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After moving to a new state state, we immediately applied for a new health insurance policy through CareFirst. It has been over a month of continuously calling and speaking to multiple agents giving us inconsistent information on if they received our lease and utility bills for proof of relocation or not. This is after faxing and emailing this information on more than one occasion. It is very concerning to see how a company operates when the simplest things like enrollment cannot be done in a straightforward fashion.
I have a high deductible plan with CareFirst. I also had breast cancer and found out in Oct of I can tell you based on my experience, their refusal to pay for things could have had a very negative impact on my care. I'm lucky that I'm ok now, but I'm not sticking with CareFirst because I want to live, and they don't care if I do not.
I'm counting this deduction in my salary and I'm not going to work for a company where I'm getting paid 13K less, so I will leave my job at the end of the year. I say this so any company considering a Carefirst high deductible plan should know, your staff like me, may leave as a result. Second complaint - They could have killed me. Both of these tests are common and important in treating breast cancer and have a significant impact on the treatment plans and timing.
Had my Oncotype indicated an aggressive tumor, the two-month delay in getting those test results could have allowed an aggressive tumor to metastasize. I'm lucky, my results were good, but for someone with an aggressive tumor, that two-month delay could be the difference between life and death. It's just more money from me.
Proton treatments are very common treatments for breast cancer as they cause less damage than traditional radiation treatments, and are covered by most insurance carriers including Medicare.
Of course, BCBS doesn't care if I live or die because my company will just replace me with another worker that will pay their premium. Until they get frustrated and quit the company as well. In conclusion: I do not recommend them. If you apply for a job with CareFirst as the Medical, I would turn down that job. Beware of Carefirst Bluecross Blueshield. Please read this complaint, and then you will choose another supplemental insurance carrier. She had CareFirst for decades as her supplemental health insurance.
I reported her death to CareFirst, Wells Fargo and Wesbanco and closed those accounts to prevent any future fraudulent monthly billing. Care First assured me that I was due a refund for the balance of the month. I told them that my mother's credit card was inactivated. CareFirst said they would send a refund check. Wells Fargo assured me that her credit card was immediately inactivated and there would be no further transactions allowed.
In the following three weeks I made many calls. Each time I was told by the person I spoke with that they would get back with me. I requested to speak with a supervisor with 4 different agents. My requests were denied. Finally, I was told I had to complain to Wells Fargo. Wells Fargo told me to contact CareFirst and simply have then rescind their refunds and then send me a check.
Further conversations with CareFirst again was just a waste of time. They have never provided me with any written or verbal response, indicating why they would not send a refund as promised.
How can CareFirst issue a refund to a credit card to a member's credit card after she has passed away, and they credit card has been cancelled? It is their responsibility to issue a refund to the appropriate party. It is pitiful the way that CareFirst has treated me.
After exploring a large variety of dental insurances and availability of highly recommended dentists, I found CareFirst most affordable and one of its inline high respected dentists was available. Excellent coverage. I pay out of pocket for CareFirst insurance. My ID card has the dentist and location on the card. I went to have services done on September 15, I checked the CareFirst website and noticed the claims for a routine cleaning was denied.
I explained that was not true, I went to the location on my card. The rep stated he will be sending the claim back through and it would take 7 to 10 business days. That rep stated she was putting the claim through again and it would take 7 to 10 business days. Ok 10 business days later still and issue and I calls back. This rep states she is sending it through again and claims can take 15 to 30 business days. Ok here we are 23 business days in and not 1 indication that they are working on this issue.
I owe a bill that I should not be owing and I need further work done but can't because I owe a bill that I should not owe. Now, as I type this I am on hold waiting for a supervisor and the rep keeps stating no supervisor is available. Well sir, guess what I will hold. I am not hanging up until someone does their job.
This is ridiculous. You will open yourself up to many many many bills from services and billing parties you never heard of conjuring up reasons to take your money. They are crooks and grifters. My doctor's office used the wrong code to bill me, the third party billing company put my address in wrong. It took me 8 hours of phone calls and paperwork and runaround to avoid most of the bills, but they are still coming.
I get a new bill from a new mysterious company every week from a routine physical that should be covered and "Free". Your doctor can also file an appeal for you if you sign a form giving him or her permission.
Other people can also help you file an appeal, like a family member or a lawyer, when they file a form i. When you file an appeal, be sure to let us know any new information that you have that will help us make our decision. We will send you a letter letting you know that we received your appeal within 5 business days of receipt in the company.
While your appeal is being reviewed, you can still send or deliver any additional information that you think will help us make our decision. The appeal process may take up to 44 days if you ask for more time to submit information or we need to get additional information from other sources. We will send you a letter if we need additional information.
If your doctor or CareFirst CHPMD feels that your appeal should be reviewed quickly due to the seriousness of your condition, this is called an expedited appeal.
You will receive a decision about your appeal within 72 hours. When you ask for an expedited appeal, you may do so by calling us, or asking us in writing. If we do not feel that your appeal needs to be reviewed quickly, we will try to call you and send you a letter letting you know that your appeal will be reviewed within 30 days.
If your appeal is about a service that was already authorized and you were already receiving, you may be able to keep getting the service while we review your appeal. Contact us at if you would like to keep getting services while your appeal is reviewed. If you do not win your appeal, you may have to pay for the services that you received while the appeal was being reviewed.
Once we complete our review, we will send you a letter letting you know our decision. If we decide that you should not receive the denied service, that letter will tell you how to file another appeal or ask for a State Fair Hearing. If your complaint is about something other than not receiving a service, this is called a grievance. If you would like a copy of our official complaint procedure, or if you need help filing a complaint, please call CareFirst CHPMD at or You may also submit your grievance in writing.
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