Anthem Blue Cross Blue Shield was reported to be Billions of dollars behind on provider payments in October 2021 due to onerous new reimbursement rules, computer problems, and mishandled claims. Healthcare providers state the company is still behind on payments, causing providers to leave the Anthem network.
The company responded in February 2022 the delinquent payments are now in the Millions of dollars.
It is not only large hospitals suffering from delayed payments. The Mental Health Clinicians Action Network of Connecticut submitted a complaint against the state’s insurance commissioner on behalf of 450 private practice mental health providers. The complaint cited difficulty being paid, frequent unexplained recoupment of funds, hour-plus wait times before speaking with a representative who often is unable to help, and the lack of a pay raise for over a decade. The complaint cited a poll stating that 84% of clinicians surveyed said they were considering leaving the Anthem network.
The delay in payments is not only affecting providers but patients are being affected; as their healthcare providers exit Anthem networks, patients are left with higher out-of-network costs for services.