Indiana group practice leads offensive against Anthem

Besides reporting payment difficulties to the state insurance department, the doctors are encouraging other practices to register their own reimbursement-related complaints.

By Myrle Croasdale, AMNews staff. March 25, 2002.

One physician group has lodged a complaint against Anthem in the health plan's home state, but the group isn't stopping there.

If Otolaryngology Associates in Indianapolis gets its way, Indiana's insurance department will be flooded by physicians lodging their own complaints against Anthem.

The 16-physician group has sent letters to 2,000 practices in Indiana, encouraging them to voice their support for Otolaryngology Associates' bid to get the Indiana Dept. of Insurance to stop Anthem's tendency, the group says, to pay late, below the contracted fee schedule or not at all.

Out of those 2,000 letters, about 50 or 60 practices have responded to say they're interested in filing complaints with the insurance department, said Ron Barrett, the Indianapolis group's administrator.

The group claims it's owed $250,000 by Anthem. Thomas H. Fairchild, MD, president of the physician group, said in a letter to the state, "We have notified Anthem several times that we were terminating our contract with them because of these continuing problems, but each time we were encouraged to not terminate based on their assertions that the problems had been corrected, with full knowledge that these assertions were false."

"This is a well-drafted complaint, and we're taking it very seriously," said Greg Thomas, chief deputy insurance commissioner in Indiana. However, no formal investigation into Anthem has yet been launched. [...]