CHICAGO (AP) — The new year brought relief to some Illinois patients newly insured under the nation’s health care law. Others still weren’t sure whether they were covered, despite their best efforts to navigate the often-balky new system.
The major benefits of President Barack Obama’s health care overhaul took effect Wednesday, the first day of 2014. By Thursday, the first business day of the new insurance system, it became clear that snags in the rollout of the Affordable Care Act still remained.
On the plus side, the law’s protections mean consumers can no longer be denied coverage if they’re in poor health. New limits on how much insured patients must pay for care will mean fewer bankruptcies after catastrophic illnesses. Insurance plans must offer a minimum level of essential benefits, and care such as flu shots and mammograms will be fully covered without cost to patients.
But early problems with the federal HealthCare.gov website led many people to wait until last week to sign up, and insurers are still processing enrollment forms.
Paperwork problems almost delayed suburban Chicago resident Sheri Zajcew’s scheduled surgery Thursday, but Dr. John Venetos decided to operate without a routine go-ahead from the insurance company. That was after Venetos’ office manager spent two hours on hold with the insurer Thursday, trying to get an answer about whether the patient needed prior authorization for the surgery. The office manager finally gave up.
“I’m not a happy camper,” said Nate Zajcew, the patient’s husband. The couple signed up for a Blue Cross Blue Shield bronze plan through the federal HealthCare.gov site on Dec. 16. “I understand it’s just a matter of paperwork and yesterday was a holiday. I can be an SOB, too, at times, but since they’re going on with the procedure, it’s OK.”
Venetos, a Chicago digestive system specialist, described “tremendous uncertainty and anxiety” among patients calling his office recently. Some thought they’d signed up for coverage but hadn’t received insurance cards yet. Others had insurance policies that were canceled and weren’t sure if their coverage had been reinstated after Gov. Pat Quinn decided to allow one-year extensions of canceled plans.
Venetos said he has decided to take a risk and provide care for these patients, at least until there’s less confusion about coverage.
“We feel it’s the right thing to do,” Venetos said. “We may end up stuck holding the bag and not getting paid on these claims.”
http://washington.cbslocal.com/2014/01/03/doctors-office-spends-2-hours-on-hold-with-health-insurer-for-patients-surgery-authorization/