“We cannot afford to allow insurance carriers to drag out payments. As of today, prompt payment is the rule and no longer the exception. In order to keep the lights on, employees paid, and vital supplies coming to the hospital we must require insurers to start paying up front, regardless if there is a denied or disputed claim.”
– Governor Eddie Baza Calvo
Administration Management Advisory Team strengthens policy
The governor is changing an old policy at the hospital that allowed insurance companies to withhold payments. The Guam Memorial Hospital Authority is now requiring insurance companies to submit 75 percent of submitted bills within 45 days of receipt.
“Even as Governor Calvo continues to work with the federal government to increase Medicaid and Medicare reimbursements for Guam to match other jurisdictions, the management team is working on solutions that are within our control. This policy will help increase revenue flow to our island’s only public hospital,” stated Wil Castro, who is an Advisory Team member and Director of Bureau of Statistics and Plans.
This new requirement takes into consideration the billings contested by insurance companies, which averages 20-30 percent.
After paying the initial 75 percent, the remaining 25 percent will be remitted to GMHA if insurance companies agree to pay that amount. In the event that a bill is contested, GMHA and the company will negotiate as usual. Depending on the final amount negotiated, the insurance company will remit payment, or GMHA will send a refund.
GMHA will work with insurance companies to meet this new requirement, which was recommended by the GMHA Management Advisory Team.