BCBS of NC: fixes, refunds to come to 25k customers this week

Thousands of Blue Cross Blue Shield customers in North Carolina can expect refunds this week as it scrambles to fix what company officials are calling the most serious system failure in recent decades, according to the Charlotte Observer.

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Approximately 25,000 customers across the state were accidentally put into the wrong health plans, representing around 7 percent of all individual insurance customers. Additionally, Blue Cross administered automatic bank drafts from 3,200 customers for an incorrect amount, in many cases drawing more than the customer owed or charging customers for several insurance plans.

North Carolina’s largest health insurer has been dealing with the problem since last Monday, shortly after individual policies under the Affordable Care Act went into effect Jan. 1. The BCBS of NC service line was slammed with 137,000 incoming calls when customers began suspecting problems by Jan. 4.

“It’s our mistake, and we’re going to make it right and give people their money back that they deserve,” BCBS of NC CEO Brad Wilson told the Charlotte Observer. “We’re going to stay at this until our customer problems are solved.”

Mr. Wilson said the problems resulted from a human error at the insurer’s claims processing and billing vendor, Naperville, Ill.-based TriZetto, and were exacerbated by a last-minute processing delay by the Medicare system.

Blue Cross announced it will need until the end of the week to completely resolve the situation, according to the article.

More articles on payer issues: 

Humana hits financial trouble with ACA enrollment
Cigna, Aetna hired total of 8 external lobbying groups despite Aetna’s departure from AHIP
Special enrollment sessions drive up premiums, insurers say

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