Complaints

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

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  Independence Blue Cross

  1901 Market St Philadelphia, PA 19103-1480

  
• 

  Independence Blue Cross

  1901 Market St Fl 13 Philadelphia, PA 19103-1463

  
• 

  Independence Blue Cross

  PO Box 41820 Philadelphia, PA 19101-1820

  
• 

  Independence Blue Cross

  PO Box 190 Dunmore, PA 18512-0190

  
• 

  Independence Blue Cross

  Union Center Plaza 840 First St NE Washington, DC 20065-0001

  

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:10/14/2024

  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.

  Hello, my name is ******* ***** ******** and I have been talking to *** for the past six months. Towards the ending of March I got sick and needed insurance so I reached out to IBX and I paid for my initial installment. I realizing the payment was too much and I was not going to receive any services that day of not knowing the stipulations I canceled my membership.I could find something cheaper so I canceled it same day. I later called within the next week requesting a refund for my payment and they still have not gave me my refund and it is now going on to be October November. I have called multiple times to talk to multiple agents and nothing has happened. I have a email trail of all of the people Ive talked to and a trail of documents that I sent from my bank stating that the money was taking out of my account. I would like a full refund to be sent to my home address that is on file which is **************************************. It has been too long and I work too hard for my money to be playing around calling yall every week is unacceptable. I need a full refund because I didnt receive any services from ***. I look forward to hearing back from you soon.

  Business Response

  Date: 10/21/2024

  Dear Ms. ******
  I am writing to acknowledge receipt of the correspondence you addressed to ***** ********-******** Manager of the Executive Inquiries Department.
  
  
  The concerns presented are being reviewed and will be addressed upon finalization of our review.
  
  As you know, the Federal Health Insurance Portability and Accountability Act,known as HIPAA, requires that we obtain an individuals written approval before disclosing his/her protected health information (PHI). For us to provide your office with a resolution, it would be necessary for the member to complete the attached HIPAA Authorization Form.
  
  
  Ms. ****** thank you for bringing this matter to our attention.
  
  
  Sincerely,
  
  ******** ******
  Specialist
  Executive Inquiries
  ***********************************************
  **********************

• Initial Complaint

  Date:10/11/2024

  Type:Sales and Advertising Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I AM BEING HARASSED NON STOP WITH **** MAIL FROM THESE PEOPLE ABOUT ENROLLING IN THEIR ******** ADVANTAGE PLANS. I HAVE BEEN TRYING FOR YEARS NOW TO GET THEM TO REMOVE MY NAME AND ADDRESS FROM THEIR MAILING LIST. I HAVE CALLED COUNTLESS TIMES AND I HAVE EMAILED MORE TIMES THAN I CAN COUNT AND YET THE **** MAIL NEVER EVER ENDS. I AM NOT INTERESTED IN ANYTHING THEY ARE SELLING! I WANT THIS **** MAIL TO STOP YET I HAVE WASTED COUNTLESS HOURS TRYING TO DO THIS MYSELF AND TO NO AVAIL. I NEED THE BBB TO HELP ME GET THESE PEOPLE TO REMOVE MY NAME AND ADDRESS FROM ALL THEIR MAILING LISTS SO THE CONSTANT HARASSMENT OF **** MAIL ENDS. JUST THIS WEEK, I RECEIVED LARGE ENVELOPES OF **** MAIL FROM THEM 3 DAYS IN A ROW!! IT IS ABSOLUTELY SICKENING THAT THESE PEOPLE WILL NOT HONOR A SIMPLE BASIC REQUEST AND CONTINUE TO HOUND ME RELENTLESSLY WITH THEIR **** MAIL ALL BECAUSE I AM 65 YEARS OLD. I WANT THIS CONSTANT HARASSMENT OF **** MAIL TO END NOW!

  Business Response

  Date: 10/17/2024

  Good morning Ms. Ortiz,

  On 10/14/2024, we removed the complainant from our contact list for Medicare sales materials/mailings. The complainant should disregard any materials that have already gone out in the mailing queue. However, afterwards, the complainant should not receive any Medicare sales material/mailings.

  Thank you.

  Tedra F.

  Customer Answer

  Date: 10/17/2024

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  
  
  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID 22410014, and find that this resolution is satisfactory to me. 

