Highmark Inc. has been fined $50,000 by the state Insurance Department for minor violations relating to denying claims.
The Pittsburgh Pennsylvania based health insurer disputed the findings of the 2-year review, but says it will review its claims procedures anyway.
The Pittsburgh Post-Gazette reports the review was begun after a customer complained about a claim being denied, which resulted from a “problematic upgrade” of Highmark’s claim processing system. That caused thousands of claims to be denied and the state says too many of those denials weren’t remedied quickly enough.
Highmark says many of the problems were out of its control and resulted from trying to implement new rules from the Centers for Medicare and Medicaid Services, and other external issues.
May 18th, 2013