Anthem Health Plans of Virginia and its HealthKeepers managed care unit have agreed to pay $300,000 to settle allegations from the state's insurance department that it was not paying claims as quickly as was required by law, the Richmond Times-Dispatch reported July 13.
The State Corporation Commission’s Bureau of Insurance revived Anthem's monthly claims reports from December 2022 through February 2023 and found that 347 of the 67,000 claims the insurer received were not paid within 40 days, according to the report.
Failure to pay those claims within the required time frame could have resulted in a fine of more than $1.7 million or a revocation of its license to do business, but regulators recommended a favorable settlement due to Anthem's willingness to take prompt corrective action, according to the report.
Anthem neither admitted nor denied violating the law, according to the report. In addition to the fine, the insurer agreed to identify all internal issues resulting in late payments of clean claims and submit a list to the bureau by the end of July. It will also submit a plan detailing steps to fix the issues in August and show that it has completed those steps by October.
"Anthem Blue Cross and Blue Shield strives to process and pay claims as quickly and efficiently as possible," Anthem spokesperson Kersha Cartwright told the outlet. "Of the claims reviewed by the Virginia Bureau of Insurance, Anthem paid over 99.5 percent of all claims within 40 days of receipt. Across Virginia’s fully insured market, Anthem processes approximately 90 percent of all claims within 48 hours and pays within 10 days."