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Department Monitoring Delays in BCBSVT Payments to Healthcare Providers

March 22, 2019

Montpelier, VT – The Department of Financial Regulation (DFR) is actively monitoring the circumstances relating to healthcare provider payment delays that appear to have resulted from implementation of BlueCross BlueShield of Vermont’s (BCBSVT) new claims payment system. DFR has been working with affected providers and BCBSVT to understand the scope of the problem and ensure it will be resolved quickly.

The delay in payments results from certain claims being held and evaluated individually by BCBSVT rather than being automatically processed, as well as some ongoing technical issues.

BCBSVT has reported to DFR that approximately 580,000 – or approximately 90% – of claims made since January 1, 2019 have been properly adjudicated. Further, BCBSVT is required to pay 12% interest on claims not paid within 30 days, and to date has remitted approximately $109,000 of interest to healthcare providers.

Healthcare providers who are experiencing payment delays should consider contacting BCBSVT to learn more about the interest-free advances the company is offering. To date 41 providers have been advanced approximately $3.4 million.

DFR has been working with healthcare providers to help resolve individual issues and will continue to do so; DFR encourages healthcare providers and consumers with specific questions or concerns to contact DFR Consumer Services Chief Brenda Clark at 802-828-4886 or at BCBSVT members and healthcare providers can also contact the company directly at (1) BCBSVT Member Services at 800-247-2583, or (2) BCBSVT Provider Relations at 888-449-0443, Option #1.

The department will provide periodic updates to its website as new information becomes available.

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