“They are picking up the phone for us - doesn’t matter what time of day.”Įmployers with Harvard Pilgrim commercial plans have also had a hard time adding new employees to coverage since the cyberattack. “I feel very comfortable that they have identified the issue and are doing everything they can to limit the abrasion to employers and employees and family members who have coverage,” Shore said. That has allowed patients to access nearly all medical and behavioral health care without obtaining administrative approvals, which are in place largely to limit health care spending.ĭavid Shore, executive vice president of Borislow Insurance, said he was receiving daily communications from the company on how to talk to employer clients and what parts of the insurer’s services are still offline. To start, the insurer has waived prior authorization requests for Harvard Pilgrim commercial and New Hampshire Stride Medicare Advantage plans for medical and behavioral health services, with few exceptions. “We will remain especially engaged on concerns around the inability to verify eligibility and coverage, the growing backlog of claims submissions, and the timing of payment to providers.”Ī Point32Health spokesman said the insurer was working directly with providers to address any immediate needs or questions.ĭespite providers’ uncertainty, brokers who work closely with Point32 said the insurer has worked diligently and thoughtfully to eliminate hurdles for patients and to manually process requests to make sure no one is without care. “Massachusetts Health and Hospital Association and our members are coordinating closely with Point32Health to receive updates on this situation with the hope that the impact on patient care will be as minimal as possible,” Karen Granoff, MHA’s senior director of managed care policy, said in a statement. Providers also expect there to be a backlog of claims once Point32 starts accepting them again. Hospital systems have voiced concern as they wait for payment, including when payments would resume and whether there would be interim payments while technology issues are worked out. Further, the insurer had asked doctors to hold off on submitting additional claims for Harvard Pilgrim commercial members, or contacting them regarding the payment delay. According to a weekend memo sent to physicians by the Massachusetts Medical Society, reimbursement for Harvard Pilgrim commercial members are delayed and would not be available on April 21 or April 28. The broken systems have prevented hospitals and physicians from being paid for claims they have submitted on behalf of Harvard Pilgrim commercial members. “While we work diligently to restore the impacted systems as quickly and as safely as possible, our team is working around the clock to provide workarounds for members to receive the services they need,” the insurer said in a statement. The Harvard Pilgrim website still redirected to a landing page for the parent company, which detailed that the insurer is unable to confirm patient eligibility, process approvals for certain medical tests or procedures (called prior authorization requests), or accept claim submissions for Harvard Pilgrim commercial members. As of Wednesday, few services seem to have been restored. Related : State’s second-largest health insurer suffers cybersecurity attackĪs a result, nearly all Harvard Pilgrim systems were taken offline.
0 Comments
Leave a Reply. |