BCBSNC reimbursement delays hurt physician practices

Blue Cross Blue Shield of North Carolina's inability to reimburse some providers due to continuing technical glitches is causing financial strain and headaches for some physician practices, according to an article from the News & Observer.

The article explains that providers who are experiencing difficulty with reimbursements are those whose patients buy their own insurance, often through the Affordable Care Act's federal exchange. According to BCBSNC, only 15 percent of claims have been delayed, and it is due to "configuration issues that are being fixed." BCBSNC has been grappling with tech issues since January.

The insurer's tech issues cause both financial distress and cash flow issues for providers, the article says. Chapel Hill Pediatrics officials also tell the newspaper that a delay in billing patients makes their practice appear disorganized, which jeopardizes patient trust.

Under state law, BCBSNC will be required to pay 18 percent annual interest, or .05 percent per day, on any claims that are unpaid after 30 days, the article says. Some doctors and therapists are owed tens of thousands of dollars, and the North Carolina Insurance Department fears that this may cause some small practices to go out of business.
 
BCBSNC Chief Operating Officer Alan Hughes, who was in charge of resolving the technological crisis, resigned earlier this month. Another executive, Stevie McNeal, also recently resigned, according to the article, and the insurer also could be facing fines from the state.

To learn more:
- here is the article

Suggested Articles

Hospitals are already signaling a legal challenge to a final rule from CMS on price transparency, but the agency is ready.

CMS issued a proposed rule and a final rule aimed at increasing price transparency from hospitals and insurers.

Medicare Advantage insurers are eyeing loneliness as a crucial social determinant of health to target.