It is not controversial to ask companies to pay their bills on time, talk to their partners when there is a dispute and provide a reason if they are not going to pay their bills. This is what HB2290, sponsored by Rep. David Cook, R-Globe, asks the commercial health insurers to do. Why are business organizations like the National Federation of Independent Businesses and the Arizona Chamber of Commerce opposed to this concept?
For hospitals like Cobre Valley Regional Medical Center, an independent critical access hospital in Globe, it is an ongoing challenge to get paid fairly, and on time, by the huge national insurance companies that control healthcare today. Staff at that hospital spend hours on the phone every day trying to get information from the health plans—why are claims for the care we have provided to residents in our community routinely denied? When those claims are denied, all we want is a person we can talk to and find out why. If we appeal the denial and the health insurance company still denies payment, it is only fair to have a neutral third party mediate the dispute without having to go to court.
When we hire a new physician or other healthcare provider, it is reasonable for that person to begin treating patients right away, instead of having to wait months, if not up to a year, for the health plan to decide to start paying for the physician’s services. It is hard enough to recruit providers to Globe—these health plan practices just make it harder.
For physician practices like Arizona Community Specialists (ACS), there are difficulties with respect to the approval of care and payment of claims for medical services. The average time for a claim to be paid for ACS is 26 days, which only adds expenses, which are carried by the physician practice. Additionally, the customer service portals for physicians and patients alike are a labyrinth of broken technology that isolates customers. This results in medically necessary care being deferred or denied to patients.
Rural providers cannot open more facilities and provide free care to our patients if the health plans continue to give us the runaround on payments. We just want to be paid for the work we do; it should not be controversial. On behalf of physicians and hospitals who provide life-saving care to Arizonans every day, we must support this effort to ensure we are fairly compensated in a reasonable time frame. HB2290 does not add any new mandated benefits that would increase costs—it just asks health insurance companies to honor their agreements. It is time to hold healthcare payers accountable.
Neal Jensen is the Chief Executive Officer of Cobre Valley Regional Medical Center, an independent, critical access hospital in rural Arizona. Dr. George Bradbury is the Chief Executive Officer of Arizona Community Specialists, providing exceptional care and service throughout Arizona, without exception.