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Enrollment Errors Cut, Officials Say; Fixes Are Overstated, Insurers Report

Mon, 12/16/2013 - 9:30am
Robert Pear

The Obama administration said Saturday that it had reduced the error rate in enrollment data sent to insurance companies under the new healthcare law, even as insurers said that the government’s records were still riddled with mistakes.

The quality of the data is important; it could affect the ability of people to get medical care and prescription drugs when they go to doctors’ offices and pharmacies starting next month.

More than 137,000 people selected health plans in the federal insurance marketplace in October and November, and administration officials say more than 100,000 signed up in the first week of this month.

For each person who signs up, the government is supposed to send information electronically to an insurance company in a standard format known as an 834 enrollment transaction. In some cases, consumers selected a health plan at the federal website, HealthCare.gov, but the government did not notify the insurance company. In other cases, insurers received duplicate files for the same person, files for one person were sent to an insurer in another state, or the “relationship code” was wrong so that, for example, a man’s daughter was listed as his wife.

The White House said Saturday that the government was now informing insurance companies of nearly all new enrollments.

Julie Bataille, a spokeswoman at the federal Centers for Medicare and Medicaid Services, acknowledged that the government had failed to inform insurance companies about some people who had chosen health plans on HealthCare.gov, but she said the number of such cases from Oct. 1 to Dec. 5 was lower than 15,000.

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