Provider Services Contact

Hello.  I am a provider and had spent time messaging today thru Facebook Messenger with KW for a crazy amount of time. I see they are also on here responding., so I hope I can get in touch with someone else.  I could not get a straight answer and they kept giving me phone numbers, links, but I simply asked how I could talk to a human, and they would say I provided the information above but I would need a claim ID.  I have no claim IDs as they were never fully processed.  

They could never answer how I could actually talk to someone.  As a provider, this is insane the amount of time I'm taking to get my claims paid.  I asked for a superivisor as we clearly were not speaking the same language.  They then told me there is no supervisor (that's unheard of at BCBS).  Then they told me they wouldn't communicate with me further since I asked for a supervisor.  I asked if there is no supervisor to communicate with then to please send me to provider relations  They said they gave the information above (the aformentioned phone number and links where I can't talk to a human)  and stated they would not reply to me further.  Who trained this person?  How is this acceptable to BCBS from an employee?  I have worked with this company for over 15 years and have never had this type of experience or issues.  

I audited my filed and found in 2024 I have over 50 claims unpaid over 22 clients.  The claims were accepted for processing, were submitted on time, but then there was no communication electronically after that, no payment, nor no claim ID.  KW stated I had to have a claim ID to help me.  I relayed the exact same issue which resulted in the circle of no answers.  I resubmitted some of the claims today, I received back a response that it was rejected since it has been 2 years past the date, even though I submitted them electronically to BCBS on time in 2024.  I don't know if there was some internal issue as most the claims were between Feb and March of 2024.  

So how do I get my claims paid.  These were professional services rendered and billed directly to BCBS with no payment, nor followup.  I cannot speak to anyone.  How do I get this issue fixed and paid.  KW suggested I should send all the members IDs and dates of service over Messenger or email.  I would think this would violate HIPPA if that information was leaked as they are not secure channels.  I need provider services to help me get my claims paid from 2024 with over 50 outstanding non payments.  This is a lot of money that is being withheld as I can't get anyone to help me.

Please help me with provider services to get this issue remedied.

Thank you.

Hello, The information provided to you by KW is correct. We do need either claim numbers or the member ID numbers and dates of service in order to assist you. We request this information through a private message, as she did, due to HIPAA privacy laws. Additionally, she advised that you would need to contact provider services directly in order to speak with a supervisor, which is also correct. Because you have requested to speak with a supervisor we are unable to assist you through these platforms. She has provided you with the correct contact information for provider services, as well as provided you with links to provider resources on our website. However, if you have unpaid claims from 2024, these claims would likely need to be resubmitted, as we do not hold claims for processing for two years. If you have further questions or concerns, you will need to reach out to provider services directly. ~ HC

That is so ridiculous! I burst out laughing at this doctor's rant because it's the same thing I have encountered over and over. You cannot get help from BCBS. They outsource customer service to the Dominican and no one knows anything. And claim numbers where there are no claims- yep been there! BCBS needs to retool and HIRE from the USA . Train people in specialties since every specialty has different nuances. I don't even bother to call anymore because I know there will be no help.

That is so ridiculous! I burst out laughing at this doctor's rant because it's the same thing I have encountered over and over. You cannot get help from BCBS. They outsource customer service to the Dominican and no one knows anything. And claim numbers where there are no claims- yep been there! BCBS needs to retool and HIRE from the USA . Train people in specialties since every specialty has different nuances. I don't even bother to call anymore because I know there will be no help.