Tagged with Aetna
Effective September 1, Aetna will require precertification is required for certain new-to-market drugs.
Aetna has released updates regarding how the insurer will handle certain ambulatory surgical center (ASC) and ambulatory payment classification (APC) code edits under the ASC and APC payment methodologies.
Aetna has posted updated information regarding how the insurer will handle certain Ambulatory Surgical Center (ASC) and Ambulatory Payment Classification (APC) code edits under the ASC and APC payment methodologies.
Effective April 1, Aetna will implement several updates to its pharmacy plan drug lists. These changes will affect all Pharmacy Management drug lists, precertification, quantity limits, and step-therapy programs.
Aetna has issued an update regarding the use of CPT II codes for HEDIS® high blood pressure measurements for patients diagnosed with hypertension.
Aetna has posted a reminder regarding provider contract termination requirements in the state of Connecticut.
Following its recent approval from the New York’s Department of Financial Services, the $69 billion merger between CVS Health Corp. and Aetna closed Wednesday, November 28. The two organizations say that the merger will immediately improve health-care outcomes and reduce costs.
On January 1, Aetna will make updates to certain products on its pharmacy plan drug lists, including such products as granulocyte colony-stimulating factor (G-CSF) and epoetin alfa products.
Aetna has released its most recent updates to its National Precertification List (NPL), as well as several clinical payment and coding policy changes set to take effect over the coming months.
Effective July 1, Aetna will update its pharmacy plan drug lists. These changes will affect all Pharmacy Management drug lists, precertification, quantity limits and step-therapy programs.
Effective July 1, Aetna will implement changes to its clinical payment and coding policies as well as several changes to its National Precertification List (NPL).
Aetna has issued a notice reminding providers and billing professionals that Medicare beneficiaries under the Qualified Medicare Beneficiary (QMB) program should not be billed for cost sharing (balanced billing).
Aetna has made adjustments to five clinical payment, coding policies that will become effective on March 1st.
Aetna has released updated clinical, payment and coding policies, including multiple procedure reduction for diagnostic cardiology, diagnostic ophthalmology, and therapeutic services.
The New York Department of Financial Services has released 2018 health insurance rates for the state’s individual and small group markets, including rates for the NY State of Health, New York’s official health plan marketplace – ranging from 4.4% for Excellus to 31.5%.
The Illinois Department of Healthcare and Family Services has announced the names of the insurers that will take part in the Governor’s proposed overhaul of the state’s Medicaid Managed Care program.
For the first time since 1990, the Illinois Department of Insurance will conduct a broad market examination of Blue Cross and Blue Shield of Illinois to see how the insurer treats its customers in compliance with consumer protection regulations.
UnitedHealth Group has announced plans to shut down its subsidiary insurance startup which offered unlimited primary and behavioral care at no charge.
Aetna has announced plans completely withdraw from the ACA insurance exchanges for 2018, citing financial losses as the deciding factor, specifically its individual commercial products lost nearly $700 million between 2014 and 2016 and could lose another $200 million this year.
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.