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Meridian delays and denials cost OSF HealthCare millions

As announced yesterday, after months of discussions with Meridian, OSF HealthCare issued a notice of termination to Meridian effective December 15, 2019.


“We are unfortunately at a standstill with Meridian because for years they have failed to honor the most basic components of our agreement and will not come forward to resolve outstanding accounts,” said Randy Billings, OSF HealthCare senior vice president of population health. “We are concerned for Meridian members, which is why we contacted the Illinois Department of Healthcare and Family Services and Meridian members to make them aware of the situation.”


Meridian owes OSF millions of dollars for outstanding claims for services provided over the past five years. 


“Meridian’s inability to pay claims per industry standards within the contractually required amount of time has created an unmanageable administrative burden for OSF in billing for services it provides,” said Billings. “Meridian’s demand that OSF resubmit claims that were properly submitted is completely unreasonable. It is our Mission to serve persons with the greatest care and love. Receiving the contractual reimbursement that OSF has earned for services provided is important to ensure that we can continue to meet the needs of those we are called to serve.” 


Meridian members who want to remain with OSF providers can choose a different managed Medicaid plan during the open enrollment period, which is now under way. OSF HealthCare participates in IlliniCare and Molina Medicaid plans.


Additionally, OSF will work collaboratively with Meridian and its members, especially those currently receiving treatment at OSF, to ensure a safe and clinically appropriate transition of care as needed.