August 22, 2016
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement Practice Management
Last week, Blue Shield of California announced that it would close its doors for the four days after Labor Day to reduce its payroll-related liabilities, citing losses in the Covered California health insurance exchange.
The shutdown, lasting from September 5 to 9, will affect most of its 6,000 employees. The company claims this will save it an estimated $4 million.
Some Blue Shield customer service representatives and medical services staff are still expected to be on the job during that period. The California Medical Association has also confirmed that while the Blue Shield Provider Relations department will be closed, the following departments will remain open: Provider Customer Service, Provider Information and Enrollment, Claims Processing, and Grievances and Appeals.
If practices have urgent prescription and/or procedure authorization requests during, they can call Blue Shield’s Medical Care Solution line at (800) 541-6652 for assistance. According to the payor, this and all other critical customer facing departments will be staffed during the closure.
The shutdown will not affect about 1,000 employees who work for Care1st, which Blue Shield acquired last fall, and some staffers in customer service and related areas who will remain on the job.
Blue Shield raised its Covered California rates by nearly 20 percent for 2017, citing the high costs of covering enrollees. The payor said it drastically underpriced premiums for the state's exchange. The insurer also plans to cut 460 jobs in Sacramento and the Central Valley.
Last month UnitedHealth Group, Humana and Aetna said they would exit most Affordable Care Act markets, citing revenue losses.