by Todd Adams

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Trustees of the North Custer Hospital District (NCHD) agreed February 21 to sign a letter to Rep. Lenore Barrett in support of "Prompt Pay" legislation being considered by an Idaho House committee.

The bill requires insurance companies to pay claims within 30 days or advise the medical provider (the clinic) specifically as to the problems with the claim.

"Contrary to what you might hear from lobbyists for the insurance industry, there is a problem with prompt pay in Idaho, as we have seen in the billing of both medical entities we manage [the clinic and ambulance service]," the letter reads. "And if the lobbyists suggest that it will raise the cost of healthcare in Idaho, it will only becase the insurance companies will finally be forced to pay claims in a timely manner....

"Because insurance companies have developed a myriad of ways to avoid paying on claims that are legitimately theirs, we end up covering for that delayed and/or lost revenue by using taxpayer dollars. We believe this legislation is the first step in holding insurance companies to the same level of financial accountability that we as providers of medical services are held to," the letter concludes.

Challis Area Health Center (CAHC) Administrator Kate Taylor told the board she's seen insurance companies reject claims for "ridiculous reasons," or for no reason at all. When there's an error in a bill, it's frustrating for Taylor and the clinic staff when the patient automatically assumes the clinic has done something wrong. "We're in the business of health care. Insurance companies are in the business of making money," Taylor said.

Trustee Don Barker said he's sometimes been unable to collect his co-pay from the insurance company because some billing or claim problems have taken over a year to resolve.

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The Challis Messenger

-- Anonymous, March 10, 2002