HQAA to Anthem/Wellpoint: 'Our Accreditation Counts'

Accrediting organization says insurance conglomerate is unfairly not recognizing its DMEPOS accreditation.

HQAA is speaking out against Anthem Insurance/WellPoint in the wake of the major insurance conglomeration deciding to not accept HQAA as a preferred accrediting organization for DMEPOS companies. Since 2006, HQAA has been one of 10 agencies across the country, recognized by Medicare, to participate in accreditation of DME providers for Medicare billing.

“The misconception is that all Blue Cross/Blue Shield insurance accreditation practices are standard across the board,” said Mary Nicholas, executive director of HQAA. “It’s an extreme contradiction that Anthem Insurance, or WellPoint, the provider in Georgia, won’t accept HQAA as an accreditation agency, but will accept Medicare dollars. All we’re asking is for equality for our customers.”

WellPoint is a private insurance company that administers Blue Cross/Blue Shield plans in 13 states, and is also a Fiscal Intermediary for Part A plans in at least two states. In early 2011, WellPoint took over administration of Blue Cross/Blue Shield in Georgia. At that time, it sent letters to all its providers indicating that in order to remain a preferred provider they had to prove they were accredited by one of three accreditors, HQAA not among them.

The companies accredited by HQAA and not by one of the three chosen by WellPoint are now faced with either losing a contract, which would cause devastating effects for many in the loss of jobs and revenue,” said Nicholas. “Or, they must spend thousands of dollars with a different company to obtain that which they already have achieved with another accreditor. None of these are viable solutions.

“We are now calling on our legislators to take a stand for good people like HQAA and the people we serve,” Nicholas continued. “We’ve asked Senator Harkin and Congressman Braley to review the situation, and if they deem appropriate, to reach out to Anthem Insurance and ask for clarification on their policy and procedures.”

HQAA says it hopes to quickly resolve with WellPoint prior to the March 2012 deadline for companies to be accredited by one of their approved accreditors.

“We feel this is a critical time and our request is justified. There is a multi-million dollar connection with CMS and WellPoint, and yet they refuse to recognize all accreditors,” Nicholas said. “We only want what is best for our customers.”

About the Author

David Kopf is the Editor of HME Business.

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