Delaware Fines BCBS $325k for Deficiencies in Pre-Authorization Process

Delaware Insurance Commissioner Karen Weldin Stewart has fined Blue Cross Blue Shield of Delaware $325,000 due to deficiencies in the health insurer’s nuclear cardiac imaging testing pre-authorization process, according to a Newark Post report.

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Concerns arose months ago that the insurer was not approving or paying for the nuclear cardiac stress tests, which were requested by Delaware physicians to diagnoses heart blockages.

According to the report, Ms. Stewart has also said BCBS of Delaware will enter a new pilot program with the American College of Cardiology, which ensures the tests of patients enrolled in the program will be automatically approved. If BCBS of Delaware does not go through with the program, it could face an additional $300,000 charge to “address the concerns uncovered in the examination,” the report said.

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