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Dan Hinmon, MCSMN Director
@DanHinmon

Posts: 2375
Joined: Apr 13, 2011

California Slaps Blue Shield, Anthem with Fines Over Inaccurate Provid

Posted by @DanHinmon, Nov 9, 2015

A word to the wise:

“An important element of access is ensuring enrollees have accurate provider directories,” said California Department of Managed Health Care (DMHC) Director Shelley Rouillard in a prepared statement. “The DMHC has taken enforcement action and fined Blue Shield and Anthem due to unacceptable inaccuracies in their directories. These inaccuracies limited enrollee access to care that resulted in an unacceptable consumer experience and must be fixed.”

Blue Shield has already reimbursed more than $38 million to enrollees who incurred out-of-network costs, according to the statement. “Both Blue Shield and Anthem will report to the department the final number of enrollees reimbursed and the total amount reimbursed.”

How accurate are your physician directories?

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