Obamacare claims trickling in to medical providers

Jan. 24, 2014 @ 06:31 PM

So far, too early to judge.
That’s what many providers of medical care say about their experience since the first of the year with health insurance claims filed for patients under the Affordable Care Act, commonly known as Obamacare.
Health care coverage through the controversial program began Jan. 1, meaning that the initial patients to arrive at doctor’s offices or hospitals have begun submitting health insurance coverage claims. Health care industry analysts say the next challenge — or opportunity — for advocates of the Affordable Care Act is ensuring that claims are processed in a smooth fashion.
High Point Regional Health System hasn’t had a patient go through the full health insurance cycle yet, said Dr. Greg Taylor, chief operating officer.
“So we’re not in any position to say how easy or difficult it is going to be,” Taylor told The High Point Enterprise.
Taylor said that the health system may experience delays with some claims under the Affordable Care Act at the outset.
“But in the long run any problems will be worked out,” Taylor said. “We’re used to dealing not only with governmental entities, but multiple payers and constantly changing contracts. In the big scheme of things, hopefully this will play out like any other new contract. We’re optimistic about it.”
An executive with Wake Forest Baptist Medical Center offered a similar view on claims so far under the Affordable Care Act.
“Any claims we have incurred or will incur will be processed by insurance companies with whom we have long-established relationships and effective claims handling processes,” said Edward Chadwick, Wake Forest Baptist executive vice president and chief financial officer. “We do not anticipate any disruption to claims processes as a result of the ACA. However, we remain concerned about the ability of patients to afford higher deductible and co-insurance amounts.”
The U.S. Department of Health and Human Services reported earlier this month that North Carolina, the 10th-most populous state, ranks fifth nationwide for enrollment under the Affordable Care Act. Through December, nearly 108,000 North Carolinians have signed up for health insurance, putting North Carolina behind California, Florida, New York and Texas. Nationally, signups through the Affordable Care Act totaled more than 3 million people, according to the federal agency.
Because of the disastrous rollout of health care signups through the website www.healthcare.gov, the number of people enrolling for coverage stagnated in the fall. After the health care website debuted Oct. 1, the administration of President Barack Obama struggled for weeks to fix the site and eliminate glitches and computer problems that prevented people from enrolling. Indeed, in North Carolina, only 1,662 people were able to sign up during October.
Controversy continues over whether the Affordable Care Act, as a whole, will help or hinder medical care.
The N.C. Republican Party reported last month that “over 473,000 North Carolinians who were impacted by cancellation notices informing them they would lose their current health insurance plans because they do not meet regulatory requirements in Obamacare.”
But this week, advocates for the Affordable Care Act touted a report from the Gallup-Healthways Well-Being Index that found a modest reduction in the number of uninsured Americans. The survey found that the uninsured rate for American adults dropped by 1.2 percentage points in January to 16.1 percent.

pjohnson@hpe.com | 888-3528


Next Obamacare deadline
The open enrollment period for health coverage this year under the Affordable Care Act continues through March 31. After March 31, unless you have a special enrollment exception, you would only be able to sign up for coverage that starts at the outset of 2015. A special enrollment exception would include losing health care insurance through loss of coverage at a work place or elimination of coverage because of a divorce or other legal separation.
Anyone who signs up under the Affordable Care Act by Feb. 15 would have health care coverage effective March 1.
Source: Blue Cross Blue Shield of North Carolina High Point agency