'A bureaucratic mess': insurers' slow payments frustrating hospitals

Mike DeWerff, CFO for Lincoln, Neb.-based Bryan Health said the health insurance industry has been slowing down payments, the Lincoln Journal Star reported Dec. 3. 

Previously, commercial payers took about 50 days to pay claims submitted by Bryan, Mr. DeWerff said in the report. That length of time has increased by about five days, or 10 percent. 

Mr. DeWerff said Bryan is also seeing more claim denials per quarter. In 2019, Bryan averaged about 800 denials per quarter, but that has increased to about 1,200 per quarter in the second half of 2022. 

Nebraska Hospital Association President Jeremy Nordquist told the new outlet the state's hospitals are seeing more requirements for prior authorization as well. 

Mr. DeWerff said that a hospital the size of Bryan Health doesn't feel "that big of a financial sting" by being paid a few days later, but what does cause a financial burden is the amount of staff Bryan has to employ to deal with insurers.  

North Platte, Neb.-based Great Plains Health CEO Ivan Mitchell told the outlet that payers' tactics are leading to "a bureaucratic mess in making it more difficult to get paid." He also called Medicare Advantage plans "Medicare Disadvantage," and said those companies look for ways to deny claims and not provide services they promise.  

Nebraska hospitals are not the only ones seeing "slow pay," according to the report. Tracy Berry, chief revenue officer of St. Louis-based BJC HealthCare, told Becker's in October that her and other hospital financial leaders are seeing their accounts receivable increase due to slow payments from insurers.  

America's Health Insurance Plans did not respond to a request for comment from the Lincoln Journal Star, but, in May, its president and CEO Matthew Eyles defended Medicare Advantage insurers' practices to CMS, according to the report. 

"We are quite aware that certain provider organizations would prefer that all clinicians be given a blank check to order any test or procedure at any time, regardless of the expected value or expense to the patient," Mr. Eyles said. "But giving clinicians carte blanche is no way to improve health care affordability and access for every American — and we have known for decades that more medical care does not equate to better care."

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