Saipan hospital drops TakeCare over claims dispute

September 26, 2017

 

 

 

The Commonwealth Health Care Corp., Saipan’s only hospital, announced Tuesday it will no longer honor TakeCare insurance, a decision that purportedly resulted from a mutual failure to resolve their claims dispute.

 

In a statement, CHCC said its move to delist from TakeCare’s provider network was effective immediately. The hospital said it "will continue to provide treatment to TakeCare members, however, they will be responsible for payment in full upfront."

 

It was not known as of press time how many patients might be affected by such decision. CHCC advises TakeCare members with questions that this raises about their coverage to "please contact TakeCare directly.”

 

Last month, TakeCare said it had been “working closely” with the CHCC to reconcile discrepancies in claims from fiscal 2012 to 2017.

 

“As a measure of good-faith to assist CHCC with their operations, TakeCare has provided a $1-million good faith payment to allow both organizations time to reconcile outstanding claims,” TakeCare said in a brief statement posted on its website on Aug. 16.

 

“Both organizations came to a mutual agreement that while claims are being reconciled there would be no disruption in services for TakeCare members,” the insurance provider said.

 

However, attempts to reconcile claims apparently bogged down.

 

 

 As of Tuesday, TakeCare said there was still an unapplied balance of $226,653.50 from the $1 million advanced payment it made to CHCC.  

 

TakeCare believes it does not owe the Saipan hospital “any further payments for historical claims” as it considers the  balance “an excess payment to CHCC.”

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