Coventry owes provider $17M in back payments, lawsuit alleges

Email LinkedIn

Coventry Health and Kentucky Spirit Health Plan are facing lawsuits by Eastern Kentucky's largest healthcare system for allegedly failing to promptly pay claims, owing the provider at least $17 million combined.

Appalachian Regional Healthcare (ARH) has filed two separate lawsuits against the insurers, which contract with Kentucky to manage its Medicaid program. ARH claims in both of the suits that it hasn't been properly reimbursed for care provided to Medicaid patients, reported the Lexington Herald-Review.

ARH has been waiting for payment on about $5.7 million in claims submitted to Kentucky Spirit since November--83 percent of which are more than 30 days late, and almost 50 percent are more than three months late, according to Insider Louisville. ARH also alleges that Coventry owes it about $12.5 million in claims submitted since November.

Coventry, however, dismissed ARH's allegations. "Coventry disputes the allegations regarding both the dollar amount and the percentage of claims that have not been paid," Coventry spokesman Matthew Eyles told WFPL. "In the very limited instances where ARH's claims are older than 30 days, Coventry pays those claims with interest, as required under Kentucky law."

To learn more:
- see the WFPL article
- check out the Lexington Herald-Reader article
- see the Insider Louisville article

Related Articles:
Insurance contractor pays $2M to settle Medicaid fraud
Excellus fined $1M for denying ER claims
Insurer uses unfair payment practices, chiropractors allege
BCBSNC exclusive: Overpayment allegations inaccurate
Blue Cross, Health Net allegedly conspire to underpay hospitals