Anonymous
map-marker Cary, North Carolina

Great company to work for

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Great employer and company that cares about the community. They also are hyper focused on finding ways to lower health care cost while improving access and quality.
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Anonymous
map-marker Charlotte, North Carolina

They don't cover Cologard

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If you have BCBS of NC, and your physician recommends Cologard.....run far, far away. This insurance company does not cover this screening procedure, and it will cost you $649.00. Just a head's up.
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David A Vym
map-marker Durham, North Carolina

Abysmally incompetent customer service reps.

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This is being written with reference to the abysmally incompetent customer service representatives BCBS of NC hires.

My wife and I were covered under BCBS/NC under the Affordable Care Plan from 01-01-2017 through 12-31-2017.

They continually got things wrong as to payments of claims.

Unfortunately somebody within the interstices of this organization indicated that we had terminated our coverage on 08-31-2017. This was without our knowledge or prior communications. Since we were paying premiums every month through 12-31-2017 until we became eligible for Medicare we had every right to expect coverage until we became totally disgusted with BCBS/NC and switched to Humana.

Additionally, the Healthcare Marketplace underreported our tax credits for a period of three or four months. We were overcharged on our credit card to about $4000. BCBS/NC advised us to go to our bank to resolve this. We got this resolved.

Then BCBS/NC turned around in February 2018 and billed us for $477 for coverage during July 2017, indicating that they had over-refunded money during the period that Healthcare Marketplace understated our tax credits.

Why should I be continually penalized for BCBS's errors. When I worked in the health insurance industry for 8 years this would have never occurred.

Finally, BCBS/NC turned me over to Rawlings Financial Services in LaGrange, KY requesting repayment of pharmacy charges from 09-02-2017 through 11-26-2017 for over $2300.

I called Walgreen's Pharmacy at 91 S. Tunnel Road in Asheville NC. I had become eligible for Medicare Part D on about 09-01-2017. Walgreen's indicated that they had billed BCBS as primary during the period from 09-01-2017 through 12-31-2017 instead of secondarily. Walgreen's representative, Kevin, indicated that they would "retro-bill" Medicare part D but that it would take 6 weeks to complete this process.

I have had two strokes and a heart attack during the past 3 years and absolutely do not need the stress this has caused.

Whenever I call a customer service representative it usually falls on deaf ears to a semi-literate incompetent with little more than a high school diploma with absent critical thinking skills. I refuse to talk with these individuals anymore.

Whenever I ask to talk with a manager or supervisor the customer service representative...to a person...refuses to do so. I am always given half-baked, conflicting answers to all of my inquiries.

I am extremely sick and tired of dealing with this abysmal organization. I paid my premiums, followed ACA requirements as best I could to the letter of the law, and refuse to ever be put on hold for 20 or more minutes every time I call.

I simply want BCBS to pay my claims, particularly those from the period 09-01-2017 through 12-31-2017. I have no idea who entered a date of 08-31-2017 into their system as a date of termination, and it takes a huge amount of audacity to bill me $477 for THEIR ERROR.

I want BCBS of North Carolina to pay my remaining claims and to get out of my life and stay out of my life.

In the meantime I advise everybody I know to avoid this insurer. I deeply and bitterly regret becoming a subscriber.

Sincerely,

David A. Molnar

Asheville NC

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Cons:
  • Everything about bcbs of nc
Reason of review:
Poor customer service

Preferred solution: Pay the claims and do not charge me $477 for BCBS's error in refunding premium overpayment

Anonymous

Disgusting company

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Been covered for knee shots for 4 years with no out of pocket expense except co-pay. Got pre-approved for this year and then got billed for $1500 spent 4 hours on the phone and finally got someone who said my benefits changed even though my policy had not changed. Dishonest, corrupt company. Angry Angry Angry Angry
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eric l Dyu
map-marker Durham, North Carolina

WORST CUSTOMER SERVICE & ACCOUNTING

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Sent refund payment for our account. We miss placed the check called them because it was over there 6 month check date said no problem go ahead and cash. check came back ,Called them back went through the process again they said no problem will re issue a check. No check ever came and now we were told that it had been cashed already. 45 days of communicating with BCBS no proof could be provided for the check and that if i wanted proof that i would have to take a day off work fill out an affidavit and have it notarized and sent in the mail to them. If i told my customers this I would be out of Business.
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Loss:
$500
Reason of review:
Poor customer service

Preferred solution: Proof That the check was cashed and in our bank account.

