Blue Cross and Blue Shield Steals From Medicare Patients - Deny, Delay, Defend, Defraud

If you are entering Medicare, beware of fraud by Blue Cross and Blue Shield. Their standard operating policies appear to illegally take money, and if caught, they may only give back the money that they have taken from your bank in the past 60 days. In my case, they returned their ill-gotten gains after hours of arguments and months of withheld funds.

As another entrant into the national internet scam of bilking people by double charging and overcharging, Blue Cross and Blue Shield (BCBS) has taken advantage of this practice to easily take money that does not belong to them. For example, WinZip also has polices that they will double-charge people for the same service, and if they are caught, they will only pay back 60 days of stolen money. BCBS has exercised the same fraudulent policies, where law enforcement agencies refuse to protect us against such unlawful actions ("U.S. Banks and the FBI Harbor Criminal Fraud Enterprises").

I do not know the full scope of this fraud. I can only tell you my experience with Blue Cross and Blue Shield. Moreover, false statements from BCBS employees rolled off of their tongues so easily that the policies to illegally steal from this Medicare patients seemed obvious.

My Ongoing Experience with BCBS Fraud

I have been a BCBS client since my teens and now into my seventies. I needed major transplant surgery, and BCBS declined to pay any money at all for that surgery to the hospital recommend by my physician. As a direct result of that decision, I transferred to United Healthcare, and my required monthly payments also decreased by more than $500 per month when we, my wife and I, transferred insurance companies.

Then the fraud began. United informed BCBS that my wife and l changed insurance companies. After a month, BCBS continued to illegally withdraw money from our bank account. My wife called BCBS in October in the first of a series of three conversations that were recorded by BCBS, and they agreed to return the money, which was only $500 so far. At first, BCBS returned our $500, and then they withdrew even more money from our bank as shown on bank records. That is, BCBS illegally kept that money plus two additional payments, totaling more than $1500.

We called again on November 26th. Then, BCBS stated that a phone call from United did not count as a cancellation, where we must tell BCBS directly that we are cancelling, which effectively allows them to keep money that does not belong to them. We pointed out that we did, in fact, call them to cancel in about one month when we learned of the first illegal bank withdrawal, and that we were calling them again to report an ongoing theft from our bank by BCBS. After some discussion, they agreed to pay for two months, and that they would call back about payment for the third month. They did not call back.

We called later on December 2nd, and started all over again as if we had not already called. The employee told us that BCBS was not withdrawing our money at all and seemed to start saying goodbye when she said Thank you, but we quickly stated that we had bank statements that proved BCBS was taking our money. We spoke some more, and she seemed to start to hang up again, falsely claiming that my wife and I were cursing. We quickly stated that we may have been loud since our money was being stolen, but we did not speak a single curse word. We were then told that there are two different departments at BCBS, where the BCBS operator had transferred us to the wrong department, we had stated to the operator that we were being defrauded, we were unaware of different departments, and asked her to transfer us to the correct department.

The next employee told us that we are not entitled to get our money back because we told the wrong department that we cancelled. Apparently, BCBS has two departments - each with their own BCBS cards - one for prescriptions and one for medical claims. I pointed out that we use the same card for all claims. Then, they agreed to pay for only two months of stolen money, and that they would call back later about the third month's bank withdrawal. We received no phone call. However, we were notified by mail today, December 16th, that the funds had been returned to our bank account, and that returned was verified to have occurred on December 10th - more than three months after a September 1st cancellation of BCBS in Medicare Advantage insurance.

Deny, Delay, Defend, Defraud

Deny, delay, defend is the chant on the internet for unpaid medical insurance claims (aydenydefend.com/), that policy seems clearly evident in this case, and fraud is the end result of these actions. In my experience with BCBS, their denials of wrong-doing and criminal intent were fired at me as fast as I shot them down. One false claim after another was used to deny my claim. When the fraud could no longer be denied, BCBS resorted to delays or non-payments. BCBS even said that we signed a document allowing BCBS to withdraw funds from our bank, and I responded that they were correct, but that I never signed any document to allow them to unlawfully take funds from us for services that were no longer provided. Again, BCBS has not provided promised call-backs but they finally provided our stolen money back to us.

The Point of This Story

My wife carefully reviews our finances every month, and accordingly limited the thefts by BCBS from our bank account, and unpleasant hours of arguments against BCBS fraudulent claims resulted in the return of stolen funds. Ohers who do not closely monitor their bank accounts can be defrauded for long periods of time, and BCBS stated that they only 'refund two months' of stolen money when they are caught.

I ask that BCBS treat clients with honesty.