09/16/2011
Letter from Chris Gorey
September is upon us, and we can already feel the transition in the weather after a beautiful late summer. Autumn is one of my favorite seasons. It's an exciting time, with baseball pennant races heating up and football season starting. With back-to-school excitement and the holidays around the corner, it's an optimistic time as well.
I'm optimistic about Regence's business as I look ahead to the end of this year and the beginning of 2012. With another year into our new centralized administrative platform we're seeing improvements in our core group service operations. Although, if you've seen some of the news coverage generated by the OIC's recent press release, you may be surprised by this comment.
Allow me to explain: Over the past year I've seen our platform make great strides in improvement and maturity. I've heard from many of you that most of the challenges we had in serving our group and association clients in Q1 and early Q2 have dissipated, and our service levels have stabilized in recent months. But we know there's still room for improvement.
We don't want to simply perform at the level of our peers; instead, we've always been known for providing exceptional service and exceeding market expectations. To that end, as our natural progression from our platform sell-over efforts advanced to platform optimization, we recently deployed a Performance Improvement Office (PIO). The PIO is focused on all opportunities for operational improvement, from system enhancements to process flow modifications; and from quality controls to elimination of wasteful duplication. This is what I mean when I say our platform is maturing. As of Jan. 1, 2012, our sell-over will be 100% complete, which means our focus on a variety of operational improvements will accelerate.
As for the OIC's concerns, the week before their press release we had what we thought was a productive, in-person discussion with the Commissioner and a number of his key staff. We regret that we've experienced a few specific issues that have affected a small subset of our membership. We also take full responsibility for our operational challenges, which have since either been corrected or are being addressed by specific action plans. The most notable issues were:
- Surepay auto-bank draft errors for Individual members' rate payments: Last month, our automatic payments system, Surepay, experienced an operational malfunction that caused a bank routing error. Unfortunately, this error meant that 6,671 Regence members' rates weren't withdrawn on the scheduled date (there was no impact to the members' coverage). Additionally, 201 non-members had rates withdrawn from their accounts due to the error. Because of how some banks identify automatic withdrawal transactions for their customers, the names and identification numbers of some Regence members who use Surepay were inadvertently disclosed to the non-members.
Upon being alerted to the error, we told all impacted members that we had identified the problem and resolved it. We notified the banks and worked with them to immediately restore funds that were withdrawn from non-members' accounts.
- Uniform Medical Plan (UMP) customer (state employees) claims delays: We have had challenges that resulted in a backlog on a select group of members who are eligible for both Medicare and UMP benefits. These claims are very complex as they involve CMS data and both our commercial and Medicare systems. We have been working with the Health Care Authority, providing them with an action plan to resolve the claims backlog, implement system upgrades, and automate the processing of these claims in the future.
These issues do not relate to our core group services operation and generally will have minimal, if any, impact on your group customers. As always, we want your feedback. If you're experiencing any service or operational issues, please raise those concerns with me or any member of our Sales team. We pride ourselves on being here for our customers and on quickly resolving any issue that may arise.
As we put these challenges behind us, I'm looking forward to an exciting year ahead. You'll soon hear about a new large-group customer that will further validate our total value proposition. In this issue, you'll read that we're simplifying our small-group portfolio. In a special release of Producer News next week, you'll hear about a new offering that features our most popular plan types and enables a new degree of choice and personalization for small businesses. I look forward to telling you more about these and other opportunities for 2012.
Thank you for your continued confidence in Regence.
Chris Gorey
VP of Sales
Regence BlueShield
« Back to Communications
|
