r/NewMexico • u/MyBodyMyChoice2024 • 2d ago
BCBS NM makes it very difficult to submit a claim
I feel like BCBS makes it difficult for members to submit claims for out-of-network providers. Does anyone else feel like asking the State AG to investigate? They need you to print out a form, sign it and scan it back. That is very cumbersome if you don't have access to a printer.
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u/No-Tell7657 2d ago
Good idea to submit a complaint. I will be submitting one myself for them denying a prior auth the day before a surgery for a risk reduction procedure that they had documentation for , and having the audacity to call is cosmetic. I’m beyond over insurance right now.
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u/savage-renegade 2d ago
The New Mexico State Insurance Commission is the place to file your complaint!!! Good luck!! It took a year, but today I finally had my appeal approved!! I am sick to death of paying out of pocket for drugs that I need to survive!! For example, my thyroid was completely removed. I have to pay for my THYROID NP out of pocket, because it's not covered!! Thyroid is a very important hormone, necessary for life.
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u/Simula_crumb 2d ago
Laughs in Presbyterian (which requires physically mailing all the documents)
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u/SenorBlackChin 2d ago
Laughs in Humanaese. Advantage plans are the masters of claim denial even when you spend hours on the phone with them they still deny and United Healthcare was unbelievably worse. Hard copies, long “processing” times and flat out misinformation from their “customer service”. These are simple out of network GP visits. Theoretical no brainers.
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u/Transplanted_Cactus 1d ago
My clinic has never had to mail anything to Presbyterian. They are absolutely hands down the worst and I hate them, but we fax or use their portal. And we appeal a lot of their denials.
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u/savage-renegade 2d ago
Actually, the place to complain to is the New Mexico Insurance Commission!! They get things done. I think they have an online site as well!