BCBS NC faces major fines for ongoing IT, reimbursement troubles

In an unprecedented move, North Carolina Insurance Commissioner Wayne Goodman said Wednesday he plans to issue a multi-million dollar fine against Blue Cross and Blue Shield of North Carolina for technology issues that have affected coverage, billing and payments for consumers and physicians, reports News Observer.

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The insurer’s technology woes began four months ago when it transferred more than 400,000 Blue Cross members to a new technology system called Topaz. The system crashed in January, leaving many policy holders uncertain whether they still had health insurance.

Technology issues have also resulted in delayed reimbursements to some physicians. During March and April, more than 150 providers told the state department of insurance it had been several months since they received payments from the insurer.

Mr. Goodman said the fine against BCBSNC will be based on the number of outstanding reimbursement claims to providers. Under state law, the department of insurance is allowed to fine Blue Cross up to $1,000 per violation per day.


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