Pushing insurance companies to pay their health-care bills on time has become such a headache for Southwest Memorial Hospital that the board of Southwest Health System, which governs the hospital, is considering dropping all insurance companies that use Sloans Lake to process claims.

Approximately 3,000 area residents could find themselves without covered local care if Sloans Lake does not speed up its process, according to hospital officials.

But instead of dropping Sloans Lake outright, the board decided last Thursday to first give doctors at Southwest until Oct. 15 the option to discontinue the company’s insurance coverage individually.

"Each physician and the hospital make their own individual choice over whether they want to participate in Sloans Lake," said Bob Peterson, hospital CEO.

Unless Sloans Lake moves the payment process along, however, the hospital will likely have to drop those insurance companies.

Laura Rice, a consultant to Southwest Health Net, said that Sloans Lake insurance companies owe the hospital close to a quarter of a million dollars in unpaid insurance claims and their turnaround time for payments is between 120 and 180 days.

"You can’t expect people to assume that kind of accounts-receivable burden," said Rice.

SWMH, a 61-bed acute-care facility, is the only acute-care facility in Montezuma County. Rice said she thinks five or six physicians could choose to drop insurance providers who use the company.

Sloans Lake is a prominent managed-care provider based in Denver. Known as a "bundler," the company builds provider networks and then sells them to insurance companies and self-funded employees. It is used as a middleman to re-price claims and then send them to the insurance company for payment.

Major insurance companies such as Golden Rule, Fortis, American Chambers Life Insurance, American Medical Security, Choice, Humana, and National Preferred Provider Network employ Sloans Lake.

Insurance companies can choose to use other companies for re-pricing and networking, but their options are few. For instance, Alliance is a Denver-based company that recently made agreements with health-care providers in Cortez and Durango.

Rice said patients whose insurance companies will no longer be honored should complain to their insurance company and ask them to change to another management company when their plan comes up for renewal. She said it’s incumbent on the insurance company to give the insurer another choice.

"The power really resides in the patient," she said.

Local insurance agents dispute this. They say there will be few choices for most local patients other than traveling to Durango for in-network health care or paying an average of 20 percent more for out-of-network care.

"There is nobody that uses anything other than Sloans Lake because there isn’t anything else in this area," said Ron Rehberg, a Cortez insurance agent with Allied Health.

Rehberg said that Sloans Lake has an in-house 10-day turn-around, and that the problem lies more with hospital billing than the speed of insurance payments.

But Rice said the hospital is not contracted with the individual insurance companies — only with Sloans Lake. So the only recourse to recover lost revenue would be to sue Sloans Lake.