What to do When You Think There’s an Error

While our goal at Blue Cross Blue Shield of Michigan is to make health insurance as easy and uncomplicated as possible for our members, sometimes things happen. When something doesn’t seem right—like a denied claim or billing mistakes—it can be frustrating and confusing. That’s why we’ve put processes in place to handle these kinds of situations and help you focus on more important things. Keep reading to find out what to do if you think there’s been an error.

What happened? A claim was denied.
What to do: If you think a claim was denied incorrectly, call the member service number on the back of your ID card or in the top right-hand corner of your Explanation of Benefits statement. The representative will be able to go over the claim in more detail and answer questions. If you aren’t satisfied with the response, there is a more formal grievance and appeals process. A good place to start is by filling out the Member Appeal form (the form is optional and can be used by itself or with a formal letter of appeal). For more information, visit us here.

What happened? I believe I was billed incorrectly.
What to do: One of the more common reasons is an incorrect code input at the doctor’s office. First, call your doctor’s office and ask to speak to someone in billing. If the correct code was used, contact Blue Cross by the member services number on the back of your ID card. If you still have an issue with your bill after taking these steps, you can form an appeal using this form and following the directions here.

What happened? A payment doesn’t go through, but you don’t notice the error until after the due date.
What to do: If you miss a payment, you have between 30 to 90 days after the due date to catch up your account without incurring a penalty. The amount of time you have to pay after the due date depends on the type of plan you’ve elected. That said, you may not be covered for treatments you received until you make the payment. Call the member service number on the back of your card as soon as you realize the payment didn’t go through. If you’d like to talk to someone in-person, there are walk-in centers across the state, where representatives are available to go over questions in person. Additionally, you can visit our Customer Action Center, which tracks your issue and puts it into our system so that a representative can reach out to you for additional support and guidance.

What happened?  You tried to pay your bill through your online account, but don’t see your new plan listed there.
What to do: A new plan may take a few days to appear on your online account. If you want to make a payment right away, you have a few options:

Blue Cross is committed to its members and their overall customer experience, which is why we’ve put such an emphasis on updating these processes and making them easier for our members.

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