Tried it, and what do you know - they say they never received it - they want me to email it to them. They want you to mail claims in, I was hesitant to do this because then there's no paper trail. They have been aware of this for at least two years, and no updates have been made to their system. Each rep I've talked to says if you submit an out-of-state claim online, it will not be approved. I believe they do this to reset the interest they're supposed to pay if they don't process a claim in 90 days (California law). I'm still waiting on reimbursements for claims from January 2022. You call to check the status, and they make you go through the whole process again. Then they close the claim out without reimbursing you or contacting you. You appeal, they approve and make you wait months to reprocess the claim. They deny claims over and over again for various made-up reasons. How could a payment be due if even after 04/10 Blue Shield did not show plan was active ? How can they expect payment if there is no bill mailed? I am NOT on paperless billing, yet I did not receive a bill. Otherwise, I'd need to appeal the decision. But, if I paid right away they could re-activate it. But since I had not paid it, the plan was inactive. They said that I had a $2K payment for the months of january through april that was due on 04/10. I called Blue Shield yesterday for an update. They put in a request for an expidited response from Blue Shield. I called Covered CA back informing them of issue. They said their system did not reflect approval and to give it a few more days. I called Blue Shield to see what was owed. I filed an appeal for reinstatement ( with Covered ********* Shield on the line) On thursday April 6th I received an email from Covered CA stating appeal was approved. But if they are saying it was never active in 2023, then I am going to be stuck with all medical bills for this time period. How then does a plan take payment and then retro-deactivate the account to a previous date and refund the money? Since Blue Shield accepted payments in 2023, that means plan was active and I had medical testing and doctor visits. But I was able to make it in January and February which means the plan was active. Reason for refund: "payment was made after plan was cancelled" When I could not make a payment in March it was because the plan was cancelled. payment towards Dec dues & refunded the Feb. I could not make March payment as I was told the plan was cancelled with effective date of cancellation being. To truly transform the healthcare system, we focus on innovations that drive real change for our members, their communities, and providers.I enrolled in a Blue Shield health insurance plan through Covered CA. We resolve issues when they arise instead of assigning “homework” to our members. Our personal member advocacy model increases employee engagement and makes getting care easier. Employees can access care however they prefer it with our expansive provider networks, choice of virtual care and telehealth options, proven lifestyle medicine apps, and much more. Our health plans and programs are designed to meet the demands of today’s workforce. How Blue Shield Delivers Valueįor companies headquartered in California, we provide a single national coverage solution – wherever your workforce is located – with the vast Blues network. No matter what size your group is, Blue Shield of California offers flexible plans with unparalleled customer service. Get more control over your healthcare spend while providing employees with an exceptional member experience.
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