Complaint Review: Trigon Blue Cross Blue Shield

This company is supposed to pay my claim at 70% of the the allowable charge considered by Empire Blue Cross Blue Shield of New York since that was the area the services were rendered.

My doctor provided me with copies of claims and predermination letters of other patients who had this same procedure code #62287 and who were insured with Empire Blue Cross
Blue Shield that show the allowable charge for this procedure to be 7000.00.

Trigon insists that Empires allowable charge is 2000.00. All documentation that I have from Empire shows the allowable charge to be 7000.00. Trigon is fraudulently processing this claim at a totally unreasonable allowable charge amount to avoid proper payment of this claim.

Here we have one of our largest insurance companies that take billions of dollars of hard working peoples money , taking money all the while saying they are on your side and to alleviate your troubles they deny every legitimate claim with legal jargon, and for all the monies paid to this organization by millions of hard working people trusting in good faith for fair treatment and in the end all they receive from their efforts is endless miles of useless litigation knowing all the while that most claims stacked against this billion dollar industry are denied across the board knowing that most people do not have the recourses available to them to fight for their legitimate rights and in so doing they just keep making their already grossly bloated assets larger .

Monopolies such as this one should not be allowed to exist as it does nothing to alleviate the problems (as promised) that have already been paid for in good faith by the consumer(s) thinking they will be treated fairly, instead the make it as difficult as possible to the consumer, as if things aren't already stressful enough to process a legal and legitimate claim to utilize the service that has already been paid for IN ADVANCE.

They are fraudulently processing claims for their own benefit. Higher profits born from dishonesty and greed. They are the truest definition of what a thief really is a thief - an insurance co in Virginia Trigon Blue Cross Blue Shield who fraudulently processes claims incorrectly by way of incorrect allowable charge amount or some other off the wall reason to avoid correct payment to their insured customers just for the reason of higher profits by the way of dishonesty ,greed, and most impartment deceitfulness with the absolute knowledge of it ( which makes it even more sickening, disgusting, and aggravating that such a prestigious or so called prestigious company would practice this way and still get away with doing this to consumers and continue to get away with the true meaning of what the worst kind of thief really is.

Julia
Asheboro, North Carolina

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