Site icon IMK

Health Net And Blue Shield Worst At Processing Health Insurance Applications

Health Net and Blue Shield have had the most annoying issues with new health plan enrollments for 2018.

In an unofficial survey, based strictly on anecdotal information and the number of irate consumers, Health Net has managed to surpass Blue Shield of California with the most problems processing health insurance applications. These two companies have turned what should be a simple online shopping transaction into a black hole of bad customer service.

You have to have an IT and systems department work overtime to deliberately create a user experience worse than Covered California. But somehow, Health Net and Blue Shield have managed to do it. Both have a witches’ brew of both legacy systems and new initiatives to create enough online mud to stop even the Trump Train.

Health Net Website Melt Down

For Health Net, the slide into online melt-down started with their acquisition by Centene. Just before open enrollment was about to begin, Health Net rolled out all new websites based on Centene software platforms. Instead of just one URL, Health Net rolled out different websites for different products and a new agent portal. The online application system also seemed to change.

All of these new online platforms have led to massive confusion at Health Net. There online enrollment crashed in early December. People were having problems actually filling out and signing online applications. Part of this involves the peculiar nature of different web browsers and Health Nets lack of ability to make their system available across multiple browser platforms. For example, their online provider search tool only works with Microsoft browser products from my experience.

Some consumers have had to apply with a paper application and faxed to Health Net. Unfortunately, even after the 5 day waiting period to be keyed into the system, the application never shows up any place. I finally called and was told Health Net would research the issue and get back to me within 24 hours. 48 hours later I received an email stating no record of the application was found. Yet, the consumer was told he had an application ID and a member ID. But the consumer’s information is still not showing up in the new Health Net agent portal like other clients.

The icing on the cake is a truly understaffed customer service department. But who could have forecasted a complete crash of the Health Net – Centene system during open enrollment, except for the people who have lived through open enrollment in the past. When I do get through on the phone after 30 plus minutes to learn nothing new, you could hear the weariness in the customer service representative’s voices. I was not about to pile on, but instead thanked for their time and attention. It was not their fault that their enrollment systems suck during open enrollment.

Billing Problems Continue To Vex Blue Shield

Blue Shield reprised their role with the worst billing system known to the internet. I have clients that applied in November who still don’t show up with a member ID. Blue Shield blames it on their billing department, which in part, is handled by a third party application back east. The customer service representatives always politely outline how they will send an urgent email to the billing department to process the credit card payment and post it to the system so enrollment can finalize a member ID.

Blue Shield is taking steps to address the billing nightmares that have been replicated over the last four years. In 2018 they will be transitioning to a new system. Of course, the transition of forcing people to change and update their billing preferences will have consequences of its own.

I can report that the customer service at Blue Shield, at least on the agent side, has been above average during open enrollment. What has caused confusion and delay is a common and preferred process for making changes to member accounts. There are many consumers who are moving from Covered California to off-exchange and splitting families up on different plans and carriers to save money. There has been no defined path or specific steps to efficiently transition members to different plans.

One Blue Shield customer service agent advises to submit a whole new application to remove family members and change plans. Another agent says they can do it internally. The new application won’t recognize a new home address if the consumer has an existing account. Some consumers can’t log in or create an account without creating a new email account. The billing unit can’t make the changes happen and get the information over to enrollment. The consequences are numerous with accounts sitting in a suspense file waiting for something to happen and no can make anything happen.

Both Health Net and Blue Shield have wasted thousands of hours of time for consumers, agents, and their customer service staff. Tempers have become short and patience has run thin. And as of December 21st, a month after some people have applied for health insurance, 10 days before the plans are to become effective, many families don’t know if they will have insurance on January 1, 2018. There is high probability that all these problems will be sorted by January 1, if not shortly thereafter. But the stress and anxiety these health plans have created is a reason why mental health services and counseling are part of essential health benefits of health insurance plans.

2018 Health Net Member ID Confusion

Health Net implemented a new member ID system for 2018. All 2017 members with an R- number were switched to member number starting with U. The last two digits of the member ID indicate either the primary applicant (usually 01) or the dependents and spouse, which will have unique last two digit numbers. In addition, the U numbers only show up in the new Health Net online platform for 2018. https://ifp.healthnetcalifornia.com/

Some members have been experiencing problems getting care because the new provider (doctor, urgent care, pharmacy, hospital) is not looking on the correct new 2018 database with the new U number member ID. Members and providers should go to the new website, listed above, to create accounts and check the members status.

Blue Shield 2018 Billing SNAFU

Blue Shield has said that over 5,000 off-exchange individual and family plan members were incorrectly billed for for January 2018. If a person was a Blue Shield member in 2017, and changed their plan for 2018, they may have been billed for the new 2018 rate for the old plan. The billing difference, either a credit or additional charge, will be reflected on the February invoice.


 

Exit mobile version