Practice Management Alert

In May the Indiana State Medical Association filed a request with state regulators asking for an investigation into payment delays with WellPoint subsidiary Anthem. The Ohio State Medical Association filed a similar request last October. Both medical associations claim that providers in their states have been facing payment issues with Anthem since late 2007.

The complaints include delayed claims payment, poor customer service, and payment errors such as checks being sent to the patients or even the wrong physician.

The prompt-pay law in Ohio requires payers to pay clean claims within 30 days unless additional documentation is required. Comparably, the law in Indiana requires electronic claims to be paid within 15 days and paper claims within 45 days. Practices in both states have reported delays of several months in claims payments from Anthem.

The problems have been caused by Anthem's adoption of a new system to process claims under its BlueCard network, which lets Blues plan members in one state use networks created by Blues plans in other states, according to Anthem.

In other news: According to an Athenahealth study of 172 carriers, Humana, Cigna, and Aetna rank as the top three fastest payers. Humana's accounts receivable averaged 26.7 days in accounts receivable. Aetna followed with 28.4 days, and Cigna ranked third with 30 days. Medicare Part B came in fifth with 33.4 days, and WellPoint rated sixth with 35.9 days.