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 Find Local Branches.

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Blue Cross and Blue Shield of North Carolina has 13 locations, listed below.

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  Blue Cross and Blue Shield of North Carolina

  5901 Chapel Hill Rd Durham, NC 27707-3346

• 

  Blue Cross and Blue Shield of North Carolina

  5640 University Parkway Winston Salem, NC 27105

• 

  Blue Cross and Blue Shield of North Carolina

  PO Box 17509 Winston Salem, NC 27116-7509

• 

  Blue Cross & Blue Shield

  3931 Long Meadow Dr Mebane, NC 27302-9532

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  Blue Cross and Blue Shield of North Carolina

  PO Box 2100 Winston Salem, NC 27102-2100

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:08/10/2022

  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 am currently helping my mother manage her medical claims and bills since she was diagnosed with Stage 4 Ovarian Cancer back in November of 2022. My mother currently has ******** as her primary insurance and BCBS of NC as her secondary insurance. As I was trying to figure out her EOB's and what has actually been applied to her deductible with BCBS (since there are a ton of discrepancies between BCBS of NC, Medicare, and the providers), I called into BCBS of NC asking for updated and corrected EOB's to be provided (online it shows incorrect information of the EOB's). I was told by the customer service representative that there has been a well known issue with ******** members/BCBS members and issues with EOB's showing correctly in their system for end users since April of 2022. I asked if a digital copy of what the customer representative was seeing could be sent and was told no. Then I asked if the updated/corrected EOB's could be mailed directly to us, which I was also told no. I asked for an ETA of when this well known issue would be resolved and was not given an answer. Also, this information has not been communicated to members of BCBS and is not even online at their blog information. This issue is affecting current claims that are being processed along with causing multiple billing issues. Due to the incorrect information that BCBS of NC is providing from the EOB's, we are not able to verify what has been applied to her deductible and what my mother is responsible for paying the provider since the system is not correct for end users (nor can we get a physical copy). This is unacceptable and unbelievable that BCBS of NC has not resolved the issue (4 months counting) nor has this information been communicated to anyone. I couldn't imagine being a member of BCBS of NC and being treated this way as a customer. Nevertheless, the end user experience is awful as well and I could not imagine being sick and having to deal with this as a separate issue.

  Business Response

  Date: 08/10/2022

  Thank you for the referral.  We will reach out to our member and address any questions or concerns.

  Customer Answer

  Date: 08/10/2022

  
  
  Complaint: ********
  
  
  
  I am rejecting this response because I have already spoken to a customer service representative and was told that this is a well known issue that is not yet fixed and they don’t know when it will be fixed.
  
  
  
  Sincerely,
  
  
  
  ***** ******

  Business Response

  Date: 08/16/2022

  BlueCross NC will contact the complainant directly
  regarding their concerns.

• Initial Complaint

  Date:08/04/2022

  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.

  In April of 2022, we received several payment checks directly from BCBS that should have been sent to the provider (in-network). We were advised that the checks were sent in error due to an issue with the payment system and we sent them back to the Recovery Department in May. BCBS cannot locate those checks and is now sending us requests for payment for the reprocessed claims. We have called several times with no resolution. We would like this resolved ASAP as we do NOT owe any money to BCBS and this was THEIR ERROR.
  
  Checks ******* ******, ****** were returned with a cover letter dated May 26, 2022, and referencing case ********.
  
  PLEASE RESOLVE YOUR ACCOUNTING ERROR ASAP AND STOP THE RECOVERY ATTEMPTS.

  Business Response

  Date: 08/04/2022

  Thank you for the referral. We have made outreach to our member to address the concerns related to claims overpayment and recovery. We are providing our member with support and assistance with the resolution of their concerns.

  Customer Answer

  Date: 08/09/2022

  
  
  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,
  
  
  
  ********* ******