“As one of the largest insurance companies in the country, they need to be able to process claims in a timely manner,” Steve Ahnen, president of the New Hampshire Hospital Association, told NHPR.
While Anthem maintains that the delays were due to technical issues and challenges posed by the pandemic, the hospitals say the problems go beyond that. “Due to challenges, these percentages dipped slightly earlier in the year, by 1 to 1.5 percent, but we are back at targeted rates for processing levels,” DuBois said. The insurer said 95 percent of claims in the state are processed within 14 days, with over 98 percent paid within 30 days. “There is a complete lack of accountability on Anthem's part.”Īfter approaching Anthem with their concerns, in July the insurer and hospital representatives began meetings to resolve the repayment delays, though the accounts payable balances have continued to grow since then, according to the survey.Īnthem, however, said it is currently processing claims at its “targeted level” and disputes allegations made by the hospitals that it is slow to repay its providers. “The amount of administrative time staff have to expend to conduct business with Anthem is unreasonable,” one survey respondent wrote. The survey results were obtained by NHPR, and have not previously been released publicly.Īlong with the rise in outstanding bills, hospitals say they’re also frustrated with “roadblocks” faced by their staff in working to resolve denials of coverage for medical services.Īccording to the survey, 20 out of 22 hospitals in New Hampshire reported Anthem had incorrectly denied claims, while other hospitals complained about long wait times to resolve disputes. Hospitals in New Hampshire reported widespread frustration with Anthem's customer service and claims processing systems. “We are dedicated to those we serve and partner with, and are focused on solving these challenges.”
#ANTHEM CUSTOMER SERVICE UPDATE#
“We recognize there have been some challenges as we work with care providers to update claims processing,” Stephanie DuBois, Anthem Blue Cross’s director of public relations said in a statement. In a statement, Anthem said the delays were caused by updates in its claims processing system and due to difficulties posed by the pandemic. “We understand there are issues with Anthem’s accounts receivable – we are concerned about it, and have been proactively working with Anthem and impacted providers to address this issue,” a department spokesperson said. The New Hampshire Insurance Department is aware of the back payments and said it is monitoring the status of Anthem’s outstanding bills, though regulators noted they believe the company is still processing payments at a rate that is on par with other insurers in the state.
Results from a survey of 22 hospitals in New Hampshire focused on delays in repayments by Anthem.
Those figures are likely 20 to 50 percent less. Those figures, however, represent billed charges and don’t reflect the actual expected repayments previously negotiated between Anthem and the medical providers. According to the survey, the hospitals report that Anthem, the state’s largest health insurer, has failed to process $300 million in claims submissions, with $181 million of that outstanding debt more than 30 days old. The delayed payments, which have drawn the attention of the New Hampshire Insurance Department, appear part of a nationwide trend of unpaid claims by Anthem, the country’s second-largest insurance company.Īfter Anthem allegedly began falling behind on payments, the New Hampshire Hospital Association surveyed 22 hospitals twice, in May and September. Get NHPR's reporting about politics, the pandemic, and other top stories in your inbox - sign up for our newsletter today. Anthem Blue Cross is working to clear a backlog of claims resulting in delayed payments for some medical providers in the state that an industry group says has grown into hundreds of millions of dollars.
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