Tagged with Aetna
Applicable to the technical component, claims billed with modifier FX to indicate X-ray imaging services were provided using film reduces will be subject to a 20% reduction.
Two separate studies investigated why consumers respond to high-deductible plans by using less healthcare services, which in turn leads to a decrease in doctor visits and clinical laboratory test orders.
The U.S. Justice Department recently disclosed that there will be an investigation into four more major health insurers as part of a False Claims Act lawsuit filed against UnitedHealth Group in 2011.
Humana has announced its plans to cease sales of individual health insurance plans through the ACA’s exchanges by 2018, potentially leaving more than 150,000 customers without a carrier.
A new study reveals insurers with the largest share of local markets can negotiate lower prices for physician office visits.
A federal judge ruled against Aetna’s proposed acquisition of Humana, maintaining the Justice Department’s decision that the multi-billion deal would be anticompetitive and raise prices for consumers.
The only northeastern state not to choose Medicaid expansion under the Affordable Care Act (ACA), Maine will be one of five of the original 23 ACA-created co-ops that will continue into 2017. In response and in hopes of in hopes of extending coverage to 70,000 residents, residents are petitioning to put a proposal to expand the ME Medicaid program before the Legislature.
A new report from Healthcare Financial Management Association (HFMA) suggests that value-based care and price transparency will add value to hospital mergers, including lower prices for consumers.
Aetna will soon offer two Medicare Advantage Part D/Prescription Drug (MAPD) plans in three counties in Central Florida.
Highmark confirms it will not sell plans to residents of York, PA on the federal health insurance marketplace on the 2017 Pennsylvania health insurance exchange.
Eleven private insurers have joined forces in seeking action from the Congressional Budget Office (CBO) to expand data collection when scoring congressional proposals to include telemedicine data from non-Medicare sources as a means to support value-based care efforts.
CMS has announced a temporary freeze on new proposals from health insurance companies pursuing automatic enrollment of commercial or Medicaid patients into Medicare Advantage plans.
Indiana University Health Plans has announced it will not offer plans on the state’s Affordable Care Act marketplace in 2017.
Effective December 1, Aetna will update its ER level of care policy for CPT code 99285 will downcode 99285 used with a designated minor diagnosis code.
Effective September 1, Aetna will update its OB/GYN policy for placement of permanent, hysteroscopically placed tubal implant devices intended for female sterilization on the same date of service as an endometrial ablation.
Aetna has announced it will narrow its individual public exchange participation from 778 to 242 counties next year. It will continue to offer off-exchange plans for most of the counties and will maintain an on-exchange presence in Delaware, Iowa, Nebraska and Virginia.
Later this year, Aetna will change how it handles “unknown” diagnosis codes for electronic precertification and notification transactions.