Behavioral Health Business November 27, 2023
Dating slang is helping behavioral health professionals describe a troubling evolution in payer relations.
Payer ghosting.
In dating, someone “ghosts” another person when they abruptly stop communicating despite previous interest. In this context, payer ghosting occurs when payers stonewall providers on claim reimbursement. This can be a trickier challenge for providers than the typical payer issues like other forms of delayed or denied payments.
Contracts often have recourse for certain actions, including payer denials, prior authorizations, and special investigations unit (SIU) letters, to name a few, but this isn’t the case for payer ghosting.
Often, there’s no clear recourse when a payer simply stops engaging with a provider on reimbursement.
For example, payers appeared especially eager to send special investigation...