BCBS NC to pay $3.6M for billing, enrollment problems

The North Carolina department of insurance has issued a $3.6 million fine against Blue Cross and Blue Shield of North Carolina for chronic IT malfunctions that have led to billing and enrollment errors for customers since January, The News & Observer reports.

Insurance regulators launched an investigation into BCBSNC in February after a system failure caused nearly 25,000 customers to be enrolled in incorrect plans.

In official documents, DOI investigators cited problems including overbilling, double-billing, failing to confirm coverage, canceling coverage without cause and enrolling customers in incorrect policies.

BCBSNC officials denied it violated state laws and settled the investigation "to avoid the uncertainty, distractions and expense of litigation," according settlement papers obtained by The News & Observer. It affirmed technology issues have been resolved.

The Durham-based insurer has faced systemic IT and billing problems since the system failure. Nearly 3,500 providers and customers lodged complaints against the insurer with DOI through August, according to the article. BCBSNC experienced a computer outage Aug. 19 that affected customer service and claims processing systems.

"As your insurance commissioner and an advocate for consumers across North Carolina, Blue Cross and Blue Shield had to be held accountable," Insurance Commissioner Wayne Goodwin said in a statement.

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