Troubleshooter: Raleigh mother frustrated by unanswered insurance claims

Diane Wilson Image
Friday, May 1, 2015
Mother frustrated by insurance claims
Troubleshooter Diane Wilson investigates a mother's frustrations with a local insurance provider

RALEIGH (WTVD) -- Filing a claim with your insurance company should be simple, but, as one local family found out, simplicity is not always the case.

"My daughter goes to a doctor that does not file the claim for the patients so we are responsible for doing that," Laura Stephenson said.

So Stephenson did what she normally does, mailed in the receipt from the visit and filed a claim with her insurance company, Blue Cross Blue Shield of North Carolina.

"I waited about two to three weeks, called to confirm that they received it and they stated that they did not," Stephenson said.

She tried sending it again; only this time, she faxed the claim.

"I called to confirm that they had received the fax, about two to three weeks later, and they had not received the fax," she said.

Despite having a confirmation the fax went through, Stephenson refaxed the claim and says she was told it would take 30 days to process.

But after 30 days, still nothing.

"So I could call about every three weeks to check on the status and each time was told it was being processed or it was being keyed, the same excuse every time but never saw it was posted on the portal," Stephenson said.

Frustrated, Stephenson contacted ABC11 and we got in touch with Blue Cross Blue Shield of North Carolina.

"I received a call from Blue Cross and Blue Shield and they stated that on Monday I would see the claim processed on the online portal," Stephenson said.

After months of waiting, the claim was finally processed.

"That quickly, getting you involved, got it resolved which is amazing," Stephenson said.

A representative with Blue Cross Blue Shield of North Carolina said:

Ms.Stephenson did everything right in filing her claim; unfortunately, we missed several opportunities to assist her. Claims should be processed in a reasonable time for our customers, in this case, it was not. We are sorry that Ms. Stephenson had this experience.