Bcbs Of North Dakota

I understand insurance companies try to deny everything, however this instance and denial is absurd. My 7 month was suffering from a severe stomach virus with all the associated issues that come with it (going to the bathroom uncontrollably). He was taken to a doctor who sent him to get a stool test in order to ensure there was not anything else that needed to be addressed. The insurance company, specifically the claims person without a medical degree, stated that my pediatrician was wrong and this test was not medically necessary. A stool test for a child with severe diarrhea, a novel idea apparently. They then went on to state in the denial this test was not warranted in people who had immune systems that were not weakened. So not only was my pediatrician wrong, apparently babies have immune systems that are comparable to those of adults and they should not be considered to be more at risk. I find it very enlightening that a young 7 month is now considered fully developed and their immune system is fully functional. Even worse, we were not notified our appeal was received and subsequently denied. When I called and asked to speak to someone with claims, I was told they were busy and would return my call. Not surprisingly, I never received a call from anyone. Would give 0 stars if possible.

I put this five stars for Kay. She is the only one who helped me. Kay is very friendly and polite. I had a problem with BCBSND for over a year. I made many calls, and no one helped me but Kay. I talked to her just once; she went through my paperwork and cases, fixed everything, and I finally got my money back. Kay actually called me before notifying that the check was on the way. I think she is very professional. Thank you, Kay. Ecaterina S.

They take your money under the guise of providing healthcare coverage. When you need it, they tell you your situation falls under and exemption. They profit from denying healthcare and they make HUNDREDS OF MILLIONS OF DOLLARS every year. If their health care "coverage" was a piece of clothing, it would be a banana hammock. Money Ghouls.

They took over ND Medicaid expansion and are not administering it properly. If you call 2 business days ahead of time to schedule transportation, they will tell you that you must call exactly 48 hrs ahead of time. If you call 48 hours ahead of time, they tell you it must be 3 days in advance. If they schedule the ride, they won't show up. SHAME on you and your poor service and training.

So I am a young adult trying to figure out how to file my insurance. So BIG shoutout to Sheila and to Heather for helping me!! They are WONDERFUL! I even made a friend! Bless their hearts!