It’s important that medical providers stay informed on the insurers they work with on a daily basis—and it’s vital they have access to the most valuable information out there. We’re here to offer that quality information. To help you better understand said insurance companies, we asked 10 medical billers a series of questions, pertaining to their experience with a wide variety of insurers. One of the questions we asked was: What was the slowest an insurance company paid a claim?
We also asked the survey respondents to disclose which company it was and describe exactly what happened. The subsequent results are below, but before you delve into those results, consider the following: while insurers surely hope to process claims efficiently, they likely prioritize processing claims correctly. Doing so prevents them from asking for money back later, which will prevent additional trouble for you in the future.
Two medical billers said they did not have information regarding this question, while two others said the longest it took for an insurance company to pay a claim was two months—however, they weren’t sure which company it was. The remaining six responses listed six different insurance companies as the slowest paying insurance companies: United Behavioral Health, Benefit Plan Administrators, TriWest, Medicare, Medicaid, and Penn Behavioral Health. More information regarding their experiences can be found below.
United Behavioral Health (UBH)
One medical biller said they were “still fighting to get payment from the beginning of 2017” from United Behavioral Health (UBH). “They will ‘pay’ the claim, but then turn around and take it right back,” as stated in this survey response. UBH is a sister company of UnitedHealthcare Community Plan, which specializes in delivering behavioral health and substance abuse services. UBH serves over 60 million members and 5 million public sector members. The aforementioned services include health and wellness programs, behavioral health support, integrated behavioral care, and more.
Benefit Plan Administrators (BPA)
Another medical biller said that Benefit Plan Administrators (BPA) was the slowest paying insurance company, but they did not provide additional details. This company has been providing healthcare services to employers for almost 50 years. Their mission is to help clients save money and also secure benefits that help them live their best life. Furthermore, they pride themselves on offering custom plans, innovative solutions, and flexible networks.
TriWest Healthcare Alliance
Another survey respondent said that TriWest took the longest to pay a claim. According to this medical biller, “they hold claims for 30 days before looking at them.” TriWest is dedicated to serving our nation’s Veterans and military community. There motto and mission is to do “whatever it takes,” as they strive to go above and beyond for all of their customers. Furthermore, TriWest respects the military culture, understands and honors the sacrifices that are made, and is committed to providing their customers with the support they deserve.
One medical biller listed Medicare as the slowest paying insurance company. More specifically, they said that it typically takes them 2+ months to process a claim. Medicare is a federal health insurance program, which is available to people over 65 years old, select younger individuals with disabilities, and those with End-Stage Renal Disease. This program covers inpatient hospital stays, outpatient care, certain doctors’ services, medical supplies, preventive services, and more.
Another biller said that Medicaid is typically slow to pay a claim, but they did not offer additional information. This program provides coverage and services to millions of Americans, from eligible low-income adults to children, pregnant women, elderly adults, and people with disabilities. Additionally, Medicaid is administered by the states, according to federal requirements, and is funded jointly by the states and the federal government.
Penn Behavioral Health (PBH)
The final survey response listed Penn Behavioral Health (PBH) as a slow paying insurer: “It is a pretty slow insurance company to process claims. I find myself always calling to check the status.” This program is run by the Department of Psychiatry at the University of Pennsylvania, which works to treat, prevent, manage, and rehabilitate psychiatric and behavioral health disorders such as schizophrenia, bipolar disorder, depression, and anxiety. Additionally, they conduct innovative research and educate future leaders in behavioral health.
Before an insurer can process and pay a claim, they must first take the time to analyze it and understand the care an individual received. Only then can they apply one’s benefits accordingly and see that the claim is processed properly. So, while most every insurer sets out to process claims as quickly as possible, they are understandably more concerned with doing so correctly. Keep this in mind while considering the above results and remember: there’s a plethora of information out there to review in regard to your partnership with said companies. These survey results are just a small piece.