September 8, 2011 in City

Glitch at Regence leads to false billing

By The Spokesman-Review
 
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Problems with medical insurance plans in Washington can be reported at (800) 562-6900 or insurance.wa.gov.

OLYMPIA – The computer for the state’s largest medical insurance company malfunctioned one day last month, causing thousands of wrong transactions and sometimes pulling money from the bank accounts of people who weren’t even clients.

After a meeting with officials from Washington, Idaho, Utah and Oregon this month, the Regence Group is under orders to make things right.

Washington Insurance Commissioner Mike Kreidler said the problems may stem from the consolidation of services for the four-state region into a single computer system. At this point, it appears problems were worse in Washington than the other states.

Idaho Insurance Director Bill Deal said the problems in that state appear to be “very minimal” compared to Washington’s.

In Washington, some 6,000 incorrect transactions were generated by the computer system on Aug. 5. While most were flagged by banks, in about 200 cases the transactions with the wrong account numbers went through, so money sometimes was deducted from the wrong accounts – sometimes from people who weren’t even Regence members.

Regence is reimbursing those accounts and will pay for any bank fees incurred.

Regence is the largest medical insurance carrier in Washington, with an estimated 1.1 million members. It operates Regence Blue Shield, Asuris Northwest Health and Regence Blue Cross BlueShield of Oregon, which has some members in the Vancouver area, a spokesman for Kreidler’s office said.

“It’s clear to us that this is a systemic problem,” Kreidler said. The company has failed to pay claims for some retirees for months, denied claims for pre-authorized medical services, delayed claims because of misplaced documents and provided a number for consumer questions that wasn’t answered on the one day of the week a recording said it was operating.

The company is working to correct the problems, he said.


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