Health care exchange glitches a mystery, official says

OLYMPIA – Thousands of customers of Washington’s health care exchange have problems with the new medical insurance they’ve purchased this year, problems the state agency hopes to have fixed by the end of August.

Sometimes they pay for coverage but don’t show up in the carrier’s computer. Sometimes their doctor’s bills are rejected for payment.

Michael Marchand, director of communications for Washington Healthplanfinder, said that as of early July, 4 to 8 percent of applicants have had problems with payment and billing issues after using the state system designed to help people find and sign up for insurance.

Healthplanfinder finishes an audit this month of its more than 160,000 accounts in an effort to identify the problems. They could be with the forms customers fill out, with computer software or how it works with the various insurance companies, or how the companies are processing the information they receive. Or it could be combinations of several problems, Marchand said.

“We’re taking aggressive steps to get this fixed,” he said. “We’re trying figure out if there’s any rhyme or reason” why more than 90 percent get coverage and bills paid, but a small percentage does not.

Some fixes have been made to improve the system, but other problems persist. The state exchange hopes to have problems identified by the audit fixed by the end of August.

If it doesn’t, state Insurance Commissioner Mike Kreidler has threatened to open a special enrollment period for health insurance after August, so residents can buy insurance outside the exchange. Kreidler’s office has no authority over the exchange, but that doesn’t stop people from calling, spokeswoman Stephanie Marquis said.

“We have been hearing from them about paying premiums and not getting coverage,” she said

The office has received more than 1,200 calls, and about 350 people have filed formal complaints, even though the office can only forward those complaints to the exchange, Marquis said.