  I am still being hounded with junk mail from them.  In fact, this weeks alone I received junk mail on 3 different days about enrolling in their Medicare plans.  I will go on the assumption that this junk mail had previously been printed however if this constant hounding does not end in the future, I will be filing another complaint.
  
  
  
  Regards,
  
  
  
  Diana Ellis
  
  

  
  

• Initial Complaint

  Date:10/10/2024

  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 was under Independence Blue cross insurance from 4/2021 - 2/2024. In march 2024, I changed to Aetna health insurance as my primary plan. After switching to Aetna, Aetna incorrectly contacted Independence Blue Cross and told them I was covered by Aetna during the time period of 4/2021 - 2/2024. As a result, Independence Blue Cross has retroactively withdrawn appropriate payment for my medical services during this time and I am now being charged for medical services during that time. *** failed to perform due diligence and withdrew payment for services performed while I was insured by ***.

  Business Response

  Date: 10/16/2024

  Dear Ms. ******
  I am writing to acknowledge receipt of the correspondence you addressed to ***** ********-******** Manager of the Executive Inquiries Department.
  
  
  The concerns presented are being reviewed and will be addressed upon finalization of our review.
  
  As you know, the Federal Health Insurance Portability and Accountability Act,known as HIPAA, requires that we obtain an individuals written approval before disclosing his/her protected health information (PHI). For us to provide your office with a resolution, it would be necessary for the member to complete the attached HIPAA Authorization Form.
  
  
  Ms. ****** thank you for bringing this matter to our attention.
  
  
  Sincerely,
  
  ******** ******
  Specialist
  Executive Inquiries
  ***********************************************
  **********************

• Initial Complaint

  Date:09/06/2024

  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.

  In Mar I was injured. Been to numerous Doc for diagnosis. Finally went to **************************************************. I received a 2nd MRI which showed I have a 50% ABDOMINAL TEAR. BC is refusing to cover the surgery I need. Stating may be experimental. Numerous famous athletes have gone to my expert ******** they saying teams would send their stars for an experiment. I am torn. It has to be fixed. I am very active and want to stay that way. I feel because I am 65 they are saying I should not be working out as much and it does not matter if I am fixed. I am suffering. I cannot sleep in bed. I am limited with no quality of life. How I can be denied is unreal. I have had BC originally with the *********** now with my ********* The surgery is outpatient and only approx 12K. I cannot afford this on my own. On their bulletin I attached about my injury they quote my ** as an expert. I have tried therapy, acupuncture. I went to *******. Only way to be fixed is surgery. I feel like they think athletes can pay for it and s**** the consumer that gets hurt. My 2nd MRI can be obtained from the *****************. I have to access a website to get it and would just cut and paste findings but the line states. 1. Right-sided core muscle injury with partial detachment of the lateral 50% of the right pubic ********* do they suggest this gets fixed without a repair? They just denied it with no other help offered.

  Business Response

  Date: 09/09/2024

  Due to HIPAA privacy laws, we are unable to disclose the complainant's protected health information (PHI) without their written consent. Attached is a blank HIPAA authorization form for the complainant to allow the BBB access to their PHI. If no form is returned, we will respond directly to the complainant.

  Customer Answer

  Date: 09/09/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 22249636
  
  I am rejecting this response because:
  
  
  Regards,
  
  ****** **********
  
  
  
  
  
  
  
  
  

  Customer Answer

  Date: 09/09/2024

  I received a call from them.  They tried to say they wanted me to take anti inflam.  They never looked in my records which showed I took them twice once in March and again in July.  I asked how I am supposed to fix a 50% tear without surgery.  I have no quality of life.  Now it goes to a 3rd party.  I asked where they want me to go for another opinion.  The ** I went to is the expert for my injury.  If I get another opinion they will just refer me to him.  I got no response what they would like me to do for my injury and what treatment I should get when I can barely function because of the abdominal tear.  For that no response.  They are refusing out patient surgery.  1st experimental.  My Doc ****** has done 20K of these surgery of famous athletes.  then it was take anti inflam I was told today.  I did that twice with no help. A 50% tear cannot be fixed with anti inflam.  yet, they gave me no further instructions how to stop this horrendous pain.  I cannot sleep in bed.  

