ST. PAUL, Minn. – Blue Cross Blue Shield (BCBS) reached an agreement with the Minnesota Commerce Department to pay a $45,000 fine and pay back $328,000 in surprise medical fees to customers.
The issue arose as BCBS’ website misrepresented doctors and hospitals as “in network” care for the Blue Cross Blue Shield Consumer Value Network, reports KARE 11. Customers later found out the services they had consumed were out of network, and came with huge undisclosed costs as a result.
Jay Craswell told Kare 11 that he was hit with a surprise medical bill amounting to $24,000. He’s now encouraging everyone to double check all of their medical bills to avoid the stress he went through.
“You know, unless you’re OCD like me and you have a yellow pad with everything you checked, you probably just assume that it’s your own fault,” Craswell told Kare 11.
The primary issue with the system came from BCBS’ failure to delist North Memorial Medical Center and affiliated clinics as “in network” reports the Star Tribune. The failure occurred during part of the 2015 open enrollment period, and BCBS also failed to maintain a system which allowed people with coverage to accurately identify in-network providers.
“We recognized and apologized for the difficulties experienced by these members and made every effort to remedy situations that were brought to our attention,” BCBS said in a statement according to the Star Tribune.
BCBS did not admit any wrongdoing in their settlement, Commerce Department Spokesman Ross Corson told the Star Tribune.
“[Blue Cross] voluntarily agreed that, for individual members who purchased a health plan utilizing the Consumer Value Network for any time in 2015 and obtained services from North Memorial … it would reprocess the member’s 2015 North Memorial claims to reflect in-network benefits,” the consent order states,” Corson told the Star Tribune.
