Health Insurance Exchanges Mean Increased Vigilance for Providers

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The very public problems with the online health insurance marketplace Healthcare.gov are causing havoc with American citizens looking to buy insurance, and as expected, these issues will soon begin to bleed over to healthcare providers.

Last month the administration of President Barack Obama began warning that the online health insurance marketplaces were certain to have bugs, and for individuals to have patience. Those bugs materialized, and many report finding the website slow or being dropped in the midst of the application process. Today there have been reports that data generated from the application process is flawed, which in turn makes it difficult for insurers to get individuals signed up.

Today President Barack Obama indicated that patience has run out, at least from his perspective. “No one is as frustrated as I am,” he said in a speech today held in the White House Rose Garden. “There’s no excuse for these problems.” While the president assured the American people that the issues with Healthcare.gov will be fixed, he presented no timetable. But problems with the website mean problems with healthcare reform and therefore problems for the nation’s healthcare providers.

Among the challenges that will directly affect providers:

Will consumers not buy insurance because of the hassle? There’s an old joke in business management in that if you want to kill an employee’s initiative, simply tell him or her, “Great idea. Put it in writing.” The same principle applies to consumers. The online health insurance marketplaces were supposed to be seamless and simple, and at least as far as the federal marketplace is concerned, it has been far from that. A slow website combined with dropping or locking out consumers may discourage insurance-seekers who will choose instead to pay the $95 penalty.

For weeks we’ve been recommending that healthcare providers be proactive in getting patients signed up for health insurance via the exchanges. Based on the performance of the online marketplace, the role of healthcare providers in getting patients signed up has become even more critical.

Hundreds of thousands lose individual insurance. Health insurance companies are canceling hundreds of thousands of plans sold directly to consumers, according to a report in Kaiser Health News. These individuals are being directed to the state and federal health insurance exchanges to get their insurance. For providers, this means individuals who have had health insurance policies for years may suddenly have a gap in their coverage. Providers might want to consider beefing up their insurance verification policies and procedures as hundreds of thousands of Americans will be going through this transition.

President Obama today assured Americans that the problems with the Healthcare.gov website are temporary. “Everybody who wants insurance through the market place will get insurance. Period,” the president said. “Nobody’s madder than me … which means it’s going to get fixed.”

To date a half million applications have been accepted, the president said. “Thousands of people are signing up and saving money as we speak,” he said. To compensate for the website problems, more resources have been poured into the call centers, where Americans can call (800) 318-2596 and reach a customer service representative who can take applications over the phone.

 

 

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Posted in Denials Management, Medical Receivables, Patient Access, Patient Experience, Patient Financial Services .

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