Anthem Blue Cross, the country's second-biggest health insurance company,
is behind on billions of dollars in payments owed to hospitals and doctors because of burdensome new reimbursement rules,
computer problems and mishandled claims, say hospital officials in multiple states. Anthem, like other big insurers, is using the COVID-19 crisis as cover to start "egregious" policies that harm patients and pinch hospital fi-
nances, said Molly Smith, group vice president at the American Hospital Association. Hospitals are also dealing with a spike in retroactive claims denials by UnitedHealthcare, the biggest health insurer, for emergency department care, AHA says. Disputes between insurers
and hospitals are nothing new. But this fight sticks more patients in the middle, worried they'll have to pay unresolved claims. Hospitals say it is hurting their fi- nances as many cope with COVID surges. "We recognize there
have been some challenges" to prompt payments amid the pandemic, Anthem spokesperson Colin Manning
said in an email. "We apologize for any delays
or inconvenience this may have caused." Virginia law requires insurers to pay claims within 40 days. In a Sept. 24 letter to state insurance regulators, VCU Health, a system that operates a
large teaching hospital in Richmond, said Anthem owes it $385 million. More than 40% of the claims are more than 90 days old, VCU said.
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2021/11/23 – Risk & Insurance Management Society and Hong Kong Confederation of Insurance Brokers Present: The Science of Risk Management
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