Technology issues at Blue Cross and Blue Shield continue piling up as the N.C. Department of Insurance disclosed last week that the Chapel Hill insurer’s website was not listing behavioral health resources in the Triangle for one of its popular health plans.
The Department of Insurance said in an internal email that patients searching for mental-health and substance-abuse resources on Blue Cross’s Duke Medicine and WakeMed network, called Blue Local, were directed to doctors “over 100 miles away from some Triangle zip codes.”
The issue is the latest to surface since January, when thousands of Blue Cross customers began complaining they were double-billed, unable to confirm coverage or unable to pay for coverage. Blue Cross on Wednesday notified insurance regulators it has added an online link on its site directing customers to a list of local providers.
Blue Cross spokeswoman Ryan Vulcan said the oversight resulted because doctors are listed by the primary specialty of the hospital where they work, which caused mental health specialists at general hospitals not to show up. Deputy Insurance Commissioner Ted Hamby said this issue is not uncommon in the insurance industry, especially for narrow health plans that limit insurance coverage for providers within specified networks.
“They are in the system,” Hamby said. “It’s just a matter of how do you get to it.”
The issue was brought to the attention of the Department of Insurance by mental health providers and advocates. Jack Register, executive director of the state chapter of the National Alliance on Mental Illness, said Friday that he is concerned about “anything that takes away peoples’ access to care – particularly people with insurance.”
The Department of Insurance, which began an audit of Blue Cross’s technology issues last week, has received more than 1,400 formal complaints from Blue Cross customers this year, and is fielding 200 calls a day from customers experiencing confirmation and billing problems. The customers affected are on individual insurance, mostly through the Affordable Care Act.
Blue Cross last week received on-site support from the staff of Highmark, a Pennsylvania Blue Cross organization that uses the same patient management software, called Facets, that has malfunctioned here affecting coverage for thousands of North Carolinians.
Blue Cross is advising its customers to pay out of pocket for medical care and medications until the company can confirm their coverage and refund them. The company has not said when it expects to resolve the technology problems.
Hundreds of Blue Cross employees have also pitched in on customer service calls to back up overwhelmed service reps. On Wednesday, Blue Cross chief operating officer Alan Hughes issued an all-hands plea for continued volunteer support.
“Recently, the number of daily enterprise volunteers has gone down significantly,” Hughes wrote. “We are not out of the woods yet, so I am asking that the entire enterprise continue to rally to provide support to our customers.”