The California Department of Managed Health fined Anthem Blue Cross of California $690,000 for failure to reimburse providers and members in a timely manner during the second half of 2021.
Anthem, a subsidiary of Elevance Health, failed to quickly reimburse providers and members after independent reviews from the state overturned the payer's initial denial of services, according to a Jan. 4 news release from the state.
The state said it took action after nine Anthem members sought the reviews, which included denials involving behavioral and urgent care claims, and denials to cover preventive tests and medications. The delays in payment spanned three to 36 days.
Anthem has paid the fine and implemented corrective actions around improving internal policies and procedures related to independent medical review decisions and providing a timely response to claims.
"At Anthem Blue Cross, we strive to provide access to outcomes-based healthcare in accordance with applicable state laws and regulations, an Elevance Health spokesperson told Becker's in a statement. "We have worked with the Department of Managed Health Care to resolve these matters and have implemented appropriate corrective measures. We remain committed to putting our members first and providing them with access to healthcare services that will improve their health and well-being."