  Customer Answer

  Date: 09/10/2024

  I am asking my doc to send the *** as a file.  I have to log on to read it. I am going to cut and paste the main parts of it which show I have a 50% tear that has to be repaired.  They denied me again yesterday stating experimental.  My doc has a whole institute regarding this injury and athletes come all over the country.  They also said to take anti inflam.  They did not check my file which would show I took a two week dose in March with the initial injury and a week in July with **********.  I have tried therapy on my own.  If I was a 20 yr old hockey player they would approve surgery.  This is like telling me they do not want me to work out again.  I have no quality of life.  I cannot sleep in bed.  My groin is almost completely torn and the only thing that will fix it is to be sewn back.  They talked about the other injury which is like an impingement that I am getting a shot for.  I already had one in April.  Dr ****** at the ***************** was my 3rd Doc.  I asked Blue cross to now tell me what to do.  Do I get another opinion and any other doc would tell me to go to Dr ****** at Vincera  who is the leading authority.  I got no recommendations on what to do and if that did not work if they will approve surgery.  I got zero input on now what to do to get approved. They denied appeal and now the other place denied without speaking to me or doc going by Blue Cross.  It may go to a judge now.  Here is the cut and pasted part of *** but  I am attempting to get a file.  I do not understand their reply to you.  I am giving permission for my records to be sent.  I do not have a printer

  .Impression
  1. Right-sided core muscle injury with partial detachment of the lateral 50% of the right pubic plate. 2. Intact left-sided core muscle repair. 3. Mild osteitis pubis. 4. Severe right hip joint chondrosis with a moderate joint effusion and synovitis. 5. Mild left hip joint chondrosis with a small joint effusion. 6. Moderate right gluteus medius and minimus insertional tendinosis with low-grade tearing. 7. Bilateral hamstring origin tendinosis with partial undersurface tearing of the left hamstring tendon origin. 8. Rounded T2 hyperintense lesion extending along the left sciatic neurovascular bundle measuring up to 12 mm, finding was not described on outside hospital *** right hip dated 7/6/2018. Images are not available for review. Findings may represent a peripheral nerve sheath tumor, a varix, or vascular malformation. Recommend correlation with prior imaging versus short-term interval follow-up (repeat *** bony pelvis in 6 months).
  

  
  

  Business Response

  Date: 09/11/2024

  Due to HIPAA privacy laws, we are unable to disclose the complainant's protected health information (PHI) without their written consent. Attached is a blank HIPAA authorization form for the complainant to allow the BBB access to their PHI. If no form is returned, we will respond directly to the complainant.

  Customer Answer

  Date: 09/11/2024

  In the denial they state about taking anti inflam meds.  IF they checked the records they would see I was prescribed anti inflam meds in the emergency back in early March for two weeks.  I also was prescribed meds ********** pack in July when I got worse at ******* from sports Doc before going to Vincera.  So they did not even check to see if I took meds before the denial!!  Also regarding therapy, I am an expert at working out.  My therapy is $40 a session if I used insurance.  I looked up rehab on line and did it daily!!!!!!!!!!!!!!!  I could not afford $120 a week for therapy.  I did set up one session in July but when I informed Dr ****** about going for the appt two days after I saw him he stated absolutely not.  I have gotten progressively worse.  Therapy cannot help an abdominal tear neither can anti inflam meds.   I have been suffering since March and the injury is getting worse with rest, my own therapy and meds did nothing.  I also got a hip shot that did nothing.  My issue is my lower abdominal adductor not my hip which does not hurt!!  If I have some arthritis, it is minimal and not causing me the horrendous groin pain.  The 2nd appeal did not even check my records to see I took meds.  Now I cannot even reopen it.  They sent it to Maximus without even calling me so I could say all I did.  

