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Third party payment rules open new possibilities for hospitals, pharma

from Healthcare Payer News

From May 23: With millions of Americans on new exchange plans now responsible for high deductibles, hospitals, drug makers, insurers and regulators are entering a new frontier of payment disputes. Exchange insurers are now required to offer a three month grace period for members who fail to pay premiums, but QHPs can pend and possibly deny claims after 30 days, and hospital advocates have been asking regulators whether community health charities might be allowed to help cover the cost of patient premiums — averting stalled or lost claims and helping patients allocate more of their personal finances to paying deductibles and co-pays. more


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