Billions of health insurance claims in Illinois have remained unpaid due to the state owing an enormous amount to providers as of June 30, said the Governor’s Office of Management and Budget. The Central Management Services (CMS) is yet to pay as much as $5 billion of group insurance claims to providers.
The amount has been outstanding since 2015, which caused insurance companies to require patients to settle upfront fees as an entire payment despite having full coverage. Others have been less fortunate, as providers have refused to compensate state employees.
The problem most likely began when state leaders failed to reach a consensus on budget issues, which ultimately led to missed reimbursements to healthcare providers. Patients have suffered the outcome, despite being on-time with their premium payments.
For those with another type of insurance, a public adjuster can assist you in making sure that you maximize the allowable amount that you can get from your coverage.
To achieve this, you should be selective in choosing a consultant when settling a claim since providers can be stringent in permitting any adjustments.
CMS’ failure to settle the reimbursements since September 2015 caused other problems aside from insurance claims. Advocate Health Care postponed a recruitment program in spring of 2017 due to the budget concerns.
The state’s biggest hospital network also decided to impose $200 million of budget cuts in May due to the situation. Some companies have been forced to lay off employees, while others have delayed maintenance projects as they wait for financial support from the state government.
Illinois needs to resolve its budget problems soon, as several patients depend on the state’s group insurance program for healthcare services. If it fails to fix the budget impasse, more people would simply stop paying premiums that could lead to further problems.