https://www.nbcnews.com/health/health-care/ghost-networks-health-insurance-companies-therapy-rcna210591
Ghost networks in NY and now CT. The data is garbage it always has been and health solutions acts like it’s not a big deal. Let’s just keep reducing that ops staff with no real solution on how to address the issues!
Just wait until other state regulators do their next audits. Some of them charge huge fines for each occurrence of a problem. Ghost networks in other states with tough regulators are going to cost the company a lot of money that EH will pay for with RIFs. The other states have to know about the situation in NY & CT. They're going to get the company on it in their states too. EH leadership is doing a bad job.
Prior Employee here. I am extremely tempted to call Steve Cohen the Attorney that's bringing the lawsuit against Elevance in NY for ghost networks and give him the FULL SKINNY on the SPS story which includes discussions with Leadership, how cr-ppy it is, Availity roster spreadsheets are an abismal joke, and my own personal dealings with Large Providers in the state I worked for whom are STILL having issues since I left. How do I know? They found me working on the Provider side. I'm actually dealing with a multi state Garbage Availity SPS issue that Elevance just cannot get right. It's extremely tempting as Elevance states "all is well." My @@@ it is.
Way to go sps
I'm not surprised. Our company makes no attempt to fix our issues. They put no viable resources in place to remedy things.
This has been going on for years. I just figured it was incompetence. The thing is that the local plan and the sales team has to deal with the angry broker, customer, and regulators.