Hudson, Blevins, Denn Back Bill To Resolve Disputes Between Health Care Providers And Insurance Companies

Low-Cost, Speedy Arbitration Process Sought To Reduce Costs For Doctors, Physical Therapists, Chiropractors, Other Providers

Wilmington - As part of overall efforts to reduce health care costs in Delaware, health care providers would gain a simpler and cheaper way to resolve payment disputes with insurance companies under new legislation sponsored by Rep. Deborah Hudson and Sen. Patricia Blevins, backed by Insurance Commissioner Matt Denn and endorsed by provider associations.

Rep. Hudson and Sen. Blevins, longtime advocates for health care providers in the state, said their goal with the new legislation is to reduce costs for providers and thus ease the burden of increasing health care costs on consumers.

“If this legislation becomes law, a health care provider who believes that a bill has been wrongfully denied will have 60 days to file for arbitration with the Department of Insurance,” Rep. Hudson said. “Thus the dispute can be resolved quickly and does not need to involve lawyers, depositions, or other costly and lengthy components of a lawsuit.”

“Health care providers, such as doctors, physical therapists and chiropractors, should spend their time and effort providing health care, not wrangling with insurance companies over getting paid,” Sen. Blevins said.

Leaders of the Medical Society of Delaware, the Delaware Physical Therapy Association and the Delaware Chiropractic Society attended Tuesday’s event to express support for the bill.

“Many health care providers have told me that more than 20 percent of their overhead cost is spent not on providing patient care, but on paying people to try to get insurance carriers to pay them for work they have already done.  Some health care providers have gone so far as to outsource that collection work to private companies,” Commissioner Denn said.  

The Department of Insurance already provides arbitration services for consumers with disputes with insurance companies over homeowner and auto insurance claims.

The proposed health care arbitration would add to previous efforts by Commissioner Denn to reduce the cost and hassle for health care providers to getting paid. A “prompt payment” regulation put in place by the Commissioner in 2005 eliminated an insurance company practice of repeatedly asking for additional information from providers while holding up payment, and set a tight time limit on payment decisions.

Taking part in Tuesday’s announcement were Dr. Janice Tildon-Burton of the Medical Society of Delaware, George Edelman of the Delaware Physical Therapy Association and Dr. Brian Chandler of the Delaware Chiropractic Society.