ILLINOIS (WCIA) -- Officials with rural and inner city hospitals say they are tired of not getting money owed to them.
Hospitals with large Medicaid populations rely heavily on reimbursements from Managed Care Organizations (MCOs). Hospital executives say those private MCOs are denying payment claims in large numbers. 26 percent of requests from these hospitals got denied.
Lawmakers introduced a package of three bills aimed at reducing those denials. "You have to come up with resources in some fashion. Fortunately, we have a small reserve, but we can't go on forever. If you have a large loss or you arent getting payment for the services you already provided, you can't continue to operate that way," said Ken Reid, President and CEO of Carlinville Area Hospital. The insurance companies can deny payment for a number of reasons ranging from not returning in the request quickly enough to the MCO deciding the patient did not actually need the treatment.
(By: Mark Maxwell, Posted March 6, 2019)