If people start getting these bills.....wake up call?

http://www.jsonline.com/business/news/990325insurancetroubleslead.asp

Insurance troubles lead hospitals to bill patients

By Joe Manning of the Journal Sentinel staff March 25, 1999

A Milwaukee-area hospital group has begun sending letters to patients asking for payments because the patients' bills for treatment have not been paid by Compcare HMO or Blue Cross & Blue Shield United of Wisconsin.

Hospitals and physicians are owed millions of dollars in back payments from the two affiliated health insurance companies who have been plagued for months with computer and claims processing problems resulting from a Y2K computer system conversion.

The letters sent to Covenant Healthcare System patients asks them for payments of hospital bills normally covered by the two health insurers.

Covenant, which said it is owed "millions of dollars" by Blue Cross and Compcare, has five Milwaukee-area hospitals, including St. Joseph's and St. Francis.

"The letter states the patients' unpaid situation and points out that we have done all that we can with Compcare and Blue Cross," said Paul Markovina, a Covenant spokesman.

The letter goes on to say that because Compcare and Blue Cross have not paid Covenant, the hospital system is left with no alternative but to seek payment from the patients.

"We must turn to you for reimbursement," Markovina said, quoting from the letter. It adds that Covenant "suggests" the patients contact Compcare and Blue Cross to try to resolve the situation.

Tom Luljak, spokesman for Compcare and Blue Cross, said the company hadn't seen the letter.

"We have worked successfully with hospitals throughout the area to resolve the problem, and we are disappointed if Covenant has chosen to place the patients in the middle of this situation," Luljak said.

"Any member receiving letters should contact us directly, and we will work with them to resolve the matter."

Bill Bazan, vice president of the Wisconsin Health and Hospital Association, said Convenant's strategy was a good one. After receiving bills, patients "moan to Compcare and Blue Cross as well as their employers.

When the employers complain, that puts more pressure on Compcare and Blue Cross to pay what is owed," Bazan said.

In addition to owning hospitals, Covenant is a joint venture partner with Family Health Plan in Community Health Plan, a health maintenance organization.

Patients of Aurora Health Care, the Milwaukee-based health care system, have also received letters about unpaid back amounts, but the letters have not specifically addressed the Blue Cross and Compcare issue, said Diane De La Santos, an Aurora spokeswoman.

Routine letters are sent to patients for large outstanding balances of more than six months, De La Santos said.

The letters ask patients to call Aurora to discuss insurance coverage.

No bills have been sent to Compcare or Blue Cross patients, she said, and she anticipated none would be.

Carolyn Bellin, spokeswoman for Froedtert Memorial Lutheran Hospital, said the hospital has not sent dunning letters to Blue Cross and Compcare patients.

Sister Renee Rose, president and chief executive officer of Horizon Healthcare Inc., the system Froedtert belongs to, said she feared hospitals may be losing patient co-payments -- which can range up to 20% of bills -- because of the billing snarls.

She said she was meeting next week with Compcare and Blue Cross officials "to discuss some of these issues."

-- maji (majiWI@yahoo.com), March 25, 1999

Answers

OK, right now the economy can handle this kind of snafu. Only those folks directly affected in Wisc. are pulling their hair out. (Just as only those folks living in the Maine/Quebec ice storm area were directly affected last winter.)

But multiply this kind of snafu by a factor of 100 (or 1,000 or 10,000?) next year at this time. Can our economy handle that? Not likely.

That "bump in the road" is starting to look like Mt. McKinley.

-- rick blaine (y2kazoo@hotmail.com), March 25, 1999.

Blue Cross in the news...again.

-- Kevin (mixesmusic@worldnet.att.net), March 25, 1999.

The medical system is a nervous heavily computer-dependent web.

-- Leska (allaha@earthlink.net), March 25, 1999.