27 Sep 2017
- By Lori Lyn C. Lirio – [email protected] – Variety News Staff
THE Commonwealth Healthcare Corp. and its related facilities will no longer accept TakeCare Insurance, CHCC Chief Executive Officer Esther Muna said Tuesday.
Muna said CHCC is “not a participating provider in TakeCare’s provider network,” but will continue to provide treatment to members of the insurance carrier. “However, they will be responsible for payment in full upfront.”
Muna advised TakeCare members to contact the insurance firm directly if they have questions regarding their health insurance coverage.
It was reported on Guam that CHCC had stopped accepting TakeCare Insurance patients since Sept. 19.
On Monday, Kyla Marie Aquino, TakeCare’s marketing and communications specialist, told Variety that there were no changes to its members’ access to CHCC.
In August, Muna gave TakeCare and other health insurance companies a deadline to settle their debt to the hospital. She said TakeCare, Stay Well Saipan Inc. and Calvo’s Insurance owed the hospital more than $2 million each.
According to Aquino, the company has provided a $1 million good-faith payment to assist CHCC with its operations and allow TakeCare and CHCC time to reconcile outstanding claim.
Asked for comment following Muna’s announcement, TakeCare issued the following statement:
“TakeCare would like to announce the completion of reconciliation of [CHCC] claims from 2012 to June 30, 2017 that were submitted in June 2017.
“As reported in the media, [CHCC] has historically failed to bill either TakeCare or its members for services in a timely fashion, which has led to the recent issues and dispute between TakeCare and [CHCC].
“In August, TakeCare made a good-faith advance payment of $1 million to [CHCC] to assist [CHCC] operationally as well as allow both parties more time to reconcile five years’ worth of claims from [CHCC].
“As of today [Tuesday], TakeCare has found that there is still an unapplied balance of $226,653.50 from the original advance of $1 million made to [CHCC]. As this balance is considered an excess payment to [CHCC], TakeCare does not owe any further payments for historical claims.
“TakeCare has received notification that [CHCC] ‘will no longer serve as a network provider to patients with TakeCare Insurance.’ TakeCare would like to make clear, despite [CHCC] sending bills for services rendered directly to TakeCare, TakeCare members have always been self-pay patients at [CHCC] as both parties have not entered into a provider service agreement.
“However, as a professional courtesy and as a matter of convenience for [CHCC], TakeCare has customarily accepted billings from [CHCC] for covered services rendered to its members, and made payment to [CHCC] subject to policy limitations and the benefit terms of its policies.
“It is our sincere hope that [CHCC] will continue to work with TakeCare to address the claims process, including working on terms of a direct payer agreement.”
Source: Marianas Variety : http://www.mvariety.com/cnmi/cnmi-news/local/98859-chcc-no-longer-accepts-takecare-insurance