B2B Payments

Kansas Health Insurance Providers Struggle With Payments Process

The Kansas Department of Health and Environment (KDHE) recently released a report showing that the three private insurance companies administering the state’s managed care Medicaid programdid not make timely payment claims during its first full year of implementation.

“We are withholding part of the MCOs’ payments for failing to meet the requirement that they process 100 percent of clean claims within 20 days and 99 percent of all non-clean claims within 45 days,” KDHE spokeswoman Sara Belfry told The Topeka Capital Journal. “None of the MCOs met this pay-for-performance measure any month during the first year of implementation.”

Additionally, the Kansas Hospital Association (KHA) provided testimony at a legislative meeting this week, which stated that Kansas hospitals have seen an increase in accounts receivable more than 90 days old since the state switched to managed care. The survey results reflect the association’s members’ concerns, the KHA said.

“Hospital patient accounts receivable under KanCare that is over 90 days old is significantly higher than it was under the fee-for-service Medicaid program. And when compared to Medicare and the hospital’s highest volume commercial payor, the hospital accounts receivable comparison is even more out of line.”


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