Carefirst claims not processing

[Anonymous]

Has anyone prior poster had their claims paid?

[Anonymous]

Anonymous wrote:

Anonymous wrote:CAN someone please help?! PP here they have still not payed my claim and its gone to collections what am I supposed to do now? I have great credit I do not want to ruin but PP posters said DO NOT PAY the doctors office. So then what am I supposed to do?

Is this OON or In network? If the latter, submit a claim with the MD AG https://oag.maryland.gov/our-office/Pages/heau.aspx. Notify the organizations billing office that you have submitted a claim to the AG.

In network!! I can't even belive it! This is after I already called the doctors office for them to put a note on my account saying it was being addressed. I'm going to report this to my company but who else? I'm in Virginia not MD. Does the AG deal with stuff like that here in Virginia?

[Anonymous]

Anonymous wrote:Has anyone prior poster had their claims paid?

I had some paid but many still pending. All OON.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:CAN someone please help?! PP here they have still not payed my claim and its gone to collections what am I supposed to do now? I have great credit I do not want to ruin but PP posters said DO NOT PAY the doctors office. So then what am I supposed to do?

Is this OON or In network? If the latter, submit a claim with the MD AG https://oag.maryland.gov/our-office/Pages/heau.aspx. Notify the organizations billing office that you have submitted a claim to the AG.

In network!! I can't even belive it! This is after I already called the doctors office for them to put a note on my account saying it was being addressed. I'm going to report this to my company but who else? I'm in Virginia not MD. Does the AG deal with stuff like that here in Virginia?

The providers are having challenges with Carefirst as well but they cannot take that out on patients. By contract, an in network provider can only charge the patient for copays and deductibles.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:CAN someone please help?! PP here they have still not payed my claim and its gone to collections what am I supposed to do now? I have great credit I do not want to ruin but PP posters said DO NOT PAY the doctors office. So then what am I supposed to do?

Is this OON or In network? If the latter, submit a claim with the MD AG https://oag.maryland.gov/our-office/Pages/heau.aspx. Notify the organizations billing office that you have submitted a claim to the AG.

In network!! I can't even belive it! This is after I already called the doctors office for them to put a note on my account saying it was being addressed. I'm going to report this to my company but who else? I'm in Virginia not MD. Does the AG deal with stuff like that here in Virginia?

The providers are having challenges with Carefirst as well but they cannot take that out on patients. By contract, an in network provider can only charge the patient for copays and deductibles.

Is there a timeframe for Carefirst to reimburse providers their contracted rate?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:CAN someone please help?! PP here they have still not payed my claim and its gone to collections what am I supposed to do now? I have great credit I do not want to ruin but PP posters said DO NOT PAY the doctors office. So then what am I supposed to do?

Is this OON or In network? If the latter, submit a claim with the MD AG https://oag.maryland.gov/our-office/Pages/heau.aspx. Notify the organizations billing office that you have submitted a claim to the AG.

In network!! I can't even belive it! This is after I already called the doctors office for them to put a note on my account saying it was being addressed. I'm going to report this to my company but who else? I'm in Virginia not MD. Does the AG deal with stuff like that here in Virginia?

The providers are having challenges with Carefirst as well but they cannot take that out on patients. By contract, an in network provider can only charge the patient for copays and deductibles.

Is there a timeframe for Carefirst to reimburse providers their contracted rate?

I want to know the same thing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Has anyone prior poster had their claims paid?

I had some paid but many still pending. All OON.

How long out? Has any gone to collections?

[Anonymous]

Anonymous wrote:I submitted a complaint to the Maryland Insurance Administration and I encourage other Marylanders to do so as well.

https://insurance.maryland.gov/Consumer/Pages/FileAComplaint.aspx

For those that have done this, was it resolved and how long was the process with them?

[Anonymous]

Anonymous wrote:Has anyone prior poster had their claims paid?[/quote

After many calls, both to Carefirst and my company HR Benefits Rep, our OON claims that have been outstanding since early Jan are slowly being processed - but oddly, in no particular order. That makes sense given reports that claims are backlogged and being processed manually because of a systems integration issue. As much as I think insurance is in the business of denying claims, this seems to be a legitimate platform issue. I am hopeful they are getting back on track.

[Anonymous]

Anyone who voted MAGA deserves to be denied. When will purple wake up. The GOP MAGAs don’t give a hoot about you or healthcare. All they care about are corporate profits.

[Anonymous]

Anonymous wrote:Anyone who voted MAGA deserves to be denied. When will purple wake up. The GOP MAGAs don’t give a hoot about you or healthcare. All they care about are corporate profits.

Because Obamacare fixed health care?!

🙄

[Anonymous]

Anonymous wrote:

Anonymous wrote:Anyone who voted MAGA deserves to be denied. When will purple wake up. The GOP MAGAs don’t give a hoot about you or healthcare. All they care about are corporate profits.

Because Obamacare fixed health care?!

🙄

+1 Democrats designed the current system and intentionally did not create meaningful consumer protections because they are beholden to rich people and corporate donors. It's better than nothing which is what the GOP/MAGA offer, but that's a low standard.

[Anonymous]

Anonymous wrote:Anyone who voted MAGA deserves to be denied. When will purple wake up. The GOP MAGAs don’t give a hoot about you or healthcare. All they care about are corporate profits.

Common folks - let’s drop this unhelpful tangent and stay focused on practical suggestions for those of us trying to deal with Carefirst claim processing issues….

[Anonymous]

It isn't an isolated issue. I work for the State of Maryland and have Carefirst through my employer. Earlier this week, all state employees got an email from our HR advising that it was a company-wide issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:CAN someone please help?! PP here they have still not payed my claim and its gone to collections what am I supposed to do now? I have great credit I do not want to ruin but PP posters said DO NOT PAY the doctors office. So then what am I supposed to do?

Is this OON or In network? If the latter, submit a claim with the MD AG https://oag.maryland.gov/our-office/Pages/heau.aspx. Notify the organizations billing office that you have submitted a claim to the AG.

I work for the Maryland AG. We all have Carefirst and are experiencing the same issue.