Errors in HealthCare.gov Forms Raise Concerns

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[Wall Street Journal]

Government Says About One in Four Transactions in October and November Could Be Incorrect

By:  Jennifer Corbett Dooren connect
Posted CWN:  December 7, 2013

obamacare-site_problemsThe federal government said about one in four electronic transactions sent from HealthCare.gov to insurance companies in October and November could contain errors, raising concerns that some consumers who think they picked a health plan won’t be enrolled by Jan. 1.

The issue involves electronic files known as 834 forms, which are sent from the federal health-insurance website to insurance companies after consumers pick a plan.

The Centers for Medicare and Medicaid Services, the federal agency that oversees HealthCare.gov, had acknowledged problems with some forms but refused to say how many were affected.

On Friday, CMS spokeswoman Julie Bataille said recent fixes to HealthCare.gov have driven the error rate down to about one in 10 for electronic files generated since Dec. 1. For October and November, she said the error rate was about one in four.

Ms. Bataille said errors fall into three categories: duplicate files, lack of a file, or a file with mistaken data such as a child being listed as a spouse.

The 834 form is supposed to contain the person’s name, address, contact information and Social Security number. Insurance companies use the information to bill consumers for their portion of the payment and to formally enroll people in insurance plans. If the 834 isn’t sent or has errors, it means insurers can’t complete the enrollment.

CMS is contacting hundreds of thousands of consumers who have tried to enroll for health coverage but aren’t enrolled. Ms. Bataille said consumers who have picked a plan should be contacted by the insurance company for a payment and would also likely receive some type of welcome packet of information.

“Our clear priority is fixing any remaining bugs causing problems and working to make sure every 834 form past and present is resolved,” Ms. Bataille said.

She said 3.7 million people have used HealthCare.gov this week. Although she didn’t say how many people have picked a plan, it is likely that thousands of new 834 forms are being generated each day, meaning a one-in-10 error rate could still cause significant trouble for insurers.

A technology team led Quality Software Services Inc. or QSSI, a unit of UnitedHealth UNH +1.03% Group Inc.’s Optum, has been working to fix the 834 problem with insurance companies.

Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@wsj.com

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