Enrollment-data errors continue, insurers say

Obama

By Robert Pear
The Obama administration said yesterday that it had reduced the error rate in enrollment data sent to insurance companies under the new health-care law, even as insurers said that files they had received from the government in the past few days were riddled with mistakes.

The quality of the data is important; it could affect the ability of people to get medical care and prescription drugs when they go to doctors’ offices and pharmacies starting next month.

More than 137,000 people selected health plans in the federal insurance marketplace in October and November, and administration officials say that more than 100,000 signed up in the first week of this month.

For each person who signs up, the government is supposed to send information electronically to an insurance company in a standard format known as an 834 enrollment transaction.

In some cases, consumers selected a health plan at the federal website, Healthcare.gov, but the government did not notify the insurance company. In other cases, insurers received duplicate files for the same person, files for one person were sent to an insurer in another state, or the " relationship code" was wrong so that, for example, a man’s daughter was listed as his wife.

The White House said yesterday that the government now is informing insurers of nearly all new enrollments.

"Between Oct. 1 and Dec. 5, the number of consumers for whom 834s were not produced was fewer than 15,000," said Julie Bataille, a spokeswoman at the federal Centers for Medicare and Medicaid Services. "Since the beginning of December, missing 834s as a percentage of total enrollments has been close to zero."

Federal officials, insurers and health-care providers said they were concerned about confusion and possible chaos in the early days of January, when people try to use the new insurance coverage they think they have.

The government’s overriding message to insurers is: Do whatever you have to do to maximize enrollment and to provide coverage by Jan. 1 to anyone who wants it. Federal health officials have told insurers that they can sort out the details and work out financial arrangements with the government later.

People have until Dec. 23 to sign up for coverage that begins in January, and they have until Dec. 31 to pay premiums for the first month.




Source: The Columbus Dispatch