HealthSource RI customers fed up with health care hassles

Spokesperson says new call center could alleviate frustrations

PROVIDENCE, R.I. (WPRI) — Billing issues, enrollment problems, and long wait times are just some of the problems Rhode Islanders are reporting when it comes to the state’s health insurance exchange, HealthSource RI.

Target 12 Consumer Investigator Susan Campbell took your complaints straight to the source to try and get some answers.

The frustration

Marilyn Ross applied for health insurance through HealthSource RI in December.

“We were told to send a payment, which we did,” she said. “This was to have my insurance effective January 1.”

The money came out of Ross’ bank account, but HealthSource RI said they never received it. The same thing happened for the following month’s coverage.

The whole time, Ross was uninsured, even though she was making payments.

“I have had to go to the doctor a couple of times,” said Ross. “I’ve had to have lab work, all out of pocket, even though I had tried to get my insurance in December. It is just beyond frustration. Frustration is not a big enough word.”

Chris Coscina is another frustrated HealthSource RI customer. For several months, he received tax credits and HealthSource RI charged him $0.62 per month for his insurance.

“I don’t make a ton of money,” explained Coscina. “So I figured maybe I was supposed to be getting them.”

But just to be sure, Coscina followed up. HealthSource RI realized there was a problem, and billed him nearly $800 for months worth of past health insurance coverage.

“It has to be paid by the end of the month or they cancel your health insurance,” said Coscina. “I couldn’t pay rent this month, but my landlord is really nice so he said don’t worry about it. I can pay him back next month.”

Both Ross and Coscina said the worst part about dealing with theses issues is that they spent hours on hold waiting for help.

“I think it comes out to about 58 hours on hold to get this insurance,” Ross added.

The call wait times are “not acceptable”

“Clearly, the wait times that our customers have experienced, they’re not acceptable,” said Maria Tocco, a spokesperson for HealthSource RI. “It’s difficult to speak to individual customer complaints. What I can tell you is customer service is our top priority, and we have identified areas where we can make improvements, and we feel we are making improvements.”

According to data provided to Target 12 by HealthSource RI, the number of account discrepancies in billing or coverage declined from about 22% in 2014 to 3% in 2015.

“I think you have to consider that HealthSource is a startup with 35,000 customers and a fairly large budget,” explained Tocco. “We had a very complex technology system to build out, and we have been continuing to build that out as we have been servicing customers. It has been a very complex undertaking and with 35,000 customers, I think you can expect to have a percentage that will have problems. We are certainly sympathetic to the issues that our customers have had.”

In fiscal year 2015, HealthSource RI’s budget was $53.2 million dollars. In fiscal year 2016, the budget was cut to $31.7 million, and in 2017, the budget was slashed even more to $12.3 million.

HealthSource RI is moving

On Monday, April 4, HealthSource RI is opening its new contact center in East Providence and a new vendor will be handling your calls.

“We believe will be able to achieve better outcomes for customers and improve the customer experience,” explained Tocco. “Certainly we would like to reduce the call wait times, and as we continue to improve the technology, we’re hoping that we have even less systems issues.”

Tocco said there will also be more training and more accountability in the contact center. “When the existing contact center vendor contract came up, we saw that as an opportunity to make those improvements,” said Tocco.

Thursday, March 31, is the last day for services at HealthSource RI’s current location on Royal Little Drive in Providence.The contact center will be closed on Friday to allow for the move, and will re-open Monday at its new location at 401 Wampanoag Trail in East Providence. Customers will be able to drop off documents and payments there, but there will still be no in-person assistance available.

More information from HealthSource RI

The new location at 401 Wampanoag Trail will be accessible by Rhode Island Public Transit Authority (RIPTA) Route 32 bus (outbound from Kennedy Plaza toward Tripps Lane via Wampanoag Trail). There is also ample free parking at the new location.

HealthSource RI’s open enrollment period ended on Jan. 31. However, some Rhode Islanders who experience a “life change” may be eligible to enroll through a special enrollment period. Some examples of qualifying life changes that may allow a person to apply for special enrollment include:

  • A job loss resulting in loss of employer-sponsored health insurance
  • A change in family make-up such as marriage, divorce, birth, adoption or foster care placement
  • A change in immigration status (a person must be a U.S. citizen or be lawfully present in the U.S. to buy insurance through HealthSource RI)
  • A move to Rhode Island without access to employer coverage

For a complete list of life-change events or for more information, visit HealthSourceRI.com or call 1-855-840-4774. Rhode Islanders can also receive in-person help from Navigators throughout the state. Visit our website, call 1-855-840-4774 or call 2-1-1 to find in-person help near you.

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