Review of HealthNow's Compliance with Medicare+Choice Prompt Payment Regulations During the Period August 1, 2003 through January 31, 2004

The objective of this review was to determine whether HealthNow New York, Inc.'s Senior Blue Health Plan (HealthNow) complied with prompt payment regulations to timely pay or deny claims submitted by noncontracted providers. HealthNow substantially complied with Federal prompt payment regulations for claims submitted by noncontracted providers and paid over 95 percent of clean claims within 30 days of receipt. However, HealthNow did not pay or deny some claims within 60 days of receipt. We recommended that HealthNow ensure that all claims are paid or denied within 60 days of receipt. HealthNow concurred with our findings and recommendations.