Dive Brief:
- North Carolina's Department of Insurance provided an update Monday on its long-running investigation of Chapel Hill-based Blue Cross and Blue Shield of North Carolina, the state’s largest health insurer, the Charlotte Observer reported.
- The investigation was launched in February in response to thousands of customer reports of IT problems resulting in being double-billed, dropped from coverage or assigned to incorrect plans.
- The state insurance agency said it will need to further examine the issue because Blue Cross has disagreed with its findings of wrongdoing.
Dive Insight:
The details of the supposed wrongdoing and of Blue Cross's disagreement with the finding are confidential, with Monday's basic update only provided in response to questions from The News & Observer.
“The initial examination report was delivered to the carrier on May 31," the agency noted, adding, "Interactions with Blue Cross Blue Shield have been ongoing but disagreements on the findings persist.”
Under state law, insurers and investigators are allowed to hold internal hearings to resolve disputes, The News & Observer said.
“There are areas where we agree and areas where we disagree,” BCBS released in a prepared statement. “This kind of dialogue is all part of the normal process. We are working with DOI to reach a resolution to this investigation and move forward.”
The company's position on its liability was laid out in an April memo to employees that stated, “Our current challenges stem from platform, technology and process issues, not actions that could be deemed illegal or unethical.”
The N.C. Department of Insurance, meanwhile, said the insurer has racked up 3,444 complaints so far this year, with most revolving around the IT issue and with 294 of those complaints coming from medical providers, many of whom said they were waiting to be paid.