Report: Dramatic Improvement Seen in Healthcare.gov Backend Error Rate

First the bad news. Or to be more precise, the formerly bad news, since the situation has been corrected.

Enrollment records for close to 15,000 HealthCare.gov shoppers were not initially transmitted to the insurance plans they selected, according to a preliminary federal estimate released Saturday.

Most of these phantom applications occurred in the rocky month of the initial rollout, October 1 through mid-November.

While these cases pose a challenge for the Obama administration, officials say they believe the situation is improving. Since early December, fewer than 1 percent of HealthCare.gov enrollments did not make their way to health insurance plans.

Now the great news.

There is now hard data available from the government confirming how big this backend problem was and a quality assurance plan in place to completely fix it, well before January 1, when enrollees may officially start using their health plans.

Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services, said that the rate of errant applications had dropped from a high of 15 percent in mid-October to less than 0.4 percent in the early days of December.

"To make sure that no consumer falls through the cracks because of earlier pervasive troubles with the site, we are contacting every consumer who has selected a plan through the Federal Marketplace to remind them to pay their premium and connect with their insurer," Bataille wrote.

Federal officials have said repeatedly in recent weeks that consumers should contact their insurer to verify that their application had been processed properly.

About 137,000 people selected an insurance plan through HealthCare.gov in October and November.

That's cold hard data--137,000 registered through the government site Oct.-Nov., and of those, 15,000 applications did not reach the insurer. The government plans to contact everyone of those applicants. Insurers are examining those applications now.

Earlier this week, Health and Human Services sent the hundreds of insurers who sell on HealthCare.gov reams of data on who the federal government believed had enrolled in their products. That information, known as a "pre-audit file," is meant to allow insurers to reconcile their own lists of enrollees with the lists of those the federal government believes have signed up.

"All the files are available, so now people are at the beginning of that process of doing the matching," Andy Slavitt, vice president of Optum/QSSI, said at conference held Thursday by America's Health Insurance Plans.

While insurers are still analyzing the data, some say they are initially seeing fewer discrepancies than they had initially expected.  Another file will be sent to insurers after Dec. 23, the last day for shoppers to sign up for coverage that begins Jan. 1.

The government, which has a spokesman with a first and last name (Julie Bataille), acknowledges that a specific number of people registered through Healthcare.gov (137,000) and that a specific number failed to reach insurers (15,000). That error rate,  estimated to be 10-15%, has now been reduced to less than one percent.

I am focusing on the specificity of this Washington Post report, because it is atypical of Obamacare coverage. Typical Obama care coverage is like this New York Times report.

Enrollment Errors Cut, Officials Say; Fixes Are Overstated, Insurers Report

The Obama administration said Saturday that it had reduced the error rate in enrollment data sent to insurance companies under the new health care law, even as insurers said that the government’s records were still riddled with mistakes.

How many specifically were "riddled?" Neither the Times nor the insurers they quote answer that question. Instead they describe what the mistakes were. They don't enumerate them. They just describe them.

In some instances, they said, the federal government reported that the home address for a new policyholder was outside an insurer’s service area. In other cases, a child was listed as the main subscriber — the person responsible for paying premiums — and parents were listed as dependents.

In some cases, children were enrolled in a policy by the federal government and parents were left off, or vice versa. In other cases, the government mixed up the members of a family: A child or spouse was listed two or three times in the same application in late November. Such errors can have financial implications, increasing the amount of premiums that a family is required to pay.

While some of the problems were discovered in the last few days, insurers said that they had previously reported many of the errors to the “help desk” at the Centers for Medicare and Medicaid Services, and that the problems remained unresolved.

Federal officials, insurers and health care providers said they were concerned about confusion and possible chaos in the early days of January, when people try to use the new insurance coverage they believe they have.

No hard data. Just 'many are riddled' and these are some of the mistakes.

What are we supposed to conclude from this laundry list? That no medical coding mistakes have ever been made on insurance applications prior to Obamacare? Did insurers expect to receive error free applications?

My point is, the types of reports coming from the New York Times and others, are not really reports. This is upscale concern trolling, and piling on, based on anecdotal complaining from insurers.

Insurers please give us some hard data about the extent of backend problems that you say you are having, so that we know the scale and nature of the problem, and so we can measure if they are improving; so that patterns can be discovered and problems can be fixed and people can be insured.

Quit this anonymous concern trolling crap and stop still trying to undermine the law of the land. Or don't.

And let your competitor reap the benefits.