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Blue Cross Blue Shield of Texas to pay $10 million fine, issue refunds after state finds billing mistakes
www.dallasnews.com ^ | 12:47 PM on Mar 6, 2020 | By Paul O'Donnell

Posted on 03/09/2020 8:34:31 AM PDT by Red Badger

Blue Cross Blue Shield of Texas is agreeing to pay a $10 million fine and issue refunds to consumers after a state review found billing mistakes in the insurer’s handling of out-of-network emergency claims.

The Texas Department of Insurance announced the fine and restitution agreement Friday. Richardson-based Blue Cross will begin sending out notices to affected consumers by May 1.

The state said its review found:

Incorrect information about how to resolve bill balances on explanation of benefits forms sent to HMO members receiving out-of network emergency care. Delays in processing out-of-network claims that went through a review process Blue Cross began using in August 2018. Those payments failed to meet the state’s prompt payment requirements. Errors in marketing materials about Blue Advantage Plus plans offered in 2018 and 2019. More than 70,000 people signed up for the 2018 plan on the federal health care exchange.

“Consumers who had higher out-of-pocket costs due to the errors will get refunds,” said state insurance commissioner Kent Sullivan in a statement.

(Excerpt) Read more at dallasnews.com ...


TOPICS: Business/Economy; Crime/Corruption; Culture/Society; US: Texas
KEYWORDS: bluecross; blueshield; healthinsurance; texas
I bet they weren't 'mistakes'....................
1 posted on 03/09/2020 8:34:31 AM PDT by Red Badger
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To: Red Badger

Bet they weren’t simple accounting “coding errors”, either.


2 posted on 03/09/2020 8:40:39 AM PDT by carriage_hill (A society grows great when old men plant trees, in whose shade they know they will never sit.)
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To: carriage_hill

Russians, again......................


3 posted on 03/09/2020 8:41:36 AM PDT by Red Badger (If people were to God like dogs are to people, the world would be a really great place..............)
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To: Red Badger

Trump’s Fault!


4 posted on 03/09/2020 8:44:00 AM PDT by carriage_hill (A society grows great when old men plant trees, in whose shade they know they will never sit.)
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To: carriage_hill

Could be, he is after all the Law Enforcer-In-Chief. Maybe his administration is actually doing their jobs.


5 posted on 03/09/2020 8:46:55 AM PDT by gspurlock (http://www.backyardfence.wordpress.com)
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To: Red Badger

Hmmm ... maybe that’s why they recently let hundreds of employees go.


6 posted on 03/09/2020 9:00:04 AM PDT by al_c (Democrats: Party over Common Sense)
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To: Red Badger

I bet those “refunds” will be huge!


7 posted on 03/09/2020 9:01:18 AM PDT by unixfox (Abolish Slavery, Repeal the 16th Amendment)
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To: Red Badger

So an aspirin really doesn’t cost $50.00?


8 posted on 03/09/2020 9:01:45 AM PDT by Larry Lucido
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To: Red Badger
I bet they weren't 'mistakes'....................

Yea, mistake like Hillary's illegal server was a "mistake".
9 posted on 03/09/2020 9:27:18 AM PDT by Old Yeller (Auto-correct has become my worst enema.)
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To: gspurlock

Same thing happened here in PA, a few years back, with Geisinger Medical Group. I got a refund from incorrectly-coded invoices for CT-Scans at Hershey Med Ctr.


10 posted on 03/09/2020 9:51:13 AM PDT by carriage_hill (A society grows great when old men plant trees, in whose shade they know they will never sit.)
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