Insurance Providers Are Behind, Disrupting Medical Services For Patients
Updated On: Jan 07 2014 11:28:28 AM CST
Outrage over the new health care exchange. New patients are being turned away from getting their doctors' visits covered by their insurance five days now after the deadline. It's just the latest issue stemming from the Affordable Care Act and patients on the Central Coast are taking a hit.
Several viewers asked Central Coast News why Anthem Blue Cross still hasn't sent out insurance cards.
Providers overall had to add about 450,000 new patients to their system in such a short amount of time. Because it's crunch time for many of them, some are behind, meaning some patients have to wait before getting their doctor visits authorized.
Salinas small business owner Brian Shaw said he'd been waiting on the Jan. 1 start date to finally see a doctor, since he recently injured himself. Now he's stuck with medical bills, waiting for Anthem Blue Cross to come through for him.
"So, finally, Jan. 1 comes along. Bam. I think I'm in and so I called my provider and said, 'I'm in. Let's get this thing fixed.' And they said, 'I'm sorry. We don't find you in the system,'" Shaw said.
It wasn't that easy, even though Shaw did what he was supposed to do. Like other Californians, he signed up for health care online through Covered California back in September.
"They said, 'OK. You're in. Wait to hear back from your insurance company,'" he said.
Months go by. He waits. Calls. Gets hung up on.
No insurance card from Anthem Blue Cross. Nothing.
Meanwhile, Shaw said he pulled a muscle on the job and now he walks with a limp.
"I submit my payment and I heard nothing more. So by Jan. 1, by this time, I figured I have a full-blown hernia and I'm still working," he said.
With the Affordable Care Act, Anthem Blue Cross gained 100,000 more customers. The insurance provider told Central Coast News that because of the compressed time frame it was given to process everyone, some patients are seeing a disruption in their medical services.
Representatives told Central Coast News they're working quickly to get to the bottom of the problem.
Meanwhile, people like Shaw are in the system, but are going nowhere, as doctors' offices are waiting for the green light.
"I was just frustrated and realized how strong and powerful the insurance companies had become and that we have no recourse but to play ball with them," Shaw said.
Shaw credits a local medical center for helping him get his member ID by using his Social Security number and payment ID. But when he went in for an emergency MRI on his hip on Monday, he said he had to sign a waiver saying he would pay the bill out of pocket if his insurance doesn't pay for it.
Anthem Blue Cross said a very small number of people are affected, yet the spokesperson couldn't provide an actual number or a deadline for when this should all be cleared up.
It will be working on a person-by-person basis and comparing records with Covered California to find out which patients are encountering issues and to make sure enrollment and electronic transfers all match up in the system.
For patients who still haven't received an ID card, Anthem Blue Cross can be reached at: 855-634-3381 or firstname.lastname@example.org.
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