Contract renewals can be a tricky business for healthcare insurers, particularly for companies like Blue Shield of California, which negotiates contracts over a period of years.
"We would often get push-back from the [customers]," says Kay Kitajima, senior program manager for Blue Shield's provider services and operations fields. "Some hospitals had better payment-tracking systems than we did, and we didn't always have the data to go back with them and look at our records."
It amounted to what Kitajima calls "anecdotal finger pointing," but the carrier kept finding itself in a position of compromise.
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