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Complaints prompt Nevada Health Link to shift billing duties

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Complaints prompt Nevada Health Link to shift billing duties

By Michael Lopardi. CREATED Apr 10, 2014

Las Vegas, NV (KTNV) -- After months of complaints, Nevada's health insurance exchange is moving to transfer billing duties to individual insurance carriers.

Developer Xerox said it has met with several carriers part of Nevada Health Link who will eventually take over billing and payments. The move comes after customers complained they paid premiums to the exchange but the carriers could not find the money.

While processing payments is routine for many insurance companies, the Nevada Health COOP expressed concern at the change. The company told the state board Thursday that it doesn't have the infrastructure in place to handle the duties because the exchange originally offered to handle the task.

"It's going to be cost and time for us and we don't want to be put in an anti-competitive environment where three carriers on the exchange are ready and we're not," said Bobbette Bond with the COOP. "We just want to make sure you take that into consideration in your  decisions."

The change is set to come up for discussion in another two weeks.

The state board held off on setting member fees for 2015. The fees help fund the exchange but board members wanted more information and the Nevada Division of Insurance asked for more time to review four proposals. 

A new audit of the health link is shining light on problems that customers have complained about for months. The report from Health Claim Auditors looked at issues with the Nevada Health Link website and long wait times at the call center.

Developer Xerox could face tens of thousands of dollars in penalties for its performance though it's unclear how much because board members have to decide how to pursue the report's results. Xerox was also allowed to respond to issues raised in the report. The issue is set for discussion at next Thursday's meeting.

Another assessment from Deloitte is nearly halfway completed, the company announced Thursday. An update shows the company has completed 108 interviews and received dozens of documents. Deloitte is conducting a separate review of problems with the health link, which could cost taxpayers up to $1.5 million. The final report is due April 25.

Finding a new, executive director for the state exchange is turning out to be more complicated than originally expected. The state board voted Thursday to abandon its pursuit of an outside recruitment firm because of costs and complications in finding a company to complete the task. 

Board chair Barbara Smith Campbell said she has received between 25 and 30 applications for the position. Former executive director Jon Hager resigned in February when frustration over system problems peaked. Steve Fisher, deputy administrator of the state Division of Welfare and Supportive Services, is holding the director's spot on an interim basis.

Michael Lopardi

Michael Lopardi

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Michael Lopardi is the featured reporter of the You Ask. We Investigate. franchise at Action News.