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KanCare Payments To Rural Hospital Smooth Out

Andy Marso
KHI News Service


A small rural hospital in Hanover, Kan., is on more stable financial footing after one of the private insurance companies administering the state's Medicaid system paid its outstanding claims.

Roger Warren, a physician who runs Hanover Hospital, said last month that $140,000 in outstanding claims from the managed care organizations operating the state' Medicaid program, KanCare, were hampering his ability to pay bills. The $140,000 represented more than half of the facility's monthly operating budget.

Most of the hospital's Medicaid patients came from one of the three companies, United HealthCare Community Plan of Kansas.

RELATED: KanCare Payment Delays Threaten Rural Hospital 

Tim Spilker, the president of the United HealthCare community plan, said the company was working to correct errors in its billing procedure and promised a swift resolution.

In an email this week, Molly McMillen Malat, a spokeswoman for United HealthCare, said "all outstanding billing issues on our end with this provider have been resolved."

Melissa Minge, Hanover Hospital's billing clerk, confirmed in a phone interview this week that the claims processing issues were smoothing out.

“They’re close," Minge said. "They have not paid them all yet unless I just haven’t gotten the check. I’ve got some pending. But it is much better.”

Minge said she last checked the pending claims at the end of last week so some might have been resolved at the beginning of this week.

Officials from the Kansas Department of Health and Environment told legislators last month that none of the three KanCare companies — Amerigroup, Sunflower State Health Plan and United HealthCare — had met contractual goals for timely claims payment in 2013. KanCare, which launched in January 2013, moved virtually all the state’s 380,000 Medicaid enrollees into health plans run by the three companies.

The problems at Hanover stemmed from the facility's 25-bed skilled nursing facility. The managed care companies initially denied claims for some services there, saying Medicare should have been billed first.

Minge said she tried repeatedly, and fruitlessly, to explain to company representatives on the phone that the services were not Medicare-eligible.

Officials from the Kansas Hospital Association said it's a billing issue at other facilities and they're working with the managed care companies to resolve it.

Minge said this week that claims processing is still not seamless, but it's improving.

"I’ve got some denied, saying they still need EOB (explanation of benefits) from the primary, but I have not called them to get those going again," Minge said. “It’s getting there. It is much, much better."

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