Best’s News & Research Service - February 11, 2016 03:56 PM (EST)
North Carolina Regulators Probe Blue Cross Blue Shield NC Over Customer Complaints
RALEIGH, N.C. //BestWire// - The North Carolina Department of Insurance will conduct an examination of Blue Cross and Blue Shield of North Carolina, after more than 1,000 customer complaints to the DOI about problems with enrollment and payment.
The complaints alleged over-billing, the insurer’s inability to verify effective coverage and company’s system errors that have caused failures in paying premiums.
The problems emanated from BCBS North Carolina’s efforts to transfer to a new information technology system during the open enrollment period for the state health exchange, DOI spokeswoman Kerry Hall told Best’s News Service. Problems ranged from being unable to verify if their coverage was in effect to being accidentally double-billed by the company, Hall said.
Consumers complained they were having difficulty with BCBS North Carolina when they submitted online requests for assistance or placed phone calls to initiate cases, Hall said. North Carolina Insurance Commissioner Wayne Goodwin has shifted as many as 20 staff members to either answer phone complaints or to help BCBS North Carolina deal with new cases.
“We are working diligently to resolve these issues as quickly as possible in collaboration with the department,” BCBS North Carolina said in a statement. “We are truly sorry for the difficulties that our customers are experiencing.” An attempt to get additional comment from the insurer was not immediately successful.
Goodwin’s first priority in working with BCBS North Carolina in recent weeks has been to address cases involving people with urgent medical needs, such as an MRI or diabetic medication. “His first concern is to stop the bleeding and address consumer issues,” she said. “He’s said for some time that he would do some sort of review over what occurred and prevent it from ever happening again.”
Goodwin is running for re-election as commissioner in 2016. He is unopposed in the March 15 Democrat primary, but one of three Republican challengers will vie to run against him (Best’s News Service, Jan. 5, 2016).
(By Thomas Harman, Washington Bureau manager, BestWeek: Tom.Harman@ambest.com)