Smaller health care providers in Illinois have been waiting on insurance claim payments from Health Alliance — an insurance company based in Champaign and operated by Carle Health — for over a month, leaving some of these providers in an uncomfortable financial situation.
That includes mental health provider Evergreen Coaching and Counseling, which is headquartered in Champaign and has locations across the state including in Bloomington. Health Alliance owes the business more than $100,000, said Denise Robinson, director of finance and human resources at Evergreen. She added that the group is still waiting on payments from as early as Jan. 18.
“As a small business, that is a lot of revenue,” Robinson explained.
Payments stalled following a Feb. 21 cyberattack on Health Alliance’s payment partner Change Healthcare that hasn’t been resolved. While clients can continue using insurance provided by Health Alliance, providers (including smaller ones like Evergreen) aren't getting paid by the insurance company for services provided.
At Evergreen, where Robinson estimates that roughly 80% of Champaign clients and 40% of Bloomington clients use Health Alliance, that can have a detrimental impact. If payments don’t start coming in by May — when Evergreen’s bills are due — Robinson said there will need to be some “serious conversations.”
Staff remain unaffected, as do patients, but Robinson said she’s not sure Evergreen can maintain its current operations if things go on much longer.
“Are we going to get ran out of business?” she hypothesized. “We have over 650 clients. That’s 650 people that we would no longer be able to service. And it’s just — it’s heartbreaking.”
She added that Evergreen is doing its best to ensure it doesn’t get to that point.
Evergreen makes a call to action
One of the ways Evergreen has brought attention to the issue was through a rally held Monday. Robinson said staff showed up at the Health Alliance building that morning, but were told to move by security. They relocated to Evergreen’s office in Champaign, catching drivers as they passed.
At the rally, Robinson said a nearby dentist came out and said his practice was also being affected.
“It's all small businesses that count on health insurance reimbursement,” she said about those being affected. “It's dentist offices, doctors, offices, foot doctors, the specialty clinics.”
Robinson added that with “too few of us in this mental health crisis” already, it’s important for mental health providers like Evergreen to reach a resolution soon.
Response from Change Healthcare, Health Alliance, Carle
As of Monday, Robinson said Health Alliance had reached out to start a conversation about payment options.
In a March 18 statement, Change Healthcare said “to assist care providers whose finances have been disrupted … the company has advanced more than $2 billion thus far through multiple initiatives.”
In the same statement, Change Healthcare encouraged businesses to explore a Temporary Funding Assistance Program through Optum health care group. On its website, Optum says it will cover costs for eligible providers without interest. It adds that payments won’t be required until providers are reimbursed for services by Change Healthcare.
Essentially, a loan.
In its own release, Health Alliance writes that it will not be involved in any agreements made with Optum.
Robinson said Evergreen is considering this option because they don’t have much choice otherwise. However, she added that taking a loan feels like “bad business” since neither Change Healthcare nor Health Alliance have clarified when claim payments will restart.
When WGLT reached out for comment, a spokesperson with Carle wrote the following:
“We have been committed to creating an open dialogue and working with our provider partners since the Change Healthcare cyber security incident issue began. While the event continues to limit our ability to process provider payments, we have been working to establish alternative vendor systems and are hopeful to resolve the situation in the near future. The issue does not affect members’ access to care.”
In an additional email, the spokesperson shared more information about the “alternative vendor systems,” citing the program offer from Optum.
There was no mention of a more specific timeline for resolving the issue.
