated refund for the month of September of approximately $480 within 4 weeks. Not only did we not receive the money, we were charged once again for the month of October for the amount of $609.06, the monthly payment.

Have been trying to get on the phone with representative, while waiting huge amount of times on the phone, and getting hung up on while waiting, and speaking with representatives with little English skills who cannot resolve the problem. We would like to get refunded right away for the charged amount for the month of October, the prorated amount for the mont of September and dollar compensation of $500 for the time spent on the phone and the stress created in my family by the careless behavior of Blue Cross Blue Shield.
Business Response
Date: 10/07/2022
Thank
you for the referral. We will reach out to our member and address any questions
or concerns.
Customer Answer
Date: 10/31/2022

Complaint: ********

I am rejecting this response because:Hello, Hope this finds you well. This is regarding a previous complaint which has been filed with Better Business Bureau recently. The complaint ID is ********. ****** ***** (Customer Escalation Analyst 984) 364-3540 | f. (919) 287-8744) from BCBS reached out to me soon after filing the complaint with BBB. As compensation for their "human error" (Ms ******* words), BCBS agreed to pay back in FULL for the month of September and reimburse the money that BCBS' "human error" caused my funds to be taken out of my account. We agreed, pending Ms ******* promise she would escalate the refund process and I would get the money back much sooner than their initial offer to send the money back within 4 weeks. Last Monday, thus much later than the promised refund schedule, I received an email from Ms ***** stating a check was issued to me (On 10/24/2022, a refund in the amount of $1218.12 was issued via check number ********). I wrote back asking whether the money would be placed back into the checking account via bank transfer or mailed. I did not get a response, so a few days later I sent another email. Finally last Friday Ms. ***** responded by communicating that I should wait for USPS to deliver the check. However now it's been a week since supposedly the check was issued and I have not yet received the check. The check would be coming from North Carolina, thus it should take only one day for it to arrive.) This entire process has caused us enormous financial burden, as well as significant emotional stress for both my husband and I. We had to reach into out savings in order to buy food. At this point we believe BCBS has acted in retaliatory manner on account of our filing a complaint with BBB. We request that BCBS pay us $1000 as compensation. Thank you for looking into this again.

Sincerely,

***** ********
Business Response
Date: 11/04/2022
Thank
you for the referral. We will reach out to our member and address any questions
or concerns. A resolution was provided to the consumer on 11/04/2022.
Initial Complaint
Date:10/04/2022
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.
Premium payment for the months of July, Aug and Sept were made on 10/1/22. This was the final due date given to me with the 180 grace period. BCBS took my payment but canceled my policy effective July 31, 2022. My request is to have my policy reactivated atleast through 9/31/22 which was what was paid. If this request can not be fulfilled I request my payment if full of $239.79
Business Response
Date: 10/05/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Business Response
Date: 10/05/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Business Response
Date: 10/05/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Business Response
Date: 10/05/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Customer Answer
Date: 10/05/2022

Complaint: ********

I am rejecting this response because: I have not been contacted.

Sincerely,

******** ******
Customer Answer
Date: 10/05/2022

Complaint: ********

I am rejecting this response because: I have not been contacted.

Sincerely,

******** ******
Customer Answer
Date: 10/05/2022

Complaint: ********

I am rejecting this response because: I have not been contacted.

Sincerely,

******** ******
Customer Answer
Date: 10/05/2022

Complaint: ********

I am rejecting this response because: I have not been contacted.

Sincerely,

******** ******
Business Response
Date: 10/06/2022
BlueCross NC will contact the complainant directly regarding their concerns.
Business Response
Date: 10/06/2022
BlueCross NC will contact the complainant directly regarding their concerns.
Business Response
Date: 10/06/2022
BlueCross NC will contact the complainant directly regarding their concerns.
Business Response
Date: 10/06/2022
BlueCross NC will contact the complainant directly regarding their concerns.
Initial Complaint
Date:09/26/2022
Type:Customer Service 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.
BCBS owes me $46.50. I've spoken with their representative four different times over a long period of time. Each time, they agree that they owe me money, and promise to send a check. I've never received the check, and each time I call they indicate that they have not sent the money. When I am late on a monthly premium payment, BCBS has no problem suspending my health insurance, potentially leading to life changing debt on my part. The least they can do is return the $46.50, which I accidentally overpaid on a premium bill.
Business Response
Date: 09/27/2022
BlueCross NC will contact the complainant directly
regarding their concerns. Thank you
Customer Answer
Date: 10/02/2022

Better Business Bureau:

