Anthem blue cross blue shield is trying to charge my 20% coinsurance from the bill total rather than the allowed amount. Is this correct?

This may be an easy fix but I’m all kinds of jumbled and need someone to explain it to me like I’m 5. I have Anthem Pathways through the marketplace. We used a company to help us get that insurance. So already my mind is boggled…so many moving parts. I have an account on Anthem that lets me see EOBs for myself. These EOBs are important because I use them to upload to the company I mentioned before in order to get reimbursed through my workplace. Still with me? I want to be able to add my son’s EOBs because that will help us reach our family OOP faster. Problem is, I haven’t been receiving his EOBs. I figured I would add him as a dependent on my Anthem account and could get those. No such luck. After looking and looking for a way to do this, I emailed Support. They told me that since I have a plan through marketplace, I need to call something called the Exchange?? What is that?? And that they will review something, send it over to Anthem, and then I can put my son on and see all his info. Please break this down for me. What does it all mean? What do I need to do in order to get his EOBs? Why is this all so effing complicated? I hope I gave enough info. Please let me know if there is something missing that could help me. Thank you so much in advance.

Hi all, I have an employer health insurance plan through my union and apparently a few months ago they had to abruptly change their mental health portion of my insurance plan. I am trying to get a therapist but my therapist says my insurance is not accepted because I am a part of a health concept plan but my employer who handles my insurance says I am not apart of the plan anymore and that I have anthem PPO. I’m in a constant loop of insurance saying one thing and my provider saying the other. The Union who handles my insurance tells me to tell the provider to call them but my provider uses a system to verify coverage. I’m not sure who to call or how to get this resolved. When I called anthem they transferred me to my union. When I called the union they said anthem handles that portion of the plan. I think I’ve been passed along every department now. Any advice would help.

I was on my domestic partners health insurance for a couple of months before they left their job. We had all the papers signed legally in front of a notary and I was officially listed on their insurance. However, they left their job and I am trying to get insurance again through Anthem Blue Cross Blue Shield by proving that I was on my partners insurance. Sadly it has been nothing but a back-and-forth struggle, sending paperwork, and asking for their phone number only to be ignored. I have given then my full name, my partners full name, my partners termination information, and I have even used the insurance at a local urgent care recently (plus printed out the document showcasing my full name listed as a domestic partner on their insurance). After proving I am who I am, they keep asking for more information and this time asked for my terimination date from my job to prove I was on the insurance. But I didn't leave my job. My partner did, which I have explained. They also asked for the loss of coverage date, but I have sent previous emails with that said date. Long story short: I am trying to prove I was a domestic partner on my partners insurance, only to be asked again and again for more paperwork (of ones specifically I have already provided). Has anyone else faced this issue? Is there any way I can go about this in a more efficient way or anyone I can contact? Thank you! I really appreciate the help.

ive asked anthem blue cross five times and not getting anywhere. my mental health is completely covered. i made an appointment to do telehealth and they said i have a copay of an office visit. the insurance company offers telehealth through their own app online. what i want to know is - how can i find info on the telehealth offerings that my insurance cover. am i wrong to assume they should cover the entire cost since its under mental health. do insurance companies have different rules for telehealth? have they come up with different rules and why cant i just read about the rule? they keep saying send them the cpt code? so would it be normal that they cover mental health one hundred percent but telehealth for mental health is the cost of an office visit?

I switched to an HMO plan, and all doctors at the practice I go to accept my insurance, including my PCP. However, the PCP I was seeing is relatively new, and because of that, they don't show up on the list of providers when I go to assign my PCP with my plan online. I remember having this issue a year ago when I tried seeing them for the first time (I wound up having to wait until my job gave me an EPO plan). I love my PCP, and don't want to have to choose a new one after being with them for a while. Is there anyway to get my insurance (Anthem) to update their list? Or would the doctor have to go through a process on their end?

I’m having trouble finding a provider I’ve applied to 30 different providers through the Anthem website (I was referred to this website through Med-iCal), when re-directed to many providers websites that can take supposedly take my insurance they usually provide a dropdown of insurances they take. I applied for California Med-iCal and am curious as how to describe my insurance? Is it an Anthem? Is it Anthem Blue Cross Blue Shield, is it a LA Care card, is it a Med-iCal card? I’d also like to add that there’s every combo version of what I just mentioned and not direct way for me to know which one? I’m am genuinely losing my mind, anyone with a similar insurance and help would be great. Yes I’ve called the numbers provided on the back. No help.

I am a 33y/o female in NYC and found out today that my enrollment into medical insurance through my employer didn’t save. i have not been covered for the last 3 months and im worried something could happen where i need it. I just looked at quotes for individual coverage and at my income level of $140k the lowest cost plan was $700 per month. I’m getting married in August and since that’s a qualifying life event i’m wondering if i have any options other than get legally married early or pay the $700. i’ve reached out to HR for other enrollment related things in the past and they wouldn’t budge in the slightest so don’t expect any workarounds with my companies insurance which is Anthem. Advice desperately needed :(

I’m looking for a new dentist and almost every dentist I calls either is out of network for Anthem or isn’t accepting new patients. I have an HSA account so I have the funds to cover any fees that I might need to pay currently but I’m unsure moving forward if I should just drop my dental insurance and just move to a dentist that I like? I need some crown work currently so I could get that work done before dropping insurance but otherwise I just need regular cleanings and an occasional filling here and there.

i visited the ED back in march 2024 and ended up being placed in observation and let go the next day. i’ve been dealing with an insurance/billing issue since then. i have anthem BCBS under an employee sponsored health plan (Union Construction Workers). the hospital i visited was In Network. for some reason, the hospital is billing me around 17000$, stating that my claim was denied due to code *00897, which requests complete medical history from the member. the member being myself, so i contact my employer sponsored health plan claims specialist, and she has no idea “why they would want that [referring to medical history]” and ensures me the claim is covered and sends over the EOB. which states patient responsibility is $1500, and not $17000. she lets me know that UCW paid mercy back in july. anyway, fast forward to november i am getting billed $17000 again. i call billing, they escalate my case, and remove the $17000 charge from my statement. i call UCW again, and they let me know the claim has been paid. billing is telling me anthem denied the claim again. they ask me to resend the EOB. fast forward to now, i am getting billed 17000$ AGAIN! i call billing, they tell me that the anthem claim is denied. i ask them if they looked at the EOB. they say yes, i ask them if we can go through the EOB together. we look through my UCW EOB and the billing employee states that my ANTHEM EOB was reviewed and for some reason my UCW EOB was not reviewed but it was received after i sent it in November. he agrees, i should only owe $1500 per the UCW EOB. but anthem is denying my claim still. i call UCW again. the rep tells me that she is now contacting anthem directly. after 9 months of issues we are finally contacting anthem. and there is no way for myself to contact anthem, only through the UCW representative. i am giving birth in about a month, im in a rush to get this handled. i would accept any help that i can. i have looked through the itemized bill, UCW EOB, and claim on anthems website and reviewed for errors. i noticed that there is one charge (for $9.50) that insurance covered that is listen on both the itemized bill and anthems claim, however not listed at all on the UCW EOB. but i, a not insurance expert, does not know what this means. please please help if you can! i have already talked to my states insurance department, which they were confused w my situation and could not help. i also have requested proof of payment from UCW, as well as a 3 way phone call between UCW, myself, and billing.