Health Blog

I received an automated call this morning from my health insurance carrier, Blue Cross Blue Shield of Massachusetts. The robot announced that this was an important call about my health insurance benefits, then proceeded to have me confirm that it was me on the line. After that it gave a little spiel, telling me something about how my responses would help BCBS serve me better and stressing that my responses would be kept confidential.

Then it asked the question. Something like: “During the past year, have you or any of your dependents been covered by another health insurance, dental or prescription plan?”

When I answered “no” the robot said “thank you” and then repeated that this information would help BCBS serve me better and that my responses would be kept confidential.

I don’t have any real problem with BCBS conducting this survey and I think the robot is a perfectly appropriate mechanism for doing so. Nonetheless I’m not thrilled about the way the question was presented.

The main reason for BCBS to conduct the survey is to lower its medical loss ratio. If they can get someone else to pay a claim then they should do so. Coordination of benefits is a difficult and expensive task, so if BCBS uses the information well it may lower its administrative costs, too. In a way, both of these add up to “serving me better” –if it translates into a lower premium or less administrative hassle for me.

However, as far as I can tell the main benefit isn’t for me, but for them.

Also, stressing the confidentiality of my response seems like a red herring. Only the health plans care if I have duplicate coverage, so the promise of confidentiality is self-serving. Does Blue Cross simply mean they won’t tell my other carriers of my Blue Cross coverage so that Blue Cross won’t find itself being asked by those carriers to pay more?

Original post by David E. Williams of the Health business blog

Tags: Administrative Costs, Administrative Hassle, Bcbs, Benefit, Blue Cross Blue Shield, Blue Cross Blue Shield Of Massachusetts, Confidentiality, Coordination Of Benefits, Dependents, Health Business, Health Insurance, Health Insurance Benefits, Health Insurance Carrier, Hello, Insurance, Loss Ratio, Prescription Plan, Red Herring, Robot