Nearly $300 Million in Claims Owed to Hospitals Statewide in Dispute
Concord, NH – The New Hampshire Hospital Association (NHHA) recently released a report highlighting the many challenges hospitals and health systems across the state of New Hampshire are facing in dealing with Anthem, the state’s largest insurance provider, including nearly $300 million in unprocessed claims for services provided by New Hampshire hospitals.
The report highlights the challenges and issues hospitals are facing in dealing with the insurer and the results continue to demonstrate systemic failures with Anthem’s practices, procedures, and overall performance, with the most egregious issue being nearly $300 million in unprocessed claims. Despite efforts between hospitals and Anthem to address the systematic issues causing significant accounts receivable (AR), hospitals have seen minimal improvements, and unfortunately, the dollars in unprocessed claims are higher now than when initially measured in May of 2021.
“This report clearly shows that there is still $298 million in unprocessed claims for services provided to Anthem members,” said NHHA President Steve Ahnen. “This is absolutely unacceptable, and while we had hoped to see demonstrative progress, Anthem has yet to implement real change, has failed to improve known system failures, and continues to rely on hospitals to identify and track their own broken processes,” Ahnen continued.
Anthem’s leaders had assured hospitals that long awaited fixes for many of Anthem’s broken system issues were in place and, that as a result, hospitals would see claims being processed and paid correctly and older claims being adjudicated resulting in a reduction in AR, however, claims processing problems continue to persist and no such reduction has been realized by hospitals across the state as demonstrated by the report.
According to the report, in an effort to mitigate financial risk to patients and providers, hospital staff spend countless hours navigating the maze of Anthem policies, identifying a variety of errors and dealing with inadequate and unempowered customer service. It concludes by stating that hospitals are seeking effective solutions to solving pervasive issues which will create a smoother experience for all parties and result in better working relationships, reduction in AR, and free up resources to focus on what matters most – patient care.
Download the full report here.
