Business
Ohio medical society wants Anthem investigation
NEWS IN BRIEF — Posted Nov. 3, 2008
In response to widespread problems doctors reported in dealing with WellPoint-owned Anthem Blue Cross and Blue Shield, the Ohio State Medical Assn. has asked the state's Dept. of Insurance to investigate the insurer's business practices.
OSMA did a targeted survey of its membership earlier this year after receiving complaints from members about major delays in getting paid, and having to get preauthorizations for tests and procedures.
OSMA President Warren Muth, MD, a general and vascular surgeon from Dayton, said the survey revealed widespread problems both geographically and by specialty.
"Some practices informed the OSMA that they were forced to devote about 15 to 20 hours a week dealing with Anthem claims service," he wrote in a message to AMNews. He said some practices had to hire extra staff to deal with Anthem, and others said they had delayed procedures while waiting for preauthorizations.
After a meeting with the OSMA earlier this year, Anthem did address some problems, but others have persisted, OSMA spokesman Jason Koma said.
Anthem spokeswoman Kim Ashley said the firm hadn't been alerted to a formal investigation. In an e-mailed statement, Ashley said changes to one of Anthem's claims processing systems earlier this year had caused "a significant disruption for our providers."
The company this year added staff to help reduce wait times for preauthorizations and other phone calls, she said.
The Ohio Dept. of Insurance does not disclose whether it is conducting investigations into specific companies.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/11/03/bibf1103.htm.
