Tired of being stiffed by TakeCare insurance for medical care to its members, GRMC is billing patients

June 22, 2017

 
Guam Regional Medical City, Guam's only private hospital, is now directly billing all TakeCare insurance members who received care at GRMC between 2015 and the present. Letters being sent to TakeCare members ask for full payment for services provided by GRMC.

TakeCare remains the only Guam based health insurance company that has not placed GRMC in its provider network. Thus, since opening its doors in July 2015, GRMC has borne the cost of care for TakeCare members, the vast majority of whom have been brought there for emergency treatment. The cost of that care now runs into the millions of dollars, but Takecare has refused to adequately compensate GRMC for the emergency care it has provided to their members.

“We deeply regret having to bill TakeCare members directly, but GRMC must be compensated for the care we provided and TakeCare has been refusing to do so,” said Dr. Michael Cruz, GRMC President and Chief Operating Officer. “It’s unfortunate that TakeCare has now placed this financial burden on its own members while they continue to collect their premiums,” Cruz added. “Still, we have never turned away any TakeCare member in need of emergency care and we never will.”

TakeCare attempted to make a payment of $48,969.76 as “full and final payment” for what it considered “bona fide emergency services” to its members prior to January 2017. GRMC, of course, could not accept the check because it covered only a fraction of the full amount due.

GRMC Director of Corporate Affairs Eric Plinske notes that GRMC has continually sought to reach a network provider agreement with TakeCare, as well as to agree on a reasonable settlement of past due claims. “We have offered discounted rate packages similar to those accepted by Guam’s three other principal health insurance providers,” said Plinske. “However TakeCare has walked away from the negotiating table regarding historical claims settlement, and has not responded to GRMC’s latest network agreement proposal.”

“Despite the current impasse,” Plinske said, “GRMC remains willing to work with TakeCare so that its members will not have to face the heavy burden of these medical bills all by themselves. The ball, however, is in TakeCare’s court.”

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