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

Sincerely,

******* **********
Initial Complaint
Date:09/07/2022
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 have a condition CIDP that requires an infusion every 3 weeks. I started a new job and my new insurance started on 8/1/22. I got my insurance id card within a week and was able to forward the information to my doctor so his office can start the process for authorizations for the treatment and medication. Per my doctors office, they faxed the required forms to the insurance company in mid August. They mentioned that the fax was delivered as far as they knew as no error was indicated on their end. In addition, my previous specialty pharmacy company reached out to CVS Specialty Pharmacy and provided information and that this will need to be expedited since I was probably going to miss my next scheduled treatment. (My last treatment was 7/22/22)As of last Friday, I called BCBS of ** and they had no record of ever receiving the forms. I'm almost 7 weeks past due and my condition has caused considerable weakness in my legs and cannot move with the aid of a cane or crutches. My condition continues to worsen each day.All this could have been avoided.
Business Response
Date: 09/07/2022
BlueCross ** will contact the complainant directly regarding their concerns.
Initial Complaint
Date:09/01/2022
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.
Filed claims in July by fax. Have documentation they received the fax. 1 month later nothing. Refiled claims early August. Also asked why previous claims not processed. They lied and said they never received them. Situation was escalated since I needed claims processed quickly to get FSA reimbursement. Was told it would be, but almost 3 weeks later they have done nothing. They just keep lying.
Business Response
Date: 09/01/2022
Thank you for the referral. We will reach out to our member and address any questions or concerns.
Initial Complaint
Date:08/25/2022
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 work in a providers office and last year we credentialed a physician in our practice. We received the necessary approval from BCBS in July of 2021. Claims were filed and denied; Denial stated our provider was not credentialed. After many phone calls and months going by we were told that BCBS was behind in adding our physician and his credentialed was logged into the system in February of 2022. We filed our claims again and each claim was denied for timely filing. We have escalated the issue and still have not had any resolution to our problem. We have also had a claim for one of our patients that was denied incorrectly when a prior authorization was on file. The claim is from March of 2022 and multiple calls and reconsiderations were made. Staff states allow more time and unable to speak to a manager.

I would not recommend this company.
Business Response
Date: 08/25/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Initial Complaint
Date:08/19/2022
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.
BCBS of North Carolina sent my husband a claim for $7,900.00 for lab work on 2/16/2022 and he never went to the doctor this year and also the place that the claim came from is Nutera which is in ***** and we have not left the state. I called BCBS and they just passed the buck to Nutera and are not helping us rectify this wrong. I have both representatives name for both companies as well as reference numbers for all my conversations. The company in ***** is actually a womens genetic lab and my husband is male and never had work done in North Carolina and/or *****. This company is scamming folks.
Business Response
Date: 08/19/2022
BlueCross ** will contact the complainant directly regarding their concerns.
Initial Complaint
Date:08/16/2022
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 paid my health insurance premium and dental insurance premium online in late July. I paid through the BCBS NC website and utilized their one-time bank draft option for the health payment and the dental payment, two separate transactions on the same day. The payments were taken out of my bank account on August 1st. The problem is that they double charged me for my health insurance premium. I was charged $35.95 for my dental premium, then charged $318.60 twice instead of once for my health insurance premium. I called BCBS NC a little more than a week ago, and was told at that time that it would take 7-10 business days for the money to be put back in my account. I was not happy about that, but I understand it can take a little time with banks and refunds. Today I called back to BCBS NC and spoke with a different employee, who told me a completely different story. He told me the refund would take 30 days, and that they will be mailing a paper check. I cannot understand how it could take a 30 days to issue a refund. It sure didn't take them 30 days to double charge me. In the current economy, I cannot afford to be without my money for a whole month, through no fault of my own. I feel that it is completely unacceptable for them to take a month to return the money to me. I would appreciate any assistance that can be offered in getting my money back in a timely manner. BCBS NC is claiming there is absolutely nothing they can do, but I really don't believe that. I've never had it take that much time to get a refund anywhere. I have attached a screenshot from my bank account that shows the double charge in the amount of $318.60. If you need any other information from me, please feel free to let me know. Thank you for any help or insight you can offer.
Business Response
Date: 08/16/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Customer Answer
Date: 08/22/2022

Complaint: ********

I am rejecting this response because:
BCBS has stated that they are sending me a check in the mail. I did receive a check this past Friday 8/19, but when I got it BCBS told me not to try and cash it, because they had put a stop-payment on it. BCBS was going to try and deposit my money back into my account like I had originally requested but it did not work out due to how their system works and the fact that my next month's bill had already been generated. While that was going on, they had put the stop-payment on the check. So now they are supposed to be sending me a new check in the mail via next day shipping. That check is supposed to be sent today. Until I have actually received this check and verified that it is good, I would like to keep this case open.

Sincerely,

******** ********
Business Response
Date: 08/22/2022
BlueCross NC will contact the complainant directly
regarding their concerns.
Initial Complaint
Date:08/12/2022
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 cancelled my coverage on May 26, 2022 via phone call and the representative assured me that I would not be charged for the next month. Was still charged on June 3, 2022 in the amount of $145.33. Have made numerous phone calls to the company and spoken to supervisor that kept telling me a check was on the way for a refund and it was never received. Today is now August 11, 2022 and I still have not received my refund check. Every time I call I have to wait over an hour to speak to a supervisor. I am in the process of moving and am trying to get the refund before next month. No one has helped me and given me accurate information. I tried to log back into my *********** account to get documentation of my case and I can't login. I guess they canceled my login too. Hoping you guys can help me find a resolution for this issue.
Business Response
Date: 08/14/2022
Thank you for the referral. We will reach out to our member
and address any questions or concerns.

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Blue Cross and Blue Shield of North Carolina is NOT a BBB Accredited Business.