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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

August 7, 2014 at 5:33 PM

Frustrated health-exchange customers can pay insurers directly

By DONNA GORDON BLANKINSHIP
The Associated Press

A major fix to problems plaguing the state’s answer to health-care reform was announced Thursday, allowing exchange customers to pay insurers directly, as they do in some other states.

While direct payments already have been an option, Gov. Jay Inslee, Insurance Commissioner Mike Kreidler, and the Washington Health Benefit Exchange made the formal announcement Thursday to spread the word and try to bring relief to consumers who have been told their payments to the exchange have not reached insurers.

For the past seven months, the health exchange has been trying to solve billing problems in the exchange, caused by a combination of software issues and human error.

Some people aren’t being properly credited by the exchange for their insurance payments.In some cases, money and information has been lost somewhere between the exchange and the insurance companies. And some people have been told by their doctors that the insurance company has no record of their coverage.

Officials at the exchange have estimated at least 6,000 accounts have been affected by the billing problems. They say thousands of accounts have been repaired each month but new problems keep popping up.

Insurance Commissioner Mike Kreidler said the fix would be a temporary solution, but it will go into effect immediately.

“Everyone involved agreed that we needed to do everything possible to ensure consumers can access care if they need it,” Kreidler said. His office does not oversee the exchange but he has received hundreds of phone calls complaining about the billing problems.

No one could give The Associated Press the exact number of people affected by billing problems at the health exchange.

The governor, the insurance commissioner and officials at the exchange met several times over the past two weeks to talk about the repair work and discuss possible solutions.

To access the new direct payment option, consumers must first call the Healthplanfinder customer support center at 1-855-923-4633 to report the problem they are having. They need to describe their medical emergency or urgent prescription needs. Then they will be able to pay their insurance company directly.

The exchange will continue to work on resolving its technical issues so payments will be processed correctly through the exchange. Exchange CEO Richard Onizuka apologized to its customers in a statement Thursday afternoon.

“We cannot stress enough that resolving these system defects is the top priority for the Washington Health Benefit Exchange and our board,” Onizuka said. “The exchange has developed an aggressive action plan to address these issues as quickly as possible.”

Onizuka said their goal is to make significant progress by the end of August.

For more detailed information, see the exchange’s FAQ.

Comments | Topics: Mike Kreidler, Washington Health Benefit Exchange, Washington Healthplanfinder

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