Rochester, N.Y. - New York Attorney General Eric Schneiderman announced a $3 million refund settlement Wednesday with insurer Excellus BlueCross BlueShield for patients and health care providers who overpaid due to improper accounting of deductibles.
Excellus reported that accounting errors affecting 12,000 customers processed after Sept. 1, 2011, followed software modifications with glitches that have since been repaired.
In a statement, Jim Redmond, a spokesman for Excellus, said, “From the time we discovered that our computer system was miscalculating some of our members' deductibles, we have worked to make our customers financially whole. We were addressing this long before discussions with the attorney general. In fact, we self-reported the problem to the state in the first place.”
He also added the agreements reached with the state are not a "$3 million settlement."
“That dollar reference includes the claims payments we already made to our customers with interest that we acted upon ourselves,” said Redmond. “When the computer problem occurred, we proactively made sure we took all steps necessary to ensure our members' claims were properly paid.”
Excellus says it’s conducted a thorough review of claims for every potentially impacted member to make sure their deductible totals and related claim payments were corrected and communicated with members, providers, employer groups, and state regulators about the steps it’s taking to fix the problem.
The health insurer will be sending a letter to each of the members in early January with claims details and instructions on how to obtain further assistance if they believe they have an unresolved claim.
