Consumer access to healthcare.gov improved, insurers still need fixes

12/06/2013 4:47 PM

12/06/2013 11:23 PM

No unscheduled shut downs, an average error rate below one percent, and typical response times of less than one second.

More than 3.7 million consumers visited the Health Insurance Marketplace at healthcare.gov over the past week, federal health officials reported Friday, reflecting an improved functionality attributed to extensive software repairs and hardware upgrades implemented since the system’s troubled launch on Oct. 1.

But now that consumers are able to access the online insurance exchange with greater ease — creating accounts, shopping for coverage, applying for financial aid and purchasing plans — federal health officials are turning their attention to significant “back-end” issues, such as the transmission of direct payments, and so-called 834 forms containing consumer data, from healthcare.gov to insurers.

Problems to be resolved with the system’s back-end include: a failure to generate forms for consumers who enroll in a plan; generation of duplicate forms; and data errors, such as incorrect spousal or parent-child relationships and misspelled names.

As many as one in four of all 834 forms generated through the federal online exchange from Oct. 1 to Nov. 30 may contain errors, said Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, the agency that oversees healthcare.gov.

Since the site’s relaunch last week, however, that error rate has dropped significantly, Bataille said.

“With recent upgrades and technical fixes in place,’’ Bataille told reporters during a conference call Friday, “we believe nine out of ten 834-form transactions are being successfully submitted.’’

Federal health officials have not updated enrollment numbers for healthcare.gov since mid-November, when they reported that more than 106,000 eligible Americans — including about 3,500 in Florida — had selected a health insurance plan in October using both the federal- and state-based exchanges that are key to the Affordable Care Act.

But only about one in four individuals who selected a health plan that month, or 26,794 people, did so using the federal healthcare.gov, which serves 36 states, including Florida. Fourteen states and the District of Columbia operate their own online insurance exchanges or partner with the federal government.

CMS officials said they resolved a significant source of errors with 834 forms over the Thanksgiving weekend, when technicians repaired a bug in healthcare.gov that was causing 80 percent of the form errors by failing to transmit Social Security numbers.

Bataille said a “dedicated team” of CMS officials, contracted technicians and insurers meets daily to comb through 834 forms and consumer enrollment data “at a granular level” with the aim of identifying errors in all transmissions past and present.

“Our priority now,’’ she said, “is making sure that we can successfully cross-reference our records with those of the issuers so we can reconcile previous data and, moving forward, our records will match.’’

CMS officials have counseled consumers who have questions about their coverage status to contact their insurer directly to verify enrollment and request welcome materials in order to avoid any possible confusion come Jan. 1 for those Americans who enroll in a plan by Dec. 23.

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