Why NH mental health providers are considering dropping Anthem | New Hampshire Public Radio – New Hampshire Public Radio

For Karen Lacharite, the checks from Anthem stopped coming in late May.

Lacharite, a licensed mental health counselor in Epping, says the state’s largest insurer failed to process her claims for more than six weeks, resulting in approximately $5,000 in overdue payments.

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“For an independent practitioner, that’s a pretty big hit,” Lacharite says. “That’s my income.”

Lacharite isn’t alone: Independent mental health providers around the state say they have faced delays and errors in recent months in seeking reimbursement from Anthem after treating patients. This comes as the New Hampshire Hospital Association, earlier this fall, said that hospitals around the state are also now collectively owed tens, possibly hundreds of millions of dollars, in unpaid Anthem claims.

The backlog in payments appears to be caused by changes Anthem made this year to its claims processing systems.

For some independent mental health providers, the delayed reimbursements and lack of communication has them considering whether to stop accepting patients with Anthem insurance.

Lacharite’s rejected payments all cited an error in one of her provider identification numbers, even though that number had not changed.

She tried getting through to a customer service representative, but faced long delays and different responses, depending on the person trying to offer assistance.

“It really feels like you are just being ignored,” Lacharite says.

“Probably not a big deal to Anthem. Kind of a big deal to me.”

Lyssa Bayne-Kim

In a statement to NHPR, Anthem says that it is still processing the vast majority of its claims in a timely manner. “However, we recognize some providers are having difficulty receiving reimbursements because of changes in processes and we are working diligently to address this. We understand their frustration and we have increased our resources to assist them,” Stephanie DuBois, Anthem’s director of public relations, said.

Ryan Aquilina is a licensed mental health counselor in Londonderry who shares a practice with three other providers. After facing glitches in getting paid this summer, she says Anthem now owes more than $20,000.

“It took me emailing and saying listen, I’m going to file a complaint with the New Hampshire insurance board if somebody doesn’t get back to me about this, that we actually got any kind of response,” Aquilina says.

The New Hampshire Insurance Department says it’s aware of Anthem’s repayment issues and is monitoring the company’s response.

According to data from the department, it has received 20 complaints from health care providers regarding bill repayments so far this year, double the total number of complaints filed in 2020.

“It’s probably about $4,000,” says Lyssa Bayne-Kim, a therapist in Durham who has seen some claims get rejected. “Probably not a big deal to Anthem. Kind of a big deal to me.”

For Meredith Orchard-Blowen, frustration over not getting paid for work she’s already performed has her questioning if she wants to continue accepting patients with Anthem insurance.

Orchard-Blowen says independent mental health providers affected by the delays feel caught between the patients they want to treat, and the insurer who is supposed to pay for that treatment.

“I’m not the only one who is thinking of ditching my contract,” she says. “We are already in a mental health crisis due to the pandemic. So what will this extra burden mean [for patients]?” she asks.

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