Tagged with Anthem
Anthem BCBS of Indiana has issued notice of medical policy revisions approved by the Medical Policy and Technology Assessment Committee (MPTAC).
Effective March 1, 2018, AIM Specialty Health (AIM) will perform medical necessity review of certain elective surgeries of the spine and joints, as well as interventional pain treatment for fully insured Anthem BSBS NH members.
Starting in 2018, more claim payments and remittance advice issued to Anthem providers will be made on a weekly basis.
Effective December 8, Anthem EDI began implementation of a new edit related to independent laboratory claims which reduces the processing time and manual intervention for lab claims.
For dates of service on or after December 1, 2017, Anthem Blue Cross and Blue Shield (Anthem BCBS) will begin reimbursement for Psychiatric Care Collaborative Management Healthcare Common Procedure Coding System (HCPCS Level II) codes.
Anthem Blue Cross and Blue Shield released updated medical policies and clinical guidelines to be implemented on November 1, 2017 in certain states.
Harvard Pilgrim, Maine Community Health Options, and Anthem Blue Cross Blue Shield are each requesting double-digit rate increases for 2018. The three insurers cite political uncertainty and a higher percentage of unhealthy policyholders as reasons for their requests.
Anthem has posted its updated Assistant Surgeon policy and code list to reflect CPT® and Healthcare Common Procedure Coding System (HCPCS Level II) coding changes for 2017 as well as updates based on American College of Surgeons (ACS) and CMS information.
Anthem Blue Cross Blue Shield has announced it will leave the Affordable Care Act market in Ohio in 2018 and will reduce its footprint in the state to one off-exchange product in one county.
The second-largest insurer in the New Hampshire Affordable Care Act (ACA) market has requested average rate hikes of 30% for 2018, citing Medicaid expansion and federally imposed risk adjustments as the cause for the request.
Anthem has announced that it will pull out of Ohio’s Affordable Care Act (ACA) individual insurance marketplace for the 2018 plan year.
Health insurers in Connecticut have submitted health insurance rate request individual and small group plans in 2018. A total of 10 health insurance companies have made 14 filings on individual and small group plans that provide coverage to approximately 270,000 people in the state. The average rate requests range from 3.6% to 33.8%.
Anthem recently announced that it will stop pursuing Cigna. The insurer claims Cigna sabotaged the deal and states it will not pay the agreed-upon breakup fee of $1.8 billion.
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.
A recent analysis by the University of Wisconsin Applied Population Laboratory showed that 94.3% of the state’s population had health insurance in 2015. Ranking seventh in percentage of residents covered across all states. According to HHS Regional Director Kathleen Falk, within the first month