Payer Payment Delays Are Escalating

Emily Brill
Published: Friday, Oct 13, 2017
Ray Page, DO, PhD

Ray Page, DO, PhD
When coding and billing consultant Roberta Buell mentions that payers are taking dramatically longer to pay claims, oncology practice administrators nod in agreement. At Carolina Blood and Cancer Care, Kashyap Patel, MD, who attended a recent public address1 by Buell, said that it is now taking up to 3 months to get paid, up from maximum delays of a month a few years ago. And Ray Page, DO, PhD, said that the constant delays and treatment denials he has seen at his Texas-based practice, the Center for Cancer & Blood Disorders, have caused losses, led to physician burnout, and adversely affected patients’ treatment regimens.

 

Table. Top Reasons for Payer Payment Denials in 2016

Top Reasons for Payer Payment Denials in 2016
The majority of Medicare Part B drug claims are generally paid within a month, according to Buell, of onPoint Oncology in Hudson, Ohio. Her review of focalPoint 2016 data from 165 cancer centers across the country found that 63% of accounts receivable claims were less than 1 month old; 18.6%, between 1 and 2 months old; 4.51%, up to 3 months old; 2.51%, up to 120 days old; and 11.32%, up to 4 months old.
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TitleExpiration DateCME Credits
Clinical Practice Connections™: From Diagnosis to Emerging Immunotherapeutic Options: Understanding the Burden and Risks in Peanut AllergySep 28, 20191.0
Enduring CME activity from the School of Breast Oncology®: 2018 Mid-Year Video UpdateSep 28, 20192.0
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