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Managed-care plans report claims, call-center and network progress; lawmakers ask for wheelchair-approval data
Summary
Healthy Blue, Sunflower and UnitedHealthcare gave operational updates to the Bethel committee — reporting claims paid, call-center performance, network counts and denial rates — while lawmakers asked MCOs for monthly reporting on complex wheelchair prior-authorizations and denials.
Three KanCare managed-care organizations updated the Bethel committee on implementation, network status and claims processing and described member outreach and local events.
Healthy Blue: Brian Beyer, Healthy Blue plan president, said his organization has paid about 1,000,000 claims since implementation and is averaging roughly $2.2 million paid in claims per day in March. He said Healthy Blue’s early focus was to "pay claims and answer the phone," reporting a member-call abandoned rate under 10 percent, average hold times around 60 seconds and strong provider-call response metrics. Beyer said credentialing and loading of provider records into KMAP are ongoing and that…
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