Performance of Blue Shield of Massachusetts Under the Tri-State Contract

HRD-88-81BR: Published: Mar 31, 1988. Publicly Released: May 3, 1988.

Additional Materials:


Office of Public Affairs
(202) 512-4800

In response to a congressional request, GAO provided information on a Medicare carrier's quality of service in Maine, New Hampshire, and Vermont, specifically its: (1) timeliness of claims payment; (2) payment accuracy; (3) telephone service; (4) review of denied claims; (5) responses to written inquiries; and (6) claims records.

GAO found that, in 1987, the contractor: (1) complied with all but one of the contract requirements; (2) met the requirement to process 85.5 percent of all assigned claims in 30 days or less, with performances ranging from 85.5 to 96.3 percent per month; (3) improved its claims payment accuracy to within the specified error rate limits; (4) exceeded the limit for busy telephone lines for beneficiaries in November when it experienced a significant increase in the number of telephone calls; (5) reviewed 98.3 percent of beneficiaries' denied claims within the required 45 calendar days; (6) responded to all beneficiary and provider inquiries within the required 30 days; and (7) complied with the requirement to locate a minimum of 97.5 percent of all claims received.

Oct 19, 2020

Oct 8, 2020

Oct 1, 2020

Sep 30, 2020

Sep 23, 2020

Sep 21, 2020

Sep 17, 2020

Sep 16, 2020

Sep 14, 2020

Sep 3, 2020

Looking for more? Browse all our products here