An Act To Amend Title 18 Of The Delaware Code Relating To Health Insurance.
The bill intends to positively impact healthcare providers by ensuring more efficient processing of claims and reducing delays in reimbursement. Key provisions, such as requiring insurers to promptly pay claims within 30 days and the interest penalties for late payments, reinforce the urgency around timely reimbursement. This adjustment serves to address long-standing issues healthcare providers face with late payments and complicated claims processes, thus potentially improving cash flow for many practices. Moreover, by imposing obligations on insurance carriers to verify a patient’s other coverage before taking recovery actions, SB143 aims to enhance transparency and fairness in claims auditing and payment recovery processes.
Senate Bill 143 aims to amend Title 18 of the Delaware Code, primarily focusing on improving the claims payment process for health insurance providers. The legislation introduces several modifications designed to streamline the reimbursement procedures for healthcare providers. Notably, it establishes a minimum timeframe of 180 days for providers to submit claims after services are rendered, ensuring that they have ample time to secure payment for their services rendered to insured patients. Additionally, the bill codifies what constitutes a 'clean claim' and mandates that erroneous claim denials be treated as timely claims without the need for resubmission, a significant change aimed at reducing administrative burdens on healthcare providers.
General sentiment surrounding SB143 appears to be supportive among healthcare providers who view these changes as beneficial for their operations. Advocates of the bill argue that it balances the powers between insurers and healthcare providers, asserting that it will create a more equitable landscape for claims handling. However, some concerns may arise from insurers who believe that the measures could lead to increased operational costs and complexities in managing claims effectively. The bill's sponsors, including Senator Mantzavinos and Representative Bush, are positioning it as a necessary reform aimed at protecting providers' rights and ensuring patients can rely on their insurance to cover claims efficiently.
While supporters advocate for the enhancements proposed under SB143, contention may arise related to how these new obligations might affect the operational practices of insurance carriers. Insurers might express apprehension about the increased burden of compliance with the new regulations regarding timeliness and accuracy in claims processing. The shift places additional responsibilities on insurance companies to ensure proper verification of other medical coverage, which could complicate their audit practices. Critics may argue that this could lead to unintended consequences, such as higher premiums or reduced coverage options for consumers as insurers adjust to the increased operational requirements.