Florida Blue enrollment, billing glitches continuing, customers say

South Florida Sun Sentinel (FL)

Jan. 19--Complaints to Florida Blue about billing and activation problems are continuing more than a week after the insurer said it had solved a computer glitch that caused thousands of health insurance policies to show up as "cancelled."

Continuing complaints, made in emails to the South Florida Sun Sentinel and posted on the insurer's Facebook page and Twitter account, cite failures of the insurer's online billing apps to accept customers' payments, payments not properly credited or credits not showing up in user accounts, and frustration with the company's customer service department.

Several complaints mentioned long hold times and long call durations with overseas-based customer service representatives, and representatives unable to contact appropriate billing department workers.

A Florida Blue spokesman acknowledged Wednesday a "small percentage" of the company's policyholders are continuing to experience problems, but stressed the company is committed to resolving all of them.

Several policyholders contacted for a Jan. 9 story about the glitches, including Plantation resident Ginny Jordan, said their problems were resolved. Yet new complaints continue to surface. Since Jan. 9, the state Department of Financial Services has logged 89 complaints about the carrier, a spokeswoman said Thursday.

Some policyholders said they've been denied treatment or prescriptions because their accounts show up as cancelled in a computer program providers use to validate insurance coverage.

A woman who identified herself to the Sun Sentinel as a physicians' office employee but asked that her name not be used described problems getting authorization from the insurer for the office's patients: "When we request authorization [through the computer program], we are given a 'fast pass code' that Florida Blue's system never recognizes. Then we have to fax clinicals to [a fax number] which never ever goes through. Then we call and are on hold for hours. It's a never ending process. We end up with patients in the hospital because we can't get things in a timely manner."

Asked how many times that's happened, the woman replied, "Many many times."

Paul Peterson, a Southwest Florida policyholder, on Wednesday said policy activation delays are preventing his wife from getting important surgery. "I just got off the phone after the usual hour and a half phone call with Blue," Peterson said in an email. "They still have not activated our plan. On two separate occasions our situation was 'escalated' over the last two weeks. This time [the customer service representative] told me they should have it activated in 7-10 days and she has escalated it once more to 'critical' so it should be sooner."

Last week, Christine C. Walker, spokeswoman for Holy Cross Hospital in Fort Lauderdale, said the hospital was seeing an increase of policies showing as inactive "but upon phone calls to Florida Blue, the policy turns out to be active."

South Florida resident David Bolger said he's been receiving invoices for premiums despite having a $15,000 credit with Florida Blue. "I have visited the North Miami office where the problem was acknowledged and yet not corrected," Bolger wrote. "Have you ever tried to mail a problem to Florida Blue? They have 27 different [P.O.] box numbers. So the best one can do is to use registered mail to verify it was received. It was received ... but so far not responded to."

Florida Blue spokesman Doug Bartel said the company has taken on a record number of customers during this year's enrollment period. As a result, "there have been some issues" largely due to Florida Blue picking up tens of thousands of Affordable Care Act policyholders "orphaned" by the departures of three large insurers from Florida's ACA market over the past two years.

"While the problems are affecting a relatively small percentage of our membership, we don't like to have any member experiencing these issues," he said. The company has about 5 million members statewide, he said. Of those, about 1.5 million are individual health insurance members.

In a prepared statement, Florida Blue said, "We apologize for the issues that some members have recently had when verifying their plans are paid-to-date and active, and for the frustration and inconvenience that they've experienced."

Anticipating a large volume of new customers in 2017, the insurer last summer hired and trained "a significant number of customers service associates to handle the influx," the statement said. Addressing consumer complaints of communications difficulties with overseas representatives, the statement added, "The majority of our customers service employees are located here in Florida."

Anyone continuing to have problems should call the toll-free number on the back of their ID cards or visit a Florida Blue Center for personal assistance, the statement said.

rhurtibise@sun-sentinel.com, 954-356-4071

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