Citibank recently had a massive mistake. They meant to restructure $900 million in debt and make an interest payment while doing so. Wrong buttons were pushed and the principal went out instead. Discovering their error the first call was to technical support. They asked for the money to be returned. $400 million came back and the recipients of the other $500 million said “Nope. We’re good.”
The judge ruled they were owed the money and could keep it. There is a multistep process for payments to go out. Citi is a big established company. They should know what they are doing.
For the last two months Anthem Blue Cross Blue Shield has been misprocessing claims. In-network services are being processed as out-of-network and checks for unadjudicated amounts are going to patients. What does that mean? It means the exorbitant rate that a provider charges before it is marked down is being paid to the patient. The rate nobody ever pays is being paid. And it is being paid to the patient. Imagine taking an ambulance ride and the $6000 bill is paid to you. Do you cash it? Do you spend it?
When an over-payment is made to a provider, the insurance company asks for it back with the threat of taking it back from future payments if it is not sent. How is Anthem going to get money back from 100,000 patients? I look forward to the lawyer representing thousands of these patients arguing that Anthem has been processing claims for years. They don’t make mistakes much less for two to three months straight. As the appeals letters we received say, these claims were processed correctly.
Straightening this out is going to be painful for everybody and will take months. It would have been nice if Anthem ever communicated that there was a problem to begin with. I guess they don’t make mistakes. I wonder if the judge at this trial will agree.