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Oops! Blue Cross Blue Shield of Texas pays big for billing mistakes

On March 9, 2020, the Dallas News reported that BCBS of Texas was ordered to pay a $10 million fine and offer refunds to customers who had been wrongly billed for out-of-network emergency care. This was a big deal across the state, and makes us wonder what happens when the Texas Department of Insurance isn't watching.

This March, after state investigators determined that Blue Cross Blue Shield of Texas had made major billing mistakes related to out-of-network emergency claims, the insurer agreed to pay a $10 million fine and give refunds to members who were overcharged. The story caught like wildfire, with coverage in virtually every major news outlet across the state. Not surprising given the high costs insured consumers already incur absent any billing errors, never mind when they are wrongly billed and it takes a state insurance commission to drive corrective action. Blue Cross says it has rectified the problem that caused these errors, but it is alarming that they occurred in the first place. Concern about high costs can interfere with consumers’ ability to access care when they need it, and can even deter them from seeking out care in the first place. Even just one large, unexpected bill like the ones identified in this investigation can totally disrupt consumers’ understanding and trust of their insurance. It is exactly this type of situation with Blue Cross that leaves consumers who are already struggling to navigate their insurance coverage more confused than ever.

Original Article:

Blue Cross Blue Shield of Texas is agreeing to pay a $10 million fine and issue refunds to consumers after a state review found billing mistakes in the...

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