PONCA CITY, Okla. (KFOR) — A SoonerSelect patient says he is unable to visit doctors or pick up prescriptions after his date-of-birth somehow got changed in SoonerSelect’s system several months ago, and still hasn’t been corrected despite numerous phone calls.
James Henley says, when SoonerCare switched him to a new SoonerSelect plan with Humana earlier this year, his new insurance card contained the incorrect birthdate and group number.
He has been unable to get the problem fixed despite placing numerous calls to Humana and the Oklahoma Healthcare Authority (OHCA)—the state agency that administers SoonerSelect.
OHCA told NewsNation affiliate KFOR they could not discuss Henley’s situation due to HIPAA regulations, but said they only change information in their system if the patient consents to it.
They recommended anyone in his situation call their helpline.
If there’s one date Henley always remember, it’s the date he’s always known to be his birthdate.
“11/2/77,” Henley told News 4.
That’s the date he’s always given out when he visits the doctor or pharmacy.
Until recently, it was even listed on his health insurance card.
“That’s all I’ve had for 46, almost 47 years,” Henley said.
Henley is insured through OHCA’s SoonerCare program.
On April 1, SoonerCare switched him to a its new SoonerSelect program, insuring him through private health insurance company Humana.
When he received his new insurance card on April 1, he noticed a problem.
“It had the wrong ID number,” he said.
Since the ID number didn’t match his previous card, he gave Humana a call. He says they told him they would fix the issue and send him a new card with the correct ID on it as soon as possible.
He still hadn’t received his new card by the time he visited his cardiologist’s office for a regular appointment in July.
At that appointment, he was surprised to learn—according to insurance records—his birthdate had apparently changed.
“His secretary tried running my insurance and told me that my birthday was not matching up,” he said. “I was like, ‘what is it?’ And she goes, ‘It’s 11/11.’ I go, ‘Well, that’s not my birthday.’”
A couple days after that, he finally received his new insurance card in the mail.
The card listed the correct ID number, but now also listed an incorrect birth date and group number.
Henley called Humana.
“They said talk to [OHCA],” Henley said. “I talked to [OHCA]. They said, ‘oh, we have it fixed for you. [Humana] should go see it on their side.’ Now I call [Humana] back and they say, ‘oh, this will take 24 to 72 hours.’ I call back in 72 hours. They say, ‘oh, we don’t see nothing about it. You need to call Oklahoma Health Care Authority again.’”
Henley said he’s been going through the same cycle of phone calls for nearly two months now.
With several doctor appointments and prescriptions coming up, he’s facing a choice: give out correct birthdate and be denied health services, or lie and give out the incorrect birthdate listed on his insurance file as if it’s the correct one.
But he worries the latter option would cause him more problems.
“Identity fraud, insurance fraud,” Henley said.
He’s cancelled upcoming appointments with his pulmonologist and cardiologist.
“They’re very important,” he said. “I feel like I’m failing my own life right now.”
He’s ‘failing’—despite answering all the questions right.
“I mean, everybody knows you can’t have two birthdays,” he said.
News 4 reached out to OHCA.
A spokesperson told News 4 they could not discuss Henley’s situation due to HIPAA restrictions.
The spokesperson sent News 4 the following statement:
“The Oklahoma Health Care Authority ensures that no member information is changed without the member’s knowing consent. If a member finds their information is incorrect, OHCA can easily update it. Members call the SoonerCare Helpline at 800-987-7767 or change it themselves by logging into MySoonerCare.org.”
