NC officials swamped with complaints about Blue Cross/Blue Shield

RALEIGH, N.C. (WNCN) –  The North Carolina Department of Insurance has been swamped with complaints about Blue Cross and Blue Shield of North Carolina, it said Thursday.

“To say that people are frustrated is an understatement. I’m frustrated, too,” Insurance commissioner Wayne Goodwin said in a statement. “As Insurance Commissioner, I will get answers from Blue Cross as to how this happened and assurances that it won’t happen again.”

The department said it has received more than 850 complaints since Jan.  4 related to overbilling, inability to verify effective coverage, and lack of a way to pay premiums due to company system errors.

Blue Cross and Blue Shield of North Carolina said Jan. 11 that about 3,200 customers had the incorrect amount deducted from their checks, but said a day later that most of the issues had been resolved.

CEO Brad Wilson, in a radio advertisement, said, “These difficulties are unacceptable and we apologize. To improve this situation, we are working around the clock—bringing in more staff and expanding customer service hours.”

But the Department of Insurance said it was still overrun with complaints. A statement said the problems were “putting a strain on consumer assistance resources at the N.C. Department of Insurance.”

“I’m going to hold Blue Cross and Blue Shield of North Carolina accountable for fixing its problems and doing right by consumers,” said Insurance Commissioner Wayne Goodwin. “In the meantime, I have shifted additional staff members to the phones at the Department of Insurance to help people get the health care they need.”

In response, Blue Cross and Blue Shield said in a statement, “We share the Commissioner’s frustration that we have not been able to provide the level of service our customers have come to expect. We are working diligently to resolve these issues as quickly as possible in collaboration with the Department. We are truly sorry for the difficulties that our customers are experiencing.”

NCDOI’s first priority is assisting people with urgent medical and prescription needs. The department has successfully escalated cases to BCBSNC’s attention for people in need of care for conditions including high-risk pregnancies, heart issues, cancer and diabetes, or services including emergency surgeries, MRIs and CT scans.

“To say that people are frustrated is an understatement. I’m frustrated, too,” Goodwin said. “As Insurance Commissioner, I will get answers from Blue Cross as to how this happened and assurances that it won’t happen again.”

Consumers in need of assistance from the N.C. Department of Insurance should call 855-408-1212 or visit www.ncdoi.com.

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