  Customer Answer

  Date: 09/12/2024

  I forgot to additionally add, in the denial when they did not check I was prescribed anti inflam, after the initial emergency visit when I did see a Dr.*******, he told me to take Aleeve when I asked for more anti inflam.  He stated that is what they tell patients.  I also saw his boss Dr ********* (spelling may be wrong).  They both told me to ride my Peloton bike.  They said the barre classes would be good therapy and wrote me a therapy script for my knee which has a slightly torn meniscus if I wanted to go. ( am rehabbing that myself).  So as far as the rejection for not taking anti inflam not only did they not check my prescription history which they would have cause it was covered, I was never contacted by the appeal person before rejection to inform them I did take medicine from the initial emergency visit when I was prescribed I believe it was ******** for 2 weeks.  Then ** ******* said they tell patient to take Aleeve.  In July when I did see their sports med Doc ******, she gave me **********.  I informed her how much worse I was since March regarding groin pain and I could barely function.  She told me to go to Dr ****** at ******************   I did that.  I have a huge tear.  I did set up some therapy and was going to go once to see if there is something else I should be doing.  At the visit with ****** he told me not know.  To try to do light thing but I am 50% torn and it could make it worse.  Now I cannot reopen it because once it was rejected you can't reopen it.  However, as you can see they mention not taking anti inflammatory medicine and I did.  They rejected it without even checking the medical records which I am now obtaining for my lawsuit and hearing I will have with Maximus Judge.

  Customer Answer

  Date: 09/12/2024

  Forgot to add I did 2 acupuncture session which they can see in the bills.  That ** told me I had major problem going on and he did not think it will help.  I have reached out to an attorney.

• Initial Complaint

  Date:09/05/2024

  Type:Product Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  At the end of last year we cancelled our policy with *** effective 12/31/2023 as we were moving out of the area and acquired different health insurance. Our account was setup for auto withdrawal, and the company took out a premium for January for $1925, even though the policy was cancelled. I called immediately and was told a refund was issued. The company said it sent a check in February, but it was sent to the wrong address and never received. Every month since, I have called them and they've said the same thing, that there would be a stop payment put on that check and a new one reissued in 7-10 business days. I have asked to speak to a supervisor the last three calls and none are available. I've also been told on the last three calls that I would get a call back when their billing department resolved it, and no call ever happens. I am at my wits end, and short of filing in court, which I'd have to drive 2 1/2 hours to do, I'm hoping you can help me get this resolved. The company has never questioned that they owe me the money, it just never issues the refund.

  Business Response

  Date: 09/06/2024

  Dear ******* *****,

  Our investigation is underway, thank you.

  Attached is our acknowledgement letter and HIPAA consent form that needs to be completed/signed by the member and returned to our office.

  Thank you for bringing this matter to our attention.

  ***** *.

  Customer Answer

  Date: 09/14/2024

  *******, thank you for your efforts. Magically after nine months and at least ten phone calls a check showed up in the mail today. Everything is square. Thanks to you and BBB

  Business Response

  Date: 09/20/2024

  Dear ******* *****,

  The purpose of this communication is to share an update with you. The premium refund check for $1,925.57 was reissued to the complainant's correct home address and it was cashed.

  If you require additional details about this matter, please have the complainant sign and return the ***** consent form.

  Thank you for bringing this matter to our attention.

  ***** *.

  Customer Answer

  Date: 09/27/2024

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
   *******, thank you for your efforts. Magically after nine months and at least ten phone calls a check showed up in the mail today. Everything is square. Thanks to you and BBB
  
  Regards,
  
  **** ******
  
  

• Initial Complaint

  Date:08/26/2024

  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.

  I enrolled in a plan with IBX through ******, which is PAs state-run healthcare marketplace. Upon completing my application and receiving confirmation that my plan with IBX would be active 8/1/24, I was prompted to pay for the first month of my plan through IBXs payment portal (accessed via the ****** dashboard). The payment portal, which was hosted by IBX and *not* ******, failed to accept my payment on my first attempt at paying with a debit card submitting payment brought me to a blank screen with a generic, unformatted HTML error in the top left of the window. I tried re-entering my info and submitting again; same error. I tried using a different card; same error. I tried paying the following day; same error. The day after that, I notice that there are THREE $229 charges to my debit card and TWO $229 charges to my credit card. I was never given any confirmation that my payment had gone through, meaning that IBXs site allows customers to basically forfeit infinite sums of money to them. I called customer service and demanded a refund and explained to them everything Ive mentioned above, and their customer service *** told me that their payment portal can be a little glitchy when a customer is first enrolled in a plan because their plan isnt actually fully setup yet, which begs the question: why was I prompted to pay for a premium for a plan that doesnt even exist yet? This was several weeks ago and I still havent received a check for the +$1200 that Im owed. Ive called customer service 4 or 5 times asking for an update and requesting that they expedite the refund, and every time I reach out they tell me its in progress and that I can expect a CHECK in the mail soon, which is rather ironic given that they siphoned over a grand out of my account *electronically* in mere seconds.

