My complaint:
Pursuant to your request via FB Messenger , I am providing more information regarding the problem that we are having with BCBS paying their claims to us correctly to the correct provider.
In Oct 2020 Dr. **** : Suffolk Cardiovascular Consultants- left the employment of NYU. Somehow, BCBS at some point ( I believe two different occasions) dropped off Dr.***’s individual credentialling and paid NYU for the services that he rendered and processed many of his claims as Out of Network.
I discovered this late 2020 and we reached out to our representative Galina *** and Jacqueline *** . They directed us to Katrina *** . Katrina is not capable of doing what is necessary and looped in some other teams. They get no where and do not make this a priority. We are approaching 3 years since dates of service and only about a dozen claims have been corrected.
I have reached out to both Kim *** and Kelly *** . We have had the onus put on us to provide information in the BCBS format. Frankly, this is abusive. I do not have the manpower to address this. We have provided lists of claims, DOS, original EOB’s. no one is denying that BCBS paid NYU in error but they are not making this a priority to get it settled and no interest has been paid on the few claims that have been reprocessed!
I am at my wits end. I am now lowering myself to going to social media. I have so far, done this privately vis messenger but I am going to blast every social media outlet that I have access to very shortly. I am also going to talk to an attorney and the department of Finance. This week I filed a complaint with the Better Business Bureau and Consumer Affairs. I am done being patient.
I am hopeful that you may get someone to finalize this. A rep should really come to our office and sit with our biller and do this line by line. I will review my contract. I have to assume that there is a time frame in which BCBS has to address unpaid claims.
Suggested solution:
They should set up a meeting to address each claim individually and reprocess complete the process within a week. It has been almost 2 years with minimal response and services were rendered almost three years ago.
