Why Greene County General Hospital is Upset with Anthem

Why Greene County General Hospital is Upset with Anthem

GREENE COUNTY, Ind.–Greene County General Hospital (GCGH) has issued a second breach notice to Anthem over claims not being paid correctly.

The hospital has been working to understand why certain claims were not being paid correctly and previously issued a breach notice related to Anthem claim payment issues.

The second breach notice raises additional concerns about Anthem’s claim payment practices and its failure to apply the contract correctly. Greene County General Hospital is asking Anthem to review affected claims, correct any improper payments, and settle outstanding amounts to resolve the financial impact.

Hospital staff are asking for both transparency and accountability from Anthem to address the payment issues promptly.

GCGH says Anthem knew but about one payment issue in March but had identified the problem internally on Jan. 8 and didn’t disclose it to the hospital for more than two months.

“This is about accountability. GCGH is asking Anthem to follow its own contract, cure the breaches, explain the payment issues, and resolve the amounts owed. A rural hospital should not have to spend months uncovering payment problems that a payer identified internally and did not promptly disclose. Anthem’s reputation depends on trust. That trust is damaged when a rural hospital spends months trying to understand why claims are not being paid correctly, only to learn that Anthem had identified an issue internally weeks earlier and did not promptly disclose it. GCGH is asking Anthem to act with the transparency and accountability its members, employers, providers, and communities should expect,” said Brenda Reetz, GCGH CEO.