NEWS BRIEFS
NEWS BRIEFS
Help for denied claims available on line
Tips and techniques on how to appeal denied insurance claims effectively are offered on the Internet through The Appeal Letter. The free bimonthly on-line newsletter, available at www.integsoft.com/appeals/tal, includes articles on appealing certain types of claims denials, a regular column focusing on appeals success stories, and links to regulatory information on the Internet.
"Appealing denied claims is one of the most effective steps medical providers can take to lessen the burden of accounts receivables on their businesses," says Tammy Tipton, president of Appeal Solutions, a Lewisville, TX-based consulting firm that specializes in claims consulting for hospitals and physicians.
The company publishes a print version of the newsletter. It also publishes other resources, including an Insurance Recovery Software System that assists providers in appealing denied insurance claims.
For more information, contact Appeal Solutions at 1565 W. Main St., No. 208-112, Lewisville, TX 75067. Telephone: (972) 219-7666. E-mail: [email protected].
Y2K guidance available on the Web
The new Y2K Information Center, an extensive list of resources to assist doctors in dealing with the millennium bug, has been created by the Washington, DC-based American College of Physicians-American Society of Internal Medicine.
The Web site includes:
• "Selecting a Software System," a guide for replacing non-compliant computer equipment;
• a list of steps to take to make sure your medical practice is Y2K-compliant;
• guidance on how to check out medical devices and business support systems;
• links to outside sites that offer free vendor inquiry forms, software for testing computer hardware, and compliance reports on specific medical devices.
The guide is available on line at http://www.acponline.org/y2k.
State fines 14 plans for violating prompt-pay law
Top fine nearly $52,000
The New York superintendent of insurance has levied fines totaling $115,800 against 14 health insurers and HMOs for violating the state’s Prompt Pay Law. This is the second time this year the state has taken such action. The first round of fines resulted in penalties totaling $72,200.
The state’s department of insurance has received over 28,000 slow-pay complaints from providers since the Prompt Pay Law went into effect in January 1998.
"We are putting all health insurers on notice that they must pay patients and providers on a timely basis," says Neil D. Levin, superintendent of insurance. "We will closely monitor industry compliance with the Prompt Pay Law and continue to impose penalties on those companies that fail to comply."
New York’s Prompt Pay Law requires HMOs and insurers to pay undisputed health insurance claims within 45 days of receipt, ensuring the prompt, fair, and equitable payment of patient and provider claims.
The companies were fined $100 per violation of verified complaints for late payments from Oct. 1, 1998, through Feb. 1, 1999. By agreeing to pay the fines, the plans acknowledged that they failed to pay claims promptly and agreed to make corrections necessary to avoid future late payments.
The late-paying plans and their fines included: Oxford ($51,900), Aetna/US Healthcare ($31,900), Empire Blue Cross Blue Shield ($1,200), Pruden tial Healthcare ($1,900), Unicare ($1,200), Wellcare ($1,200), HIP ($7,100), NYLCare ($2,400), GHI, ($2,200), CIGNA ($2,700), Capital District Physi cians Health Plan ($1,100), Health Now ($1,200), VYTRA ($8,300), and CHP ($1,500).
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