Blue Cross Blue Shield Hit With Largest Insurance Fine In Georgia History

"As Georgia's Insurance Commissioner, my No. 1 priority is protecting Georgia consumers," King said in a news release. "To that end, after numerous complaints made to our office regarding the operations of Blue Cross Blue Shield from individuals, physicians, hospitals, and others from around the state, I instructed my staff to conduct an extensive examination into the carrier's practices.

"This examination uncovered a number of serious issues, including improper claims settlement practices, violations of the Prompt Pay Act, failure to reply to consumer complaints in a timely manner, inaccurate provider directories, and significant delays in loading provider contracts. As a result, our office has issued the largest fine in agency history, with potential additional penalties if certain benchmarks are not reached."

To avoid additional penalties, Blue Cross Blue Shield must develop a new process for handling regulatory provider complaints, pay claims within the timeframes established under state law, and load provider contracts in a timely manner.

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