Pueblo resident Lisa Bridwell said she has spent hours trying to get billed for the health insurance she purchased through the state exchange, and she’s afraid her coverage will be dropped because the exchange and Kaiser Permanente can’t get the billing issue straight.
Bridwell and her husband signed up for insurance effective May 1, and since then she received only one bill — and that bill was sent after she already paid that month by phone.
“I’m afraid of going to the doctor and being told (the policy) is void,” she said. “They’re having a lot of problems, and I’m not sure what they’re doing.”
In response to a request from The Denver Post, Connect for Health Colorado provided data showing that the categories covering billing issues and questions were about 5.8 percent of calls to customer service in June. That was the fourth-largest percentage after individual categories of general customer assistance questions, Medicaid questions and exchange representatives calling customers to resolve a problem.
Exchange chief executive Patty Fontneau said billing delays were a big issue at the beginning of the year but not at this point.
“I believe there are exceptions and problems, and we will absolutely get them resolved and investigate,” she said.
Fontneau said the billing category includes people calling with questions and not just problems, but she conceded the exchange does not know what percentage of the roughly 1,800 customers who called last month had problems with or didn’t receive their bills.
“Is it a huge problem?” she asked. “I don’t believe so. We haven’t been hearing that.”
After the problems last winter, Fontneau said the exchange recently began sending notifications to health insurance companies three times a day, and the companies usually confirm a new policyholder within 48 hours. Individuals are billed by the insurance companies — not the exchange — so usually it is more effective to call the insurer with billing concerns, exchange officials said.
Kaiser regional president Donna Lynne said the company received about 70,000 new members through the exchange and Medicaid expansion this year, and only about 1,600 have had trouble receiving bills.
“Given the magnitude of the numbers enrolled and the complexity of the system … we are putting all resources into fixing this problem,” she said. “We’re sorry about inconvenience.”
Lynne said Kaiser has set up special “concierge” teams to help people who have not received bills, and the company treats patients who say they signed up even if they can’t provide documentation. She expects the problems for the 1,600 customers will be fixed in the next 30 days.
Anthem, another major insurer on Colorado’s exchange, said it doesn’t release its enrollment figures for competitive reasons. Anthem isn’t experiencing issues related to members not being billed, spokeswoman Joyzelle Davis wrote in an e-mail.
Bridwell estimates she has called the exchange three or four times on billing issues and spent about 45 minutes to an hour on each call. She also called Kaiser once to pay by phone and was told she should just pay by phone each month until the billing issue is resolved.
Connect for Health communications director Linda Kanamine said exchange records show Bridwell called just twice — both times in April — primarily to put her son on the policy and discuss how to provide verification documentation.
“She made us aware that she was not receiving statements but she didn’t ask that we contact Kaiser,” Kanamine said.
Bridwell said she called a third time from her son’s phone last month, and she expected the exchange to help when she complained about Kaiser’s failure to send her bills.
Kanamine conceded her records might be incomplete if Bridwell called from a different phone and the customer service representative did not note that third call in her account.
“The important thing is we are going to resolve it now,” she said.
Bridwell said she feels like she’s getting the run-around on something that should be simple.
“I don’t think one hand knows what the other is doing,” she said.
This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
