Blue Cross Blue Shield of Texas to pay $10M fine, issue refunds after state finds billing mistakes
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 insurer’s handling of out-of-network emergency claims.
The Texas Department of Insurance announced the fine and restitution agreement Friday. Richardson-based Blue Cross will begin sending out notices to affected consumers by May 1.
The state said its review found:
• Incorrect information about how to resolve bill balances on explanation of benefits forms sent to HMO members receiving out-of network emergency care.
• Delays in processing out-of-network claims that went through a review process Blue Cross began using in August 2018. Those payments failed to meet the state’s prompt payment requirements.
• Errors in marketing materials about Blue Advantage Plus plans offered in 2018 and 2019. More than 70,000 people signed up for the 2018 plan on the federal health care exchange.
Read more: https://www.dallasnews.com/business/health-care/2020/03/06/blue-cross-blue-shield-of-texas-to-pay-10-million-fine-issue-refunds-after-state-finds-billing-mistakes/