California health exchange pulls error-ridden physician list--again

The Covered California exchange yanked its directory of network physicians after finding too many errors. Above, Executive Director Peter Lee discusses enrollment numbers in Los Angeles last month.
(Rick Loomis/Los Angeles Times)

Admitting it gave some consumers bad information, California’s health insurance exchange pulled its physician directory for having too many errors.

Covered California made the move late Thursday amid growing frustration among both consumers and doctors over inaccurate information about insurance networks in the state marketplace.

The exchange yanked its online directory of medical providers in mid-October after acknowledging there were serious problems then with the data. It published an updated list in November.


Since Obamacare policies took effect Jan. 1, many enrollees have complained that doctors won’t take their insurance even though the physicians were listed as part of their network on the state website and by their health plan.

The exchange said Thursday that “while the combined provider directory was a useful service for many consumers, some enrollees located physicians thought to be in their plan, and subsequently discovered they were not.”

The exchange has touted the directory as an important consumer tool because some insurers have sharply limited the number of doctors and hospitals in policies being offered under the federal healthcare law.

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The state said enrollees who are unsatisfied with their provider network still have time to cancel their coverage and sign up with a different insurer before open enrollment ends March 31.

However, that may be little comfort for people who experienced computer errors and long delays to enroll the first time under the Affordable Care Act.

Customer service problems continue to plague the exchange and some insurers in light of 625,000 people enrolling through mid-January. Covered California said people waited nearly 52 minutes, on average, to speak with someone at the state’s call center last week.

The exchange is in the process of hiring 350 more people to answer the phones and assist people.

Covered California said it will continue to include online links to insurers’ provider directories. But the exchange directory offered the advantage of enabling people to search for doctors across health plans while shopping for coverage.

In an interview last week, officials at the California Medical Assn. said they were still finding flaws in the state’s data, often because of incorrect information from insurers.

Health insurance companies, in turn, blame some doctors’ offices for mistakenly turning patients away even though they are under contract for the networks.

Many insurers have adopted narrower networks to help hold down premiums on individual policies sold in and outside the exchange.

Micah Weinberg, a health-policy expert and senior advisor at the Bay Area Council in San Francisco, said these errors and the finger-pointing that has ensued could sap recent momentum on enrollment.

“One of the things that worries me a great deal about all this is that it runs the risk of setting consumers, doctors, health plans and Covered California against each other,” Weinberg said.


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