1/8/2015
The Insurance Commissioner of Iowa and the Insurance Director of Nebraska have addressed concerns regarding the receipt of payment for services provided to CoOportunity Health members. They have advised providers and enrollees of the following:
- Providers will be paid for services delivered to CoOportunity Health Enrollees. Claims are being processed as usual but payments will not be made as promptly as they have been previously.
- It is important that CoOportunity Health enrollees continue to receive healthcare services without interruption from providers. Claims for these services should be submitted as usual for payment.
In the event CoOportunity Health moves into liquidation, the Guaranty Associations (GAs) of Iowa and Nebraska will pay all eligible provider claims regardless of date of service. GAs typically pay claims on a bi-weekly basis.
However, there is a $500,000 per member limit that GAs pay on medical and pharmacy claims. Based upon a review of the enrollees, this limit may only affect a very small number of CoOportunity Health enrollees.
The Iowa Insurance Division and Nebraska Insurance Department websites have additional information and answers to frequently asked questions.