  Business Response

  Date: 09/09/2024

  Dear *************************,

  Our records indicate that we issued the premium refund check for $1,146.85 to the member on 8/29/2024. Please allow more time for the check to reach the member.

  If you need more information about this matter, please have the member complete the attached HIPAA consent form and return it to our office.

  Thanks so much.

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

• Initial Complaint

  Date:08/23/2024

  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 signed up for health insurance on 7/24/24 and paid $132.51 Then by 8/3/24 I didnt receive cards or info on my insurance so I submittted another payment of $132.51 because online it said I still needed to make payment by 8/1/24 so I thought my 1st payment didnt go through. I called a few days later after realizing both payments went through and asked why my insurance info wasnt available on my portal because it kept showing my last insurance policy through my old job and that coverage ended at the end of June. I got hung up on, calls disconnected after waiting 40 mins trying to get through. Everytime I called they said they couldnt see my new policy info yet, were rude, and not at all helpful. On 8/7/24 I spoke with a **************** And requested my second payment be refunded. She said she would get it taken care of but continued telling me she couldnt see my policy. I had a UTI for 5 days and was unable to use my health insurance until 8/9/24 because thats when my portal finally updated and showed my insurance card with all the info I needed to go to the doctor. I had called several times before this and requested they send me that info but they kept saying they couldnt. I called again today on 8/23/24 because I didnt receive my refund for the double payment. I got hung up on after waiting 15 minutes to get through. I then was on the phone for 40 minutes and transferred to 3 diff people, all of whom were rude, uncaring, and unhelpful. They also told me my refund was never actually processed. I needed that money to pay bills and I have to pay Independence again on 9/1/24 for my September bill so by the time they refund it now I would just have to pay them again. I feel like Ive been robbed and that **************** didnt process my refund on purpose. I am beyond disappointed with the lack of customer service and feel that I deserve a discount and or refund for the 8 days I couldnt use my insurance.

  Business Response

  Date: 09/06/2024

  Dear **************,

  We are in receipt of your correspondence, and our investigation is underway.

  Attached is our acknowledgement letter and HIPAA consent form that will need to be completed by the member and returned to our office.

  Thank you.

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

• Initial Complaint

  Date:08/22/2024

  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.

  Me, my wife and 2 daughters are on the ****** Health Insurance program with Personal Choice Gold PPO coverage through IBX. Since January of 2024 we have been experiencing non stop issues with IBX. For the first 5 months of 2024 we received no invoices for our health insurance premium in the mail or via email. Since Jan we have been charged different amounts of money every month. We have recurring payment setup on IBX's portal with our checking account# so payments can be automatically taken out monthly. There are months where we receive bills in the mail with a specific due date and the money is not withdrawn. Than the premium isn't paid and we have lapses in coverage. On a regular basis when we go to pickup medications at the pharmacy we are told we have no coverage. We have gone to doctors appointments and turned away cause we have lapses in coverage. We call IBX and I can't tell you how many hours we have spent trying to get these issues constantly corrected to no avail. When there is a lapse in coverage due to IBX's constant errors it can take up to a week for our benefits to be reinstated in the system. We have been told by IBX representatives that they are having issues with the billing system, the have a new billing system and a plethora of other excuses that quite frankly is unacceptable and borderline criminal. This is affecting our health and lives! I would expect thousands of other IBX members are experiencing what we have and continue to experience.

  Business Response

  Date: 09/04/2024

  Dear **************:
  
  I am writing to acknowledge receipt of the September 4, 2024 correspondence you addressed to ******************************************, Manager of the ******************************* The complaint was received in our office on September 4, 2024.
  
  As you know, the Federal Health Insurance Portability and Accountability Act,known as HIPAA, requires that we obtain an individual's written approval before disclosing his/her protected health information (PHI). In order for us to provide your office with a resolution, ************** may complete the attached HIPAA Authorization form.
  **************, thank you for bringing this matter to our attention.
  
  Sincerely,
  
  *************************
  Executive Inquiries Specialist
  ***********************************************
  **********************
  P  ************  x22145

• Initial Complaint

  Date:08/19/2024

  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.

  My wife and I are enrolled in the ****** healthcare initiative if Pennsylvania with helps with affordable healthcare options. This year we started to have billing issues with Independent Blue Cross charging us the wrong amount on multiple occasions and as we had auto pay engaged, it wasn't initially caught. The amount exceeds $1,500 and we have tried now since March of this year to get it corrected through their billing department. I was told that it would be resolved over and over again and on my last conversation of the beginning of August, I was told that it had my wife listed as a smoker which is untrue on my application end and is not a fact. So it appears that they tried to correct it for the month of June but we are talking the entire year has been a mess of mis-********. I just got disconnected for the second time today after waiting an hour each to speak with a supervisor. This process has been nothing but a complete fiasco not to mention the financial burden of lost moneys. I wish for help in getting a complete accounting of what Blue Cross has received from ***** as well as all the moneys they have collected from my checking account. I wish to have this resolved prior to Blue Cross trying to collect from an agency moneys they are not due. I also wish to be refunded my due as the consumer who has been wrongly billed. We are presently dis-enrolled in their program as I have reached the age of 65 in July. Please inform us what can do to finally have this resolved. Thank you.

  Business Response

  Date: 09/03/2024

  Dear **************,
  
  I am writing to acknowledge receipt of the September 3, 2024, correspondence addressed to ******************************************, Manager of the ******************************* The complaint was received in our office today, September 3, 2024.
  
  As you know the federal health insurance portability and accountability act, known as HIPAA, requires that we obtain an individual's written approval before disclosing his/her protected health information (PHI). In order for us to provide your office with a resolution ********************** may complete the attached HIPAA authorization form.
  
  Thank you for bringing this matter to our attention.
  
  Sincerely,
  
  *********************, Specialist 
  Executive Inquiries Department
  P *******************

• Initial Complaint

  Date:08/08/2024

  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.

  On March 7, 2023 I had a C-section at ********* Health in **********************. On February 9, 2024 I received a bill for $6,515.00 from ********* for the above service. I contacted my insurance (personal choice BCBS) at that time and they were going to look into my benefits, at which point I never heard back. On April 9 of 2024, I received another bill and called my insurance again. I was on the phone for 53 minutes in total, reference number ******. The representative told me my claim was submitted wrong and that they were making an adjustment. A ********* Health representative was also on this call and they were instructed to put my account on hold until BCBS paid them. The insurance representative said my patient responsibility was $0 and that my maternity benefits were never applied and I repeated that back to her, again while on the phone with *********, and she said yes. Yesterday, I received a bill from a lawyers office for the this bill. A supervisor at **** was zero help and didnt even bother looking at the previous call phone, which was recorded.

  Business Response

  Date: 08/09/2024

  Due to HIPAA privacy laws, we are unable to disclose the complainant's protected health information (PHI) without their written consent. Attached is a blank HIPAA authorization form for the complainant to allow the BBB access to their PHI. If no form is returned, we will respond directly to the complainant.
  
  

  Customer Answer

  Date: 08/13/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 22115334
  
  I am rejecting this response because: I have faxed over the ***** form so they can release my medical information. Attached is the fax confirmation.
  
  
  Regards,
  
  *********************
  
  
  
  
  
  
  
  
  

  Business Response

  Date: 08/15/2024

  Attached is our response to the complaint

  Customer Answer

  Date: 08/16/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 22115334
  
  I am rejecting this response because: on April 11, 2024 a representative told me my patient responsibility was zero and that should be upheld. I reject their decision. I am dealing with cancer at the moment and nothing will be paid towards my BCBS claim.
  
  
  Regards,
  
  *********************
  
  
  
  
  
  
  
  
  

  Business Response

  Date: 08/16/2024

  We are required to administer the benefits outlined in the plan provisions. We regret the misinformation supplied to the complainant regarding the post-service review of the claim submission by our representative. However, the benefits of the plan were administered appropriately.