In the roughly two weeks since new health coverage began for the first wave of Americans who signed up for plans in the insurance exchanges, reports have surfaced that insurance companies are struggling to collect premiums and providers are having trouble verifying that new patients are actually enrolled.
Dr. Austin King, president-elect of the Texas Medical Association, said he experienced these hiccups immediately in his own practice.
A patient walked in Jan. 2 with a “huge tumor” on his face who needed an immediate CT scan, the Abilene otolaryngologist said. The man didn't have a patient identification card, but had his identification number on a piece of paper. The practice's staff spent more than an hour on hold with the insurer before connecting with a representative, who wasn't able to verify coverage, King said.
Several insurance companies have pushed back their payment deadlines—to as late as Jan. 30 for coverage effective Jan. 1—in order make sure as many applicants as possible get enrolled in the policies they chose.
Still, it may take weeks or months for the companies to sort out the information on the massive influx of new enrollees, particularly after weeks with rampant technology flaws with the federal and state enrollment portals.
King said he convinced a friend to perform a CT scan on the patient, though the friend probably will never be paid. The man enrolled—or at least believed he enrolled—in a bronze plan with a deductible somewhere between $5,000 and $6,000, a sum King doubted he could afford.
Follow Andis Robeznieks on Twitter: @MHARobeznieks
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