Resolved
Rishav Cdz

Resolved: Uninformed Customer Service

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We probably spent a total of about five hours on the phone with several different agents and each of them gave us different information. We overpaid a provider by nearly $500 and BCBS couldn’t do anything about. Basically the provider overcharged us by not disclaiming the copays we had paid during several visits. At the time of the visits we haven’t reach our out of pocket max for the year so we were paying our copays like we should. However, when the provider submitted the claims we had already reached our out of pocket max so the provider submitted the claims to the insurance requiring total payment for each claim (a total of eleven claims) and not disclaiming that we already had paid $40 copay each visit, a total of eleven visits. I am not a insurance agent but for me this seems like fraud. I believe BCBS should take responsibility for this types of acts and solve the issue with the provider since it’s demanded that we pay copays to the provider. I pay the provider directly but only because my insurance card says so and to add to that I haven’t reached my out pocket max at the time. Now BCBS doesn’t want to take front and solve the issue when the provider is clearly trying to mislead and keep the money we overpaid. Last time we call a agent called our provider after arguing for one hour on the phone but instead of solving the issue and explaining to the provider the problem, the agent simply put the provider on the line with me to talk to him myself. If I wanted this type of resolution I would have called them myself. To top that the provider just alleges on the phone that he can’t login to the system and that’s it we ar still out of the overpaid money and having to deal with the provider ourselves. Why do we even have insurance?? BCBS used to have away better customer service. It’s beyond bad now!
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Reason of review:
Poor customer service
Anonymous
map-marker Winston Salem, North Carolina

Talking customer service

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I had to scream for him to shut the *** up while I’m talking. This last year I have had to call them about 12 times it’s always 20 min on hold the when they finally answer they ask you everything you put in their computer answering machine, last time I told them *** NO I PUT IT IN YOULOOK ITUP !!! Sent wrong card, can’t explain what they cover and HIGH PRICED . My insurance premiums have gone from $455 to now $1652 with less and less coverage. I have been a Blue Cross customer since 1997 and this last year I deeply regret signing up for another year
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Reason of review:
Poor customer service
Jaidynn Kwr

Blue Cross And Blue Shield Of North Carolina Health Insurance Review

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Went to the emergency room to be told I have to pay a $500 copayment to see a doctor. Since I didnt have $500 so I left. Still going to get billed just for a nurse asking me my name, weight, age, and what I would rate my pain. I never dealt with anything like this until I moved to North Carolina. I had Blue cross blue shield in New York. It was the best. Here it sucks!!
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Reason of review:
Problems with payment
Anonymous

Worst Appeal Process of All

I work for a provider who bills many different insurance companies every day, including Medicare and Medicaid, and BCBSNC and other BCBS plans are the worst when it comes to denials and appeals. I wonder if they find ways to deny, making things up as they go due to the inconsistent way they process claims and handle appeals...

.or.. .are they just incompetent? The main issue with them is their appeals process. They have forms on their website to use, but then one representative says this form is correct, while another says no, it's another form.

You can fax and get confirmation that it's received, and you can mail and have tracking confirmation that it was signed for upon delivery, yet, they never seem to find appeals. We will submit the same appeal up to three times in some cases. Most insurance companies send a letter stating that the appeal is received. BCBS makes you call them (only to find that 85% of the time, they can't find it) and follow up.

That's fine if not for their limited timely filing deadlines. Sometimes you get the appeal to go through and the claim reprocessed, and other times they will dismiss the appeal all together stating invalid appeal, even if their denial was inappropriate for the circumstances, or even if the denial was the SAME, for the same account and same rental, as other claim appeals they DIDN'T dismiss and did reprocess. The inconsistency is very consistent.

They used to be okay, but something happened with them around the end of 2015 and they fell off a cliff. It's a lot of extra time and resources wasted dealing with this company and considering how large they are, you would think they would get with it and I can't help but wonder how they get away with some of what they do.

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Reason of review:
Order processing issue
Anonymous

Blue Cross And Blue Shield Of North Carolina - Review in Insurance category

I have been on the medication Xyrem for 11 years. It saved my life 11 years ago. This year, 2017 BC/BS have denied my coverage saying it is used only for Narcolepsy. I have a bad sleep disorder from Fibromyalgia and was prescribed the medicine 11 years ago. There are many other people with fibromyalgia that have also been on it. I found out the price of Xyrem has gone up again. It is made by Jazz pharmaceuticals. I really feel they denied coverage due to the price. This has left me devastated and having difficulty again with pain, sleep, and working. I will appeal again. I don't know how an Insurance company that I pay for can judge better than my doctor what medication I need to live a quality life.
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Anonymous

Blue Cross And Blue Shield Of North Carolina Health Insurance Review

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Welcome to your new "only choice for health insurance in NC" Blue Cross Blue Shield. Denied medication that she had been taking for years. Deemed necessary by the doctor's that has examined her and treated her for years. Denied by some unprofessional company profit seeker, that has never even looked at her medical records. Thank you Blue Cross Blue Shield of NC.
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Reason of review:
Bad quality
Anonymous
map-marker Charlotte, North Carolina

