Blue Cross and Blue Shield’s unprecedented technology problems, which the company had previously hoped to resolve within a week, are now dragging into their second month, with no indication as to when all customers will be able to count on purchasing health insurance that activates on time without complications.
The N.C. Department of Insurance said Thursday it has received more than 3,400 calls in the past month, including more than 850 complaints from Blue Cross customers seeking immediate attention for urgent medical issues. The complaints involve overbilling by Blue Cross, as well as customers unable to make insurance payments and unable to confirm coverage.
Blue Cross, the state’s largest health insurer, was beset with troubles upon transferring more than 400,000 insurance accounts from a legacy software to a new system, mostly customers covered by individual insurance under the Affordable Care Act. The system failed to transfer data accurately last December, causing customer confusion in January when the insurance policies were supposed to go into effect.
“This is a very live issue,” N.C. Insurance Commissioner Wayne Goodwin said. “The fact that we’re still getting the number of calls we are getting indicates that it’s not over.”
Chapel Hill-based Blue Cross has repeatedly apologized and assures it is working to resolve the situation. The company is not providing status updates or disclosing how many of its customers are still in limbo.
“We share the Commissioner’s frustration that we have not been able to provide the level of service our customers have come to expect,” Blue Cross spokesman Lew Borman said in a statement. “We are working diligently to resolve these issues as quickly as possible in collaboration with the Department. We are truly sorry for the difficulties that our customers are experiencing.”
This week Blue Cross customers reported another problem: insurance invoices listing an incorrect customer service number. The recorded message launches into a pitch for rewards programs and promotional offers for a medical alert system, a two-night cruise to the Bahamas and free tickets to Disney World in Orlando, Fla. The instructions have since been modified, directing Blue Cross customers to the correct number, before the promotional pitches begin.
In another indication of the complexity of the situation, Blue Cross has opted for a one-year delay in transferring 685,000 customers to the troubled software system for the North Carolina State Health Plan, which Blue Cross administers.
By postponing Blue Cross’s planned transition to Facets, the delayed data transfer could avert another embarrassing debacle. Facets, a software program that has cost Blue Cross an estimated $750 million, is part of a medical technology system called Topaz, designed by TriZetto, the nation’s leading health care billing and administrative vendor.
Brad Young, spokesman for the N.C. State Treasurer, confirmed that on Jan. 19, Blue Cross notified the State Health Plan it will delay the data transfer until 2018.
“There is a potential operational risk with any platform transition,” Young said by email. “This delay provides ample time to work with the Plan’s various vendors to ensure a smooth transition.”
In response to a News & Observer request for emails and communications related to the Facets delay, the state treasurer’s office provided 19 documents that were heavily redacted by Blue Cross. Some of the pages identified participants of meetings, and some included boilerplate language, but others were entirely blacked out.
State law allows companies doing business with the state to shield corporate secrets from public documents. Borman defended the thoroughness of the redactions.
“The SHP documents were redacted because of the sensitivity of the information contained therein – and justified by law, not to hide anything embarrassing,” Borman said in an email. “The redacted parts contain information that could give competitors an edge.”
The Insurance Department and the state Attorney General’s office have both vowed to review Blue Cross’s technology mishap and will seek assurances Blue Cross has systems in place to make sure a technology fiasco of this magnitude never happens again.