Healthcare industry braces for questions, confusion under new ACA coverage

As 2014 begins, so does coverage under the Affordable Care Act, which means hospitals, doctors and insurers must deal with questions and confusion from the newly insured.

More than 2 million people have enrolled for coverage through the site since October, Reuters reports. However, changing deadline dates and technical snafus throughout the enrollment process have healthcare providers geared up for a rough start to coverage. 

"It will be difficult for us to actually verify coverage--that's my concern," William Wulf, M.D., chief executive of Central Ohio Primary Care, which has 250 primary-care physicians, told Reuters.

Fort Lauderdale, Fla.'s Broward Health invested about $100,000 in new computers to help people enroll online under the health law at 19 of its locations, Chief Executive Frank Nask said in a Wall Street Journaarticle. The health system treats about 14,000 people through a charity-care program, and Nask expects about 4,800 of them will qualify for the new plans, which means the hospital should gain new paying customers. 

Before offering free care, Broward now will ask to see proof that patients were unable to obtain coverage under the law. "There's a lot more art to this than science," Nask told the WSJ. 

Insurers are also having trouble determining who's actually covered after the government admitted it transferred some data and information to payers incorrectly, with many patients still without proof of insurance like insurance cards, Reuters reported.

Insurers call these patients "orphans"--sign-ups the government has a record of, but who don't appear in the insurer's system, and "ghosts"--new customers that insurers have a record of, but whose information doesn't appear in the government's database, according to PBS Newshour.

Although the number of errors has dropped since the start of the program, there's still no way to quickly correct the mistakes, which could have serious implications for those seeking treatment.

"There are going to be problems for any number of people who thought they had signed up, and it won't work right off the bat," Mark McClellan, who oversaw the rollout of Medicare's prescription drug benefit, told PBS. "It would be particularly disruptive for people in the midst of treatment."

But Lynn Richmond, chief of staff at New York's Montefiore Medical Center, told Reuters the organization is ready to handle all the likely questions from the newly insured. She said the medical center trained staff on how the new healthcare plans work, partly so they could help patients resolve any coverage issues. "There's not a lot of active worry on our part," Richmond said. "We feel ready to manage the hiccups."

To learn more:
- here's the Reuters article
- read the PBS Newshour article
- check out the Wall Street Journal article