Many still can't use state health coverage months after phase-in
By Donna Gordon Blankinship
The Associated Press
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Although some problems have been resolved during the past few weeks, new issues also have come to light in Washington's implementation of the federal health care overhaul.
Insurance companies and the state insurance commissioner are concerned the total number of people who bought insurance through the exchange and are now having billing problems could be many more than the 6,000 customers identified by the exchange a few weeks ago.
Some people aren't being properly credited by the exchange for their insurance payments.
In some cases, money and information has been lost somewhere between the exchange and the insurance companies.
And some people have been told by their doctors that the insurance company has no record of their coverage.
“I know we're only looking at a small portion of the problems,” said state Insurance Commissioner Mike Kreidler.
His office does not have authority over the exchange, but that hasn't stopped consumers from calling him to complain.
Kreidler said he's giving the exchange one more month to fix the problems or he will take what action he can to help the people of Washington who want health insurance.
“I've got my fingers crossed” the problems will be resolved this month, he added.
If not, he will open a special enrollment period for anyone who wants to give up on the exchange and buy insurance outside of the new system through brokers and insurance agents.
No one could give The Associated Press the exact number of people affected by billing problems at the health exchange.
Hundreds of known problems are being resolved every day, said exchange spokesman Michael Marchand.
He estimates 4 percent to 6 percent of the 164,000 who bought insurance through the exchange have been affected by billing problems.
An average of 2,500 accounts have had their problems solved each month, according to the exchange.
But people who purchased insurance through Washington Healthplanfinder but haven't been to the doctor might not know they have a problem, an insurance company spokeswoman said this week.
Melanie Coon of Premera Blue Cross, which has sold more policies on the exchange than any other insurance company in the state, could not say exactly how many of Premera's customers are having problems.
The number varies from day to day, Coon said. She advised people who have any questions about their insurance status to call the company and check.
If there is a problem, however, Premera might not be able to fix it.
“I don't want to create an unrealistic expectation that we can resolve their problem,” she said.
Most problems still need to be fixed by people at the Washington insurance exchange.
An official at the governor's office said he's just starting to see some progress, because everyone is literally sitting at the same table working together to tackle the problems at the exchange.
Dr. Bob Crittendon, the governor's senior health care policy adviser, said insurance company representatives spent most of last week meeting with technical people at the exchange and at Deloitte, the company that created the software to run the exchange, to get a handle on the problems and start to resolve them.
“From top to bottom, everyone is trying,” Crittendon said this week. “I would like to say that we have it resolved, but we don't.”
Crittendon added, however, that he is tentatively optimistic that many of the billing issues will be resolved by the end of August.
The difficult part is that there are multiple problems in the exchange's billing system and one software fix is not going to make a dent, he added.
The exchange's Marchand agreed.
“These applications are almost like fingerprints. They're all very unique,” he said.
One customer who has seen most of his problems resolved — following a call to the governor's office — has gone from being concerned about his own health insurance to worrying about the whole system.
Seattle therapist and entrepreneur Clinton Campbell, 34, said he'd like to see the exchange publicly acknowledge the issues and provide a support pathway from the front page of Washington Healthplanfinder.
“They've apparently known about many of these issues for six months, and they're still leaving consumers out on their own,” Campbell said.
Washington exchange: https://www.wahealthplanfinder.org
Healthplanfinder help line: 1-855-923-4633
Exchange help page: http://wahbexchange.org/get-involved/contact-us/
Last modified: August 07. 2014 8:03AM