State insurance commissioner Mike Kreidler had hinted about this a few weeks ago, but now has released the official go-ahead: Any customer having trouble making payments through Healthplanfinder on their new exchange-purchased insurance plan can now pay their insurer directly.
Though Washington’s Healthplanfinder website has been touted as one of the most successful exchanges in the country, even it’s not working that well. Customers have been complaining for months that their insurance payments are not getting through to the insurance companies, causing them to be billed multiple times for the same bill.
Patients are growing increasingly frustrated when they’re told they don’t have coverage, even though they’ve paid, and in some cases, doctors have provided care before discovering that patients don’t have the coverage they thought they had.
Exchange spokeswoman Bethany Frey said tonight that at least 6,000 people are affected by the billing problems.
The Healthplanfinder website is where consumers go to buy Qualified Health Plans and find subsidized coverage from private insurance companies like Premera and GroupHealth. Medicaid applications run through a different system and require no payments, so they aren’t hitting the same problems.
To pay insurers directly, a release from Healthplanfinder says, customers must follow these steps:
• First, contact the Washington Healthplanfinder Customer Support Center at 1-855-923-4633 to ensure they are aware of your issues.
• Clearly communicate any medical emergencies or urgent prescription needs to the Customer Support Representative.
• If you have called in previously, please provide your issue “ticket number” to the representative.
• Next, you may submit your monthly premium directly to your health insurer.
• If you enrolled in a Qualified Health Plan after April 1, 2014, you’ll need to submit supporting documentation to prove you’re eligible for a special enrollment period. Both enrollment information and monthly payments for these customers will not be sent to the insurance company until this information is received and reviewed by Exchange staff.
• If a customer has enrolled and paid their premiums through Washington Healthplanfinder, the Exchange will work with their insurance company to ensure that their coverage start date as listed in Healthplanfinder is upheld. Even if their premium payments have not been immediately sent over, their coverage will be effective from their start date and claims for services will be covered under their plan benefits.
Not exactly a foolproof process. In the meantime, exchange director Richard Onizuka says the resolution of these glitches is their “top priority.”
“The Exchange has developed an aggressive action plan to address these issues as quickly as possible, including implementing emergency system updates, bringing on additional staff members, and engaging in collbaborative meetings with our IT integrator, Deloitte, and the insurance companies to identify technical issues and define a roadmap that will allow us to achieve significant progress by the end of August,” he said in the release.
That’s only 3.5 weeks away, so it’ll be interesting to see what “significant progress” looks like. Frey said exchange staff will provide another update to their board on Aug. 28.