Bookmark & ShareFor Immediate Release: 10/18/2011
Contact: Heidi Robbins Brown, Deputy Director, Health Care Authority 360-725-1040
Elizabeth James, Acting Asst. Director, Division of Public Employee Benefits (206) 521-2026
Jim Stevenson, Communications, Health Care Authority, 360-725-1915
OLYMPIA - Health Care Authority Deputy Director Heidi Robbins Brown said today (Tuesday, October 18) that the third party administrator of state employee and retiree health benefits is making solid progress in cutting a backlog of retiree medical claims nearly in half.
Regence BlueShield, which took the job of administrator on January 1, had fallen behind in payment of more than 300,000 claims by September, when the Health Care Authority assigned Regence to a corrective performance plan aimed at eliminating the backlog by the end of the year. On Tuesday, Robbins Brown said the current backlog had shrunk to below 155,000 claims – exceeding the pace assigned in the corrective action plan.
"Regence has added a significant number of experienced workers to handle these claims manually, and is amending its system to process more claims in an automated fashion. They are ahead of the plan right now," Robbins Brown said. "If they continue at the same pace, they will reach our targeted normal claims inventory ahead of schedule."
HCA representatives are currently meeting with Regence every week to monitor progress and resolve any problems. Robbins Brown said those meetings are part of the corrective plan and will continue as the state ensures that Regence meets the terms of its contract, and that state employees and retirees receive a high level of service and providers receive accurate payment from Regence.
The payment problem centered on a group of 38,000 Medicare retirees with the Uniform Medical Plan. HCA received complaints from some of them in late summer, reporting that some providers were trying to bill them for unpaid claims balances that should have been covered after Medicare processed the claim.
In addition to the weekly status updates, the performance plan includes a detailed timeline, claims inventory milestones, a commitment to hire additional staff, and penalty steps to be taken if Regence fails to meet the terms of the plan and its state contract.
The Health Care Authority does not discriminate and provides equal access to its programs and services for all persons without regard to race, color, gender, religion, creed, marital status, national origin, sexual orientation, age, veteran’s status or the presence of any physical, sensory or mental disability.
FOR ADDITIONAL BACKGROUND, CONTACT:
Sharon Michael, Communications, 360-923-2764, sharon.michael@hca.wa.gov
NR011-018
