For the past two years, mega health insurance company Anthem has experienced significant payment delays, resulting in millions of dollars owed to hospitals across the country, including right here in Wisconsin.
“We are hearing from more and more of our members that have concerns about Anthem payment delays,” said WHA President and CEO Eric Borgerding. “Whether it is due to technical system issues, lack of sufficient staffing, or other challenges doesn’t really matter—health care providers are too often left holding the bag when insurers systems fail.”
According to
a recent report from Becker’s, hospitals in New Hampshire have experienced claims processing delays since 2021, now totaling about $300 million. According to a New Hampshire Hospital Association report, about 1/3 of the accounts receivable were outstanding for greater than 90 days. And in March 2022,
the state of Georgia fined Anthem $5 million for failure to pay insurance claims timely.
Hospitals here in Wisconsin are experiencing similar issues, with at least one—Aurora—having filed a lawsuit in September 2022 alleging that despite repeated attempts to resolve the issue with Anthem, it failed to pay 25,000 claims that were pending for more than 180 days, amounting to payments owed on more than $125 million in billed charges.
Aspirus Health in Wisconsin has also experienced significant claims delays. According to CEO Matt Heywood, “We have in good faith provided exceptional care to patients with Anthem insurance. It is becoming more difficult for us to do so, though, given the financial burden we are carrying because of outstanding Anthem claims dating back to last year for which we have received no payment. Anthem has made certain to collect its premiums but has not passed along full compensation to the dedicated caregivers who provide care.”