NO FAST FIX healthpolicyandmarket.blogspot/2013/10/just-what-is-834-transaction-why-is-it.html even if the ACA rollout issues are repaired today, the damage will take at least a year to fix: ~quote~ DC: In the case of the ACA, the health plan will use the member data transmitted from the government to bill the member and presumably will invoice the government for the subsidy component. This split bill scenario has been a common requirement in programs retiree medical programs and is the hardest thing we do in the industry. The dynamic nature of the subsidy means this invoice amount can change throughout the year. If the member or government remittance isnt what the health plan has on its rolls, the carrier system will suspend eligibility and not pay claims. The member to cash reconciliation is hard when the data is pristine. With all of the problems occurring in just getting accurate data to the carriers, if cash starts flowing before this is pretty tightly locked down that toothpaste wont go back in the tube easily. RL: Did Obama administration officials not understand how hard this really is? DC: We talk about the health care system like it really is a system. The decision to build the ACA on top of the Rube Goldberg contraption we call a system was either very naive or a case of using the system you have not the system you want. RL: If lots of enrollment starts coming through before we have improved the system to an acceptable data error rate (very close to zero) it is going to be catastrophic for consumers and the health plans customer service reputation. So, how long will it take to fix the 834 problem such that we have an acceptable error rate? DC: At least a year.
Posted on: Wed, 30 Oct 2013 18:58:07 +0000
Trending Topics
Recently Viewed Topics
© 2015