""I want to understand the percentage of claim denials. I want to understand the duration of time to respond to those claims and resolve those claims," said Supervisor Connie Chan."
""We take members concerns incredibly serious. When we fall short, it's always moments to learn. We recognize our role and our role is to make sure we are following policy," said Tim Lieb, Blue Shield's senior VP of Commercial Markets."
""Blue Shield called UCSF and cancelled my appointment and said, 'Too bad. It's not covered. It was a mistake,'" said Miriam Pengel."
"Chan said she was also disappointed in the city's health service system, for its inability to track denials and provide additional help for enrollees."
Ken Jones, a retired firefighter in San Francisco, had his stage 4 cancer treatment denied by Blue Shield, the city-provided insurer. This situation led to increased scrutiny from the Board of Supervisors, who held a hearing to question Blue Shield executives about the high rate of claim denials among city retirees. Supervisor Connie Chan expressed concerns about the percentage of denials and the response time for claims. Other retirees, like a former police lieutenant, shared similar experiences of denied claims and appointment cancellations by Blue Shield.
Read at ABC7 San Francisco
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