Wiki Blue Shield of California Erroneous Denials

Kcancode

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Is anyone else receiving denials from Blue Shield of California stating "no referral or auth on file", when the services/plan do not require auth or referral? We have been having issues since February, and for every denial we have to call to have the claim reprocessed after the painstakingly slow process of discussing each individual claim with a BS rep, explaining why it shouldn't have been denied, then having them confirm it was in fact denied in error. I have tried to have some of my calls escalated to management to have them investigate their adjudication system for glitches, but I've not been able to speak to anyone who can actually help.
 
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