Brighton Health Plan

Edit: I have come back to revise my review! Someone from escalations reached out to me and instantly solved my problems via Brighton's child company Magnacare. My 2 month problem has finally been solved! My review will remain at 3 stars for 2 reasons: 1. No one in Brighton's lower level support could even find a supervisor or even bothered too. That's along with the attitude I got. My situation got resolved because my client called their benefits company who directly reached out to Brighton to get things solved. I get that I'm a payee in the billing cycle but if my client had financial impact then it shouldn't matter who calls when a client has an active plan and an auth. Just solve the problem or investigate properly. Other BCBS plans do this since I interact with many across the nation. 2. The reaction time and inefficiency AFTER providing info that should've pushed our claims through. I had provided an auth for half of the claims we had an issue with. Meanwhile this was on file and the item requested from client's parent was sent 3.5 weeks ago. Despite this not being my office's mistake, I was told it will take 30-45 business days to see a single claim remitted. Talk about a punishment. I hope someone who handles bridging their vision of "transforming the healthcare landscape. Through our unique perspective and the alignment of stakeholders, we are bringing about significant change in the way healthcare is accessed and delivered" reads this and recognizes there is a ton of room for improvement with provider relations to avoid issues for their clients.

Called in to do a STAT authorization this morning for a patient. Was told authorization has to be faxed in. Absolutely absurd.

Truly the worst company I’ve had to deal with involving insurance. The website doesn’t work, the agents are kind but absolutely no help when it comes to actual issues with claims, and the 1 question survey that asks you to rate how much you would recommend BCBS NC to someone from 0-10 says ‘0’ is an invalid option, probably because that’s the only response they get. Nothing about working with them since my hospital/workplace switched over from UMR has been pleasant. It’s been the worst experience.

**** Avoid wasting your time working here*** Blue Cross partnering with this company did not resolve any issues internally, enhance the work environment or the services offered. Unprofessionals HR department- privacy & confidential information means nothing. Your info and anything you report will be spread across the gossip clique daily. Toxic workplace, the high-school cliques mentality is hideous amongst Executives, Management & HR. Unethical practices and procedures throughout the IT, Sales, Benefits and Operation departments both internally and externally. The Medical Management, Training & Customer Service Department are grossly mismanaged. Extremely Non-Professional Leadership tacts are widely documented. Narcissistic leadership ruins advancement opportunities within the organization. Management’s refusal to collaborate with or train lower level employees is next level sabotaging behaviors.

Ever since my job became covered through Brighton health solutions I spend 1-2 hours on a weekly basis disputing incorrectly processed claims. It took 6 months to get an emergency hospitalization that was supposed to be 100% covered finally settled. The doctors offices that our family uses regularly get processed incorrectly, not once in a while, every single time. Truthfully if I wasn’t a healthcare professional and understood medical billing I would be thousands in debt from improperly billed fees. This company needs to be brought to the better business bureau because there negligence is honestly criminal.