Blue Cross bungle nearly costs transplant patient treatment

Posted January 11, 2016 7:01 p.m. EST
Updated January 12, 2016 6:37 a.m. EST

— Duke University Medical Center staffers told Mitch Hart on Monday that he wasn't covered by Blue Cross Blue Shield of North Carolina and tried to turn away the transplant patient from Wake Forest.

Hart persisted, though, and eventually convinced them he had health coverage and received his treatment.

"I almost didn't get a CAT scan. I almost didn't see my transplant doc today and all the other docs that I see," he said.

Hart is among the thousands of North Carolinians snagged by problems Blue Cross has experienced since the start of January.

The state's largest health insurer had 25,000 customers who were impacted by the issues, including 3,200 whose bank accounts were drafted in the wrong amount.

When customers tried to call Blue Cross to sort out the problems, they either got a recording saying representatives were "unable to take your call at this time" or faced wait times of more than three hours.

Blue Cross Chief Executive Brad Wilson is now calling some customers personally to apologize for the enrollment debacle and issued a corporate mea culpa in radio spots statewide on Monday.

"These difficulties are unacceptable, and we apologize," Wilson said in the radio ads.

Blue Cross officials said the company's call centers have been overwhelmed by about 500 times the number of calls they got this time last year.

Other insurance companies, including Aetna, which manages Coventry Health Care of the Carolinas plans, say they've also experienced some technical issues at the start of the new coverage year and have expanded call center operations to handle customer questions.

Blue Cross officials said all customers wrongly debited should be refunded the money owed them by the end of the week, and identification cards verifying coverage are in the mail to more than 92 percent of the insurer's customers.

"We're on 24/7, involved and focused on resolving these issues that customers have," spokesman Lew Borman said. "We're making slow but sure progress."

Promises are a start, Hart and his wife said, but they want to see a solution.

"I just want to know that we're covered," Lisa Hart said.

"I want Duke to be able to call up Blue Cross Blue Shield and say, 'Is Mr. Hart covered?' and they say, 'Yes, he is. Everything's fine,'" Mike Hart said. "It's not happening."