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BCBSMT, Insurance Commissioner Sign Agreement to Resolve Customer Service Issues

Dec. 11, 2014

Helena, MT — Blue Cross and Blue Shield of Montana and Insurance Commissioner Monica Lindeen have signed an agreement to address service issues that the state's longest-standing and largest health insurer experienced this year.

"This is the most transformative time in the history of our industry," said BCBSMT President Mike Frank. "In our nearly 75 years of doing business in Montana, we have never before seen this degree of change all at once."

The past year ushered in unprecedented change to the health insurance industry. BCBSMT implemented hundreds of new product configurations and benefit designs for 2014 in order to comply with the Affordable Care Act. During the first-ever open enrollment period, BCBSMT succeeded by enrolling 42,000 members — nearly 70 percent of all individual plans sold in Montana — and fulfilling its longtime commitment to expand access to health care.

At the same time it was navigating health care reform, BCBSMT finalized its transaction to become a local division of Health Care Service Corporation. This included converting all of its business to new information technology platforms and migrating members to a new claims-paying system.

As a result, some customer-service issues arose, primarily in the individual market. BCBSMT identified the issues and put in place several solutions, such as increasing the number of resources dedicated to helping members enroll, adding new online tools and capabilities to improve the member experience, and enhancing how it responds to and fixes issues.

"Our challenge was implementing what was right for our members long-term in a compressed time span," Frank said. "We have resolved many of these issues and we are now poised to provide better service than ever before."

Frank added that BCBSMT is honored that so many customers chose BCBSMT as their insurer of choice, and he's confident these new enhancements will improve the member's experience.

"We remain deeply committed to our employees, members, providers and Montanans," he said. "We are in it for the long haul and we will continue to fulfill the promise we have with Montanans to do everything in our power to provide security and peace of mind when you need us the most."

Over the course of the past year, BCBSMT worked closely with the CSI to resolve many of the service issues. Among the service enhancements that BCBSMT implemented to enhance its customer experience are:

  • Establishing a dedicated call center team for individual policyholders to fix customer service issues
  • Substantially increasing the number of call center staff, including adding a 24/7 customer hotline to answer member calls more quickly
  • Offering members a way to access and print online 30-day temporary ID cards to verify proof of coverage
  • Offering an online chat capability and online enrollment tracker to allow members and applicants to communicate directly with a BCBSMT sales representative and to track their enrollment progress
  • Establishing a special appeals team to focus specifically on individual policyholder appeals
  • Continuing to offer various fast track and escalation processes to more quickly resolve customer issues
  • Dedicating two full-time employees to work with the CSI on addressing consumer complaints to speed up resolution for the member

As part of the agreement, BCBSMT will pay $500,000 to the CSI. BCBSMT will donate $500,000 to the Center for Mental Health Research and Recovery at Montana State University in Bozeman that will benefit all Montanans.

"We take a holistic approach to physical and mental health. Together, they are essential to improved health outcomes," Frank said. "We are hopeful that this donation will improve how Montana diagnoses and treats serious mental illnesses."

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