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SFHSS and Blue Shield report fewer calls but retirees say problems persist after Medicare Advantage transition
Summary
San Francisco Health Service System and Blue Shield of California said call volumes and call-center metrics improved following the Medicare Advantage PPO transition, but retirees and advocacy groups told the board ongoing issues remain, including benefit replication and acupuncture claims.
San Francisco's Health Service System (SFHSS) and Blue Shield of California told the SFHSS Health Service Board on March 13 that transition-related call volume and service metrics for the Blue Shield Medicare Advantage PPO have fallen since January, but members and advocates said problems persist and need additional outreach and fixes.
SFHSS Chief Operating Officer Ray Guillen said the number of members walking in or calling for help related to the Blue Shield MAPD transition “has dropped by 50% compared to January,” and that the system’s average speed to answer, average handle time and first-call resolution improved in February. Guillen said HSS hosted a March 4 roundtable with Protect Our Benefits, Blue Shield leaders and SFHSS staff to discuss member-reported issues.
The session’s purpose was to assess remaining problems and Blue Shield’s plans to resolve them, Guillen said. “Once we move away from these monthly transition updates, we will continue to share with this board the HSS and Blue Shield call metrics in the…
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