Claims Processing

I work for a provider and we submit claims for payment to BCBSNC. First having to submit the same basic member information for each individual claim is archaic for such a large insurance entity. I should be able to enter a members identification number and their personal information populate to the appropriate fields. Second, once a claim is submitted, having to wait weeks before you can even see that a claim exists implies their entire system is archaic. As a provider who bills several thousands of dollars a month, BCBSNC has evidently put the least effort is updating their technology. If United Healthcare, Aetna, Tricare and especially Medicaid are capable of providing better user friendly claims processing, then BCBSNC should as well.
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Anonymous
map-marker Raleigh, North Carolina

Dropped with no notice

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My daughter"s Insurance dropped ... With no notice of potential of such.....due to being "late" but BCBSNC cashed my check every month?!!? Had to fork over $500 for reinstatement. What a shoddy freaking way to treat customers. No wonder their CFO recently resigned and their are hundreds of customer service issues. Seems like the whole process over there in Durham is F'd up. Should file a complaint with State Insurance board. If there was any perceived issue with the potential of being dropped SOME notice should have been given. What a *** business. What will it take to get things straight at BCBSNC? Loisy customer service.
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Loss:
$500
Cons:
  • Lack of notice of cancelation
Reason of review:
Problems with payment

Preferred solution: Let the company propose a solution

1 comment
Guest

Get rid of Obama Care. Same thing happened with my two kids.

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Peytyn Bbh
map-marker Austin, Texas

Worst Customer Service since the Soviet Union

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Without question I will never let a Company I have anything to do with buy insurance from this outfit. Without question the most pathetic customer service system I've ever dealt with. No idea how to solve problems, no clue on their own systems, no idea how to identify customers: all in all a Saturday Night Live skit that would be hilarious if it wasn't so maddening. BCBS of Texas looks like Apple compared to these clowns. Worse, I've been on hold 40+ minutes, hung up on their auto-system 3 times, and the best is the mortuary voice that if you don't get the answer right just says "goodbye" and hangs up. Nationalized Health Care could not be this bad and, for me, that's saying something.
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Loss:
$1090
Cons:
  • Lack of employee knowledge
  • Poor automated systems
  • Customer service
Reason of review:
Poor customer service

Preferred solution: Find out where my coverage is

Anonymous
map-marker Cary, North Carolina

Who Are They "Assisting?" Define "Shortly."

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Dear Blue Cross Blue Shield, I hash-tagged you so everyone can see what you did. I stayed with you but switched my plan on December 28. I have Multiple Sclerosis. I take a daily pill. This pill costs $101.17 PER PILL. I have 4 refills remaining. How could you POSSIBLY be STILL processing the pre-authorization!?!? There shouldn't be a pre-authorization required to begin with! I talked to the doctor's office and had them fax you the URGENT authorization. I was told BY YOU that it was received on Monday, January 18. I was told to call back on Friday, January 22 LATEST. You are aware that my last pill is for Saturday, January 23. I've been talking to you since January 8. I called this morning to see where you guys were on getting this pill to me. You're closed, "due to inclimate weather." How is it that I pay you hundreds of dollars and you guys can't get a medication to me after a MONTH of "working on it?" Everyone else is on board. If I have an MS attack, guess who's to blame. Putting your CEO on the radio with an apology message does not make my medications arrive any faster. And it does not make me any more patient with a medicine that protects me from serious complications. It's your job, not mine, to make sure my insurance insures me. My job is to pay you. I did my part. It's now Tuesday, January 26, and I'm writing this as I'm on hold. 1 hour 11 minutes so far and not a single human being spoken to yet. Get it together.
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Cons:
  • Not treating customer like human being
Reason of review:
Order processing issue

Preferred solution: Deliver product or service ordered

1 comment
Dona Yja

You may be able to pay for the pills yourself and then submit the bill to BC for reimbursement. Perhaps.

Who knows. Read your contract/brochure/terms either that you got or online at their site. This is the future, however.

For those who are wishing for single payer health care, be careful what you wish for. Take a look at Canada and Great Britain and see how well that works for people.

Anonymous
map-marker Lawrenceville, Georgia

Blue Cross And Blue Shield Of North Carolina - Bcbsnc Health Insurance Review from Lawrenceville, Georgia

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I have been trying to reach BCBSNC for 2 days due to their failure to deduct my daughters health insurance premium from my account for February. Her policy isn't terminated per the online account and I havet requested a termination to cause a delay in payment. Her premium is not through the marketplace as I have had her insured with BCBS since 2014.

Today I am currently on hold for 1 hr and 20 seconds (and counting). I have had a home inspection completed, ate lunch, and now prepping for after school activities while I have waited. Not once have I heard a live voice.

I on the other hand differ from most because I'm asking why haven't BCBS taken my money. Not that they have taken too much or that due to ACA my child's insurance may be terminated. I don't fall in either of those categories.

Very disappointed!

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Reason of review:
Poor customer service

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