Originally Posted on January 12, 2017
The following information has just come to the FOP:
Your offices have been receiving reports of a significant uptick in problems with Blue Cross health coverage. I want you to know the City is extremely frustrated with the current situation. Blue Cross is experiencing a technical problem which means its systems do not correctly reflect those who have coverage. Stated differently, although a medical provider contacting BCBS today will not be able to confirm coverage in all cases, coverage is in effect and claims will be processed by BCBS retroactively. From the perspective of your members, of course it will appear that the coverage has terminated, although that is not the case for anyone who is entitled to coverage.
Blue Cross has not been able to fix the problem through a systematic change. Because it cannot come up with a systematic correction, BCBS is updating records manually, one by one. As BCBS works through the population affected, those with immediate medical needs are being prioritized to the top of the list.
We have been pushing BCBS to correct the problem as quickly as possible. BCBS assures us it continues to update records as fast as it can, although it too is frustrated with the pace. BCBS promises us that it will be mailing insurance cards to those who need new cards and who are corrected in the system. In the meantime, individuals who need to move to the front of the list because of immediate care needs should contact:
HMO PHARMACY CUSTOMER SERVICE - 1-800-423-1973
For HMO members who need help filling a prescription contact
HMO GENERAL CUSTOMER SERVICE 1-800-730-8504
For HMO members who need to verify coverage at the doctor’s office or emergency room, or for other general questions.
If employees want to check to see if they have coverage, please direct them to the Blue Cross customer service: Blue Cross PPO customer service – 1-800-772-6895
Dean, providing benefits to our employees and retirees in accord with the City’s agreements is our highest priority. We find this situation extremely frustrating. Rest assured we are striving to correct the situation as quickly as possible.
If you have any questions, please feel free to contact me or Carol Hamburger.