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UnitedHealthcare and Blue Shield brief Health Service Board on urgent-care access; board presses carriers over phone and directory problems
Summary
UnitedHealthcare and Blue Shield presented follow-up reports on member access to urgent care. Commissioners and retirees reported that phone-based member services could not locate in‑network urgent‑care centers; carriers pledged retraining, committed to follow-up audits, and Blue Shield agreed to provide Marin County data.
UnitedHealthcare and Blue Shield returned to the Health Service Board on Sept. 11 to address ongoing member complaints about access to in‑network urgent‑care centers.
Michelle Balrath, vice president of account management for UnitedHealthcare, reviewed customized search tools (myuhc.com), a CCSF‑specific flyer the carrier offered to publish, and a mobile app called "Health for Me." She acknowledged multiple member reports that UnitedHealthcare customer‑service representatives could not provide accurate urgent‑care locations when members called. "We will look that up," Balrath said, and UHC committed to retrain the phone teams, to pull recorded calls for targeted coaching and to return with follow‑up at the next meeting.
Board members and retirees described examples of callers getting incorrect or incomplete phone responses, including being directed toward emergency departments instead of urgent‑care centers. Commissioners emphasized that many members lack internet access and rely on phone support and printed open‑enrollment materials; several asked that urgent‑care phone numbers and guidance appear in the enrollment booklet.
Paul Brown, area vice president for Blue Shield of California, said Blue Shield is working to improve member education and provider messaging, and described a three‑part Blue Shield definition for labeling facilities as "urgent care" (extended hours, walk‑in availability and same‑day appointments). He said Blue Shield has seen modest reductions in emergency‑department use tied to ACO work and offered to supply the board with Marin County directory information requested by commissioners.
Public commenters representing retiree groups urged more printed materials and phone‑based outreach for members without computers. Both carriers said they will follow up with additional data and targeted training; the board asked UHC to "shop" its phone system from non‑office locations and to return next month with verification of improvements.
