July 11, 2014
ERROR CODE – IBX HAS A NEW OPERATING SYSTEM
On July 1, 2014 Independence Blue Cross in Philadelphia () began utilization of its new operating system. Unlike the smooth operations of their other forms of utilization – utilization management, that is (retrospective case reviews prompting denials of care/payment, prior authorization policies), they are experiencing major glitches with the new operating system. ID cards, which should have been in the hands of EVERY member, are still not available. One local business affected by this learned earlier this week that IBX incorrectly loaded data files resulting in individual subscribers having their medical and/or prescription coverage incorrectly reflected in IBX’s system. Consequently, when providers check coverage status, the error makes its impact by hindering access to services that are seemingly not covered for that individual. Contacting the IBX help desk (1-800-ASK-BLUE) does not help, as operators were telling subscribers that “the employer” made the changes. That was apparently supposed to be corrected, as IBX had already admitted their error, but it should not be surprising that an insurance company would allow that to happen. When that particular business contacted IBX about this repeatedly, they were ultimately promised that the error would be corrected by the end of the business day on July 9. As of yesterday morning, July 10, the problem was still not resolved. Further contact lead to a promise that the problem would be fixed by this morning (July 11). As of this writing, there is no further news.
On November 8, 2013 IBX posted online a FAQ document titled Transition to New Operating Platform . So why, in July 2014, is IBX still not ready? Health care does not simply get paused like a You Tube video to wait for a company that has been woefully inadequate and inept with respect to their customer service. If you have any of IBX’s products and you have to seek health care, keep your fingers crossed that access to care is not denied. I urge all who read this article and are affected by this to begin complaining immediately to IBX. Ask your employers to complain and to keep complaining, every day, both online and by phone, or in person if you live close enough to their Philadelphia headquarters. There are simply NO EXCUSES for this. If you purchase a car with a navigation system, do you have to wait for the GPS company to upgrade before the system will give you your directions? No. This reminds me of the mid-1990’s when the internet was fairly new to the American public and those who used America Online (AOL) would have their internet experience periodically interrupted while AOL “updated its art work.” Remember those days? Sometimes, service would be interrupted and then one would have to undergo the tedious process of logging back on through whatever dial-up service was available. But this is 2014. Do you think IBX’s executive would tolerate ANY delay in the payment of premiums and other fees? Of course not. No pay, no insurance. Your benefits would be suspended. Does IBX, or any insurance company, for that matter, tolerate a provider’s coding error, for instance? No. Reimbursement is withheld, and explanations for why will vary depending upon who answers the phone when the provider’s office calls. So what is IBX’s consequence?
Who is holding insurance companies accountable? Why is this allowed to happen and all any of us can do is wait till they fix their error? Why was this not foreseen last November when they published their FAQ’s? Why has there not been a very public apology from IBX’s CEO to any and all subscribers and businesses affected by their ineptitude? How refreshing would that be if there was a public service announcement from IBX chief executive officer, Daniel J. Hilferty. After all, he did just earn the 2014 Southeastern Pennsylvania (SEPA) Citizen of the Year Award from American Red Cross (click here to learn more) for his support of the Red Cross and advocacy for philanthropy (click here to learn more). But that would be too much to expect. It’s very nice he supports the Red Cross. I just wish that the philosophy and values that underscore his philanthropy would pervade the corporate operations and help to establish a stronger commitment to the discipline of customer service. Back in the 1960’s, it took one person to go up against a large company after a major problem had occurred and things began to change. The Chevy Corvair, with all its problems, led Ralph Nader in 1965 to write the groundbreaking book Unsafe at Any Speed in which he chronicled unsafe practices in the auto industry. (click here to learn more). The Corvair existed from 1961-1974, but Nader’s book forced change to occur. GM harassed him and tried to intimidate him, but in 1966 then GM President James Roche was forced to appear before a US Senate subcommittee to apologize to Nader. So in answer to the question that opened this paragraph, WE are going to have to be the ones to hold insurers accountable. And unlike the 1960’s, or even the 1990’s, we don’t have to write a book to get noticed. Social media, when used properly, is a powerful tool. Go to IBX’s Facebook page and register your displeasure whenever there is some negative outcome attributed to their actions, such as not getting ID cards out in time because of a “glitch” or denial of a medical service or a medication (ibx.com/facebook). Also, call them out on Twitter at @ibx.
Hopefully, by the time you’ve read this the problem will have been corrected. And hopefully, there will have been no serious consequences. But I truly hope that reading my blog will spark you to take action whenever you don’t like the outcome your insurance company has delivered. Every person counts, every voice needs to be heard. Silence represents hopelessness, or worse, apathy and tacit approval.