Found an issue on this page? Let us know and we will look into it as soon as possible.
I am needing an attorney that can litigate a law suit against Blue Cross Blue Shield. I have documentation ongoing since 2/2015
Anonymous9 views6 answers
I am on a 90 day hold for non-payment per blue cross blue shield they have not received a payment since 4/2015 and on 6/29/15 I faxed the member services as I had been instructed to show proof of all payments made for 11/1/2015 - 6/30/2015 and requested an escalation because I also included a letter from my doctor advising them that I need weekly and monthly appointments to prevent me from requiring hospitalization and daily meds that if not taken can result in death. no one bothered to look at it per my call today when. They are telling providers and pharmacy that I am on a hold and if I do not pay them past due premiums in $940+ then the provider will have to give them back the money for my claims so no one will see me or give me medications that I have been out of and am getting sicker
I am sorry for the experience you have had with BCBS. In my opinion, your situation is unacceptable. You entered a contract with BCBS and apparently performed by paying the provider for its services. Now, for whatever reason, BCBS is refusing to uphold its end of the bargain by denying you benefits to which you are entitled. Although the amount in dispute appears nominal (i.e., $940), the length of time involved seems unreasonable ("ongoing since 2/2015").
I agree with the others that you should consult an attorney. I suggest you find a good business litigation attorney and make an appointment. Gather your documents and take the items to your appointment with the attorney. During the consultation, the lawyer will analyze the facts of your case and explain the legal options available to you. Afterwards, you can decide how you would like to proceed. Hopefully, with the help of an attorney, you can favorably resolve this matter once and for all.
Good luck.
You made payments, but BCBS is stating that they have not been received by the insurance company - is that correct? If so, I would have an attorney send a DTPA letter ASAP. That may be the grease those wheels need. Call an attorney in our area that specializes in insurance disputes. You can also file a complaint with the TDI - http://www.tdi.texas.gov/consumer/cpportal.html.
Richard Kurt ArbucklePersonal Injury LawyerHouston, TX ·
Unfortunately, it could cost more to use a lawyer than the amount the insurance company is wanting. Contact the Texas Department of Insurance and see if you can get someone to act quickly to help you. Otherwise, use the search function to find someone who handles consumer cases.
Your situation is not unusual--insurance companies handle innumerable claims on a daily basis, and wires can get crossed without fault by either party. I would recommend that you try to find an attorney that provides free initial consultations. Bring any paperwork you have along with you to the consultation. The attorney can tell you frankly whether he/she thinks you should pursue legal action, and why. If the attorney thinks you should pursue legal action, his or her first step will likely be to write a letter to your insurance company. As noted in the other responses, however, hiring an attorney can be expensive, and taking legal action may not be necessary. There may be another solution. Good luck, and I hope that your health improves soon.
Please be advised that this is not intended as legal advice, and I am not your lawyer. My only intention is to provide guidance based on the limited information you have provided. If you decide to take legal action, you should contact an attorney in your area and speak to him or her one-on-one.
The Department of Insurance highly regulates insurance companies in all states. They will have a department of consumer affairs. Look it up, and begin a grievance immediately. It is possible that because of your exigency, they will intervene on a temporary basis to get you the immediate coverage that you need.
Good Luck.
