Wednesday, January 03, 2018

Two steps forward, one back

So in December, we began moving several small groups to Anthem (mostly from United Healthcare)(Heh). But we weren't alone, and they are severely backlogged.

How backlogged? Well, my rep told me that groups approved on December 21st are still not all keyed in. Which is a problem for groups approved late last month or even earlier this week.

Here's why that can be an issue: in the early morning hours of January 1st, one of my client's daughters suffered severe frostbite (long story). In fact, she had to spend time in the burn ward, and we're still not sure whether they'll be able to save her feet. As one can imagine, there's a heck of an ER and burn unit bill, and surgery is likely.

I've been on the phone with the hospital about this numerous times over the past few days; she'll be covered, but the billing situation is a mess (fortunately, this just happened so nothing's actually been billed yet).

She also mentioned that there seemed to be (at least) two factors involved here: first, of course, is the aforementioned exodus from UHC. But a close second is, interestingly, the implosion of the individual market, especially here in southwest Ohio: a lot of smaller employers who had been on the fence about installing a group plan took the plunge as a result of that implosion.

So, not a bad problem to be sure (hey, lots of new business means lots of new premium dollars), but a service mess for at least a while.

[Hat Tip: FoIB Liz M]
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