Florida Hospitals Say HMOs Playing Games With Claims

MANAGED CARE March 1999. ©1999 Stezzi Communications

The Florida Hospital Association says more than 37 percent of unpaid claims that HMOs owe hospitals are more than four months old, and the association is considering a class-action suit to speed things up.

In Broward County, the problem is worse, according to the association: almost half of unpaid claims are 120 days or older. Hospitals in the county spent more than $1 million last year on collection agencies to try to get HMOs on the ball.

Some Florida HMOs admit to tardiness, but fire back that the accusations are partly just so much blather — that if more claims were filled out correctly, there would be fewer delays.