Blue Cross Canada

I have provided health services to the local Military and Veteran community for years. These services were all pre-approved including the number of treatments and cost, and were directly billed to Blue Cross. Over the years, many claims remained unpaid despite extreme efforts to follow-up with them, sort out THEIR administrative issues, and get paid. More recently they decided to send an auditor out. I spent the day with them proving treatments had occurred via file audit. In the end, they claimed that there was no evidence treatment had occurred and therefore I owed them back thousands of dollars. I spent many hours following up with this bogus audit. They has taken photocopies of the charts - proving the treatments and yet still said they did not exist. They claimed "over charging" with no evidence. Despite me re-sending all necessary documents including offering client and local CFB statements that the treatments had occurred, they still did not consider any of the facts. Fast forward over 2 years without resolution, they are now refusing to pay my private paying (civilian) clients' reimbursements and what's worse is they tell the client I am not a registered therapist. I am a legally licensed and registered therapist in good standing with my college! What they are not telling people is that they are not allowing me to be registered with THEM as a provider on their list. They are like the mob! Trying to bully and blackmail me into paying them thousands of dollars just for the privilege of seeing clients that pay for extended health benefits through Blue Cross.
I know I am not the only provider to experience this issue and behaviour with Blue Cross. I have spoken to several, but they are afraid to say anything publicly for fear of going up against a shady insurance giant. Sadly, there is little to no recourse for our industry with respect to dealing with their inappropriate practices.

Please do not buy your insurance with Blue Cross and support this type of company. If you work for a large company that uses Blue Cross as its provider of extended health benefits, encourage them to change providers. If your claim has been denied, take it to the Ontario Ombudsmen at www.olhi.ca and have them investigate the practices of Blue Cross. This needs to change!

it doesn't mater what claim you submit they come up with a reason even after talking to them about it. to not cover it.

Denied my drug claim, stating it was a "duplicate service that was paid on a previous submission". I got the pharmacy to call and let the company know that I paid and not them, but all they said was they'll "look into it". I haven't seen any money and it's been weeks. Would never recommend this company, I had to pay $65 out of pocket for their mistake and they won't reimburse me.

Terrible insurance company, they still work from snail mail and haven't been able to cover half of the prescriptions I need to stop being sick.

Blue Cross partner CanAssist denied my claim for Air Canada fare cancelled due to Covid arguing that the airline company offer of a 1-year credit is full compensation. I haven't even accept the credit fro airline.If I do,the chances a being able to use the credit is zero given the current situation. They also provided misleading information on the claim process when first contacted that resulted in a delay of the claim processing by several months.

Blue Cross partner CanAssist denied our claim for air fares cancelled due to Covid arguing that the airline company offer of a 1-year credit is full compensation. The chances a being able to use the credit are approaching zero given the current situation. They also provided misleading information on the claim process when first contacted that resulted in a delay of the claim processing by several months.

Bad customer service
Claim took 6 weeks to get processed
I had to open two online cases and call 4 times
I dont recommend

Gave me coverage I did not want for drugs. Incredibly complicated website and horrible customer service !

One star is too generous for this company, I have had so much trouble getting reimbursements owed to me. I feel like I am criminal trying to defraud the company each time I have a claim outside of the routine claims. Claims that are rejected are extremely difficult to resolve, common sense is not something this company uses. I imagine most people simply give up trying to resolve contested claims as the company wears you down until you are so frustrated, you don't have the energy or will to pursue the money owed to you. I have no choice in medical insurance as this is the company my employer uses, if it was my decision I would NOT use Bluecross,

Of course the app and the online portal are both inaccessible. I never have any issue registering on any sites other than for an insurance company. My thought is that it is in hopes that you will give up and they won't have to pay, despite that I have already paid the premium.

I had to see a psychologist to assist my daughter with a disability claim. I provided a receipt to Blue Cross for $ 1000.00 and my plan only reimbursed $ 60.00. This has left my unable to pay my credit card and now paying high interest rate! They insist on yearly prescription for a lousy $ 15.00 month massage coverage. I pay $ 25.00 for the prescription. Ridiculous. Go with anyone else for coverage!!

These guys ripped me off!

Long story short is by the Canadian laws, if you had travel insurance then you've got provincial insurance covering you, these insurance companies must refund you the rest of the time you have bought from them!

I was literally broken then, and finally had our OHIP but these guys refused to refund us even though I extended our insurance with them 1 or 2 weeks before that!

Their claim for not refunding us was that we made a claim one time for my daughter when she got sick and took her to the emergency! However, that was in the old contract, not the new one!

So when I spoke to a manager on the phone and explained to her that I just extended my insurance to technically it's a new one, she replied that 'you're right, but this is a trick in our policy and I can't help you!'

Well, the amount that they were supposed to refund me was about $300. It's not much! But back then, I was literally broken! I used to work 14 hours a day at two jobs to feed my daughter and wife and that $300 made lots of difference to me!

Anyway, I'm happy to say that I know more than 25 people from family and friends who came to Canada for long and short visits and the first thing I'd advise them not to do is getting their insurance from the blue cross!

It'll always be one of the first things I'd tell anyone coming to Canada not to get their insurance from this company!

Had a short stay hospital claim for my wife a few years back and paid by Blue Cross with no hassle what so ever. Very professional and would highly recommend.

After 18 years with Alberta Blue Cross I moved to BC. They will not waive waiting periods for dental.

Submitted a claim in September and were told 5-10 business days to deposit it into our account- nothing.
Called and advised it was not deposited and confirmed banking info and they said it was processed and deposited on September 19. Said they would trace it and advise- no return call. Made multiple calls and were told they "were still tracing it". Called today (Tuesday, October 30) and was told it it was being processed and would be sent out by cheque on Thursday (November 1).

Requested interest for two months that the bank or Blue Cross had earned on our money and was told "No".
Supervisor in Contact Centre would only identify herself as "Laura L."

I have NEVER refused to provide my name to a client.

Blue Cross has provided the worst customer service I have ever experienced!

This is the third time we have had issues getting reimbursed promptly. Twice they have lost the paperwork and than denied getting it even though we had a confirmation from our dentist. This las time we have been waiting 3 weeks for a simple reimbursement for glasses. When we called they said they were working on mid June billings this is now early August. We will be cancelling our policy very poor customer service.

My wife has a travel insurance and is taking medications in the hospital and will not be able to get back from her visit ontime, as per all the hospital reports, she has to be under monitoring and she had a kidney attack and her doctor strongly recommended that she needs more time to be recovered and she will not able to travel (travel duration is 20 hours). we submitted all the reports from the hospital and labs to the blue cross travel insurance and they have denied the claim knowing that we are not asking for medical benefits but only cancellation or delay the reservation. since many days I am discussing with them with no use. They sent me email only saying that their medical team found that she is fit to travel. she is now in the hospital and she is supposed to get back tomorrow and they say that she is fit. I asked them to send me documents on what basis they took their decision but they refused.

Someone tells me how a person in the hospital and he is fit to travel !!

I don't recommend them as honest travel insurance,