Therapists say insurance company isn't paying claims

April 28, 2020

Thousands of Connecticut therapists say they aren't getting paid, even though they're seeing patients.

 

Before COVID-19, therapists said they would see their patients, file the claim with the insurance company Anthem Blue Cross and Blue Shield, and would get paid within a week.

 

Now, they said it’s been six weeks and they haven’t gotten their money.

 

Licensed Marriage and Family Therapist Rebecca Burton has been seeing her patients virtually, but says she isn’t getting paid for some of the services she’s providing.

 

“I don’t know if I’ll be able to pay my rent this month,” said Burton, of Beehive Counseling and Wellness.

 

She said Anthem Blue Cross and Blue Shield owes her at least $7,000, as they haven’t paid telehealth claims for about six weeks.

Burton adds that 40 percent of her patients have Anthem as their insurance provider.

 

“Any of the claims that have been submitted since March 17, most of those haven't been paid, denied outright or they have been paid incorrectly at a low telehealth rate,” Burton said.

 

She said some claims are being paid at a 15 percent lower rate, and they’ll have to be reprocessed by the insurance company.

 

She shared a detailed record of when she’s contacted the insurance company, saying “One phone call after another, or one email after the next and to not have it resolved, it's challenging to ludicrous.”

 

Another practice owner, Julie Longton, is also facing the same situation. She’s been losing money as well.

 

“We need to have it resolved. Anthem needs to process claims so that therapists can get paid and we can pay our staff and we can pay our office expenses,” said Longton, of Affinity Behavioral Health.

 

Both say the company told them they’re backlogged or are having computer issues.

 

Practice owners also said they haven’t had any issues with other insurance companies.

 

A spokesperson for Anthem issued a statement saying "Anthem Blue Cross and Blue Shield is working to provide members with greater access to care during this pandemic. This includes increasing the number of services available for coverage through telehealth as well as reimbursing covered audio/video telehealth services received from in-network professional providers at the current in-office reimbursement rates, which are higher than standard telehealth rates. Anthem worked as quickly as possible to implement the system changes required to pay at the new rates. However, some claims were incorrectly processed or denied before these system updates were made and we are reprocessing those claims to ensure providers are reimbursed correctly. We informed these providers of this situation and we appreciate their patience. "

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