Insurance snags hurt Oklahoma health care providers

A backlog of more than 200,000 unpaid health and dental claims totaling $80 million to $100 million by an insurance plan for state employees and retirees is squeezing medical providers.

An Oklahoma City medical group for the first time has had to borrow money to meet payroll, and most physicians in the group did not take a salary the past couple of months because of the delay in HealthChoice payments, said Dr. Carl Raczkowski, a gastroenterologist.

"We did not collect enough money to pay ourselves once we paid our overhead,” he said.

The backlog of HealthChoice payments at Share Medical Center in Alva at one point earlier this year reached $250,000 — the same amount it takes to pay the hospital’s monthly operating costs, said Denise Reed, the hospital’s chief financial officer.

The backlog has had a significant effect on the hospital because several state agencies are in the Alva area, including a state prison, a university and local school districts.

The backlog is now down to about $50,000, Reed said. The backlog was reduced after she complained to her state legislators, Sen. Bryce Marlatt, R-Woodward, and Rep. Jeff Hickman, R-Fairview. A short time later, HealthChoice assigned a representative to the hospital, she said.

"We have been receiving payments almost weekly since the first of March,” Reed said. "We’re still surrounded by other providers who are still struggling. It’s affecting physicians, drug stores, pharmacies.”

Bill Crain, administrator of the Oklahoma State and Education Employees Group Insurance Board, which manages HealthChoice, has blamed the backlog on technical issues caused when HealthChoice switched companies that process claims.

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