Another Story About Broken Healthcare

I had a wonderful weekend away on the North Carolina coast, but when I returned home I found that I had a letter from Blue Cross Blue Shield of North Carolina:

Dear Group Administrator:

According to our records, your group insurance premium has not been received. As a result, claims for services rendered after 02/29/2012, are now suspended.

This was followed by:

If you are planning to terminate your group coverage, please be advised that under North Carolina General Statute 58-50-40 employers are required to give employees 45 days prior notice of insurance cancellations. Violation of this law is a felony.

What a way to harsh the mood. First I’m informed that claims will be denied and then I’m threatened with a felony.

The part that pisses me off the most is that I pay all premiums on time. I pay my bills. On time. I have no idea what our business credit score is, but my personal score is over 800 at all three major reporting agencies. I take debts seriously.

This letter is a result of a bug in their software. It turns out that our annual renewal starts on 1 March. This is when our premiums increase, on average 30-35%, and for some reason this causes their billing system to invoice us late.

Usually, the insurance premium invoice arrives at the beginning of the prior month – i.e. I already have an invoice for April that’s due on the 22nd of March. But because of their billing system issues, my March bill did arrive until March 1st, with a due date of the 12th.

I paid it on the 8th, and according to my bank, BCBSNC cashed the check on the 12th – the same day they sent me a letter for non-payment.

What’s funny is that I have a collection of six of these letters. Yes, every single year they do this to me, and I’m not taking it anymore. In the spirit of Karen Sandler, I’d decided to take them to task for their crappy software.

So I called 877-237-6275, the number on the letter I received from “Sonya Walker, Director of Membership Operations” where I sat in queue for 20 minutes. I was then greeted by “Chris” who told me, oh, yeah, your account is paid in full, and that my payment and the letter must have passed in the mail.

I informed him that this wasn’t the case – I was never in arrears and that I was about to get very angry. If he wanted to, I suggested he transfer me to a supervisor, because I was getting ready to yell.

He decided to transfer me. Wise man.

After another 20 minutes of waiting I found myself talking to Misha Newman. I explained the situation again that I was tired of being told I was delinquent in my payments when it was untrue, and she replied that their software couldn’t handle renewals, which is why the letters get sent.

I asked for a bug report number.

She was a bit confused, so I told her that I’ve been getting these for six years now and that it needed to be fixed if they want to keep me as a customer. You can’t just send out threatening letters and then brush it off. If BCBSNC can’t manage the simplest accounting issue, doesn’t that cast serious doubt on their ability to manage things more complex things like medical claims?

I want someone in their IT department to at least document the issue and give me a way to know when it has been fixed.

I also demanded an apology from “Sonya Walker” if she even exists. It is quite common for large companies to make up names and positions for letters like the one I received. When someone calls to complain, it gives them a code to route the call. Ms. Newman informed me that Ms. Walker was no longer with their group, but that she did exist, and she would be happy to get her director to send me a letter. That should be interesting.

The sad part is that I doubt the alternatives to BCBSNC are any better (suggestions welcome). I think it is incredibly callous of them to value my time so poorly. On just this call alone I spent nearly an hour. You might say that I brought it on myself, which is partially true, but I also have over a dozen people that rely on me to make those insurance payments and I can’t be sure that there wasn’t some other mistake – so I’m forced to make that call.

I can’t help but think if health care was more transparent and used more open source ideas, if not software, that problems like this would be less common and easier to fix.