Blue Shield of CA Updates – Network, Renewals and Technology

Expanded PPO Contract with Hoag Hospital, Orange County

We have signed a new contract with Hoag Hospital in Orange County. Beginning March 1, 2014, Hoag Hospital’s Newport Beach and Irvine locations will now participate in Blue Shield of California’s Exclusive PPO Network for Individual and Family Plan products. Hoag Hospital has been a participating provider of Blue Shield’s network since 1984.

Consumers who buy the new 2014 Individual and Family PPO Plans directly from Blue Shield of California or Covered California will now have expanded access to care at Hoag’s Orange County facilities.

This new contract DOES NOT change Hoag’s previous arrangement with Blue Shield.

April Renewal Bills Delayed for Small Business Customers

Small Business customers renewing in April will receive their April bill the week of March 17, 2014 – one week later than all other non-renewing Small Business customers. The delay is due to the continuing transition of customers to our newly enhanced eligibility and billing system.

Here are five things to know about this delay:

  1. The bill delay does not impact members’ access to care and coverage won’t lapse because of it.
  2. This delay will help ensure your clients receive accurate bills.
  3. Non-renewing Small Business clients will be mailed their bills on schedule the week of March 10, 2014. The one-week delay only applies to Small Business customers with April renewals.
  4. There is a 30-day payment grace period from the time bills are mailed.
  5. Commissions will be paid upon receipt and allocation of customer payment.

Service and Technology Updates

  • New automated phone account management
  • Our new, easy-to-access telephone feature for IFP customers is already starting to make a positive impact on serving customers who call us. With our new system, customers can now:
  • Check on the status of their account
  • Order additional ID cards
  • Verify a payment was received
  • Make a payment
  • Customers can now call the number on the back of their member ID card to access a 24/7 automated service. The new system, however, is not designed to accept the customer’s initial month’s payment, so they still need to make that payment through the traditional channels.
  • We believe the benefits of this new system will be embraced by customers, since it will eliminate waiting on hold if they want to make a payment (once coverage has started), and it will reduce hold times for customers with other questions.

New online tool provides price transparency

Blue Shield of California recently launched a new online Treatment Cost Estimator (TCE) that provides the transparency for healthcare costs that our members deserve and that brokers can share with them, as one of the many advantages of Blue Shield coverage.

Currently, the TCE is available to our PPO plan members, who can use it to budget and plan for healthcare expenses. Brokers can use this online tool to help clients and can recommend it to them as well. The TCE provides estimates for more than 400 of the most common treatments and services by network providers, and encompasses both the total cost and out-of-pocket expenses for medical treatments and services.

The February 25 issue of the Wall Street Journal featured a major story on the national momentum that is building for increased price transparency in the healthcare industry, which aims to “empower patients and other payers to be smarter health-care consumers” and to address the expectation that consumers will be “much more price-sensitive as they shoulder a growing proportion of health costs themselves.”

Blue Shield is engaged in this pivotal time for increased transparency and welcome the momentum for change.

Enrollment Updates

March 31 open enrollment deadline is nearing. The deadline for open enrollment for Individual and Family Plan products is March 31. The industry is anticipating another surge in enrollments during this time and we are preparing for this. Thank you in advance for your patience as we move into this next phase.

Reducing Small Business enrollment backlog

For Small Business customers, we are implementing a three-step plan to reduce enrollment backlog:

  1. Adding staff to process enrollments
  2. Increasing the capacity of our vendors to handle more volume
  3. Reducing any processing system downtimes for routine maintenance

These process improvements will help further reduce the backlog in the coming weeks.

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