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Providers raise data and privacy concerns after COB updates; UnitedHealthCare says it will investigate
Summary
Providers told the Commerce & Insurance panel that UnitedHealthCare added incorrect primary-payer information to members' coordination-of-benefits records, producing provider-side privacy breaches; United said it gets COB data from the state and is investigating, while Commerce & Insurance said it lacks jurisdiction over the Tennessee Anytime system.
Providers and managed-care plans raised a potential data and privacy issue during the meeting when a provider representative said UnitedHealthCare had been adding incorrect primary-payer entries to members’ coordination-of-benefits (COB) records.
Sherry Ernst of Covenant Health told the panel, “United has been adding primary payers to their members COB that don't belong to them. And it's actually created a couple of privacy breaches on our side.” Ernst asked how Tennessee Anytime updates and verifies COB information and requested a point of contact to escalate the problem.
Kim Maltempo, vice president of operations for UnitedHealthCare, acknowledged awareness of some instances and said the plan “does get our COB information from the state,” adding the insurer is investigating with its eligibility team and can follow up offline with providers. Lisa Jordan, assistant commissioner for the TennCare Oversight Division, advised that Commerce & Insurance does not have oversight authority over Tennessee Anytime and offered to connect providers with TennCare’s MCO operations staff who might assist.
The panel did not adopt any formal action during the meeting; Kim Maltempo offered to pursue individualized follow-up and Lisa Jordan offered to broker a connection to TennCare operations. The panel scheduled its next meeting for Oct. 27 at 1 p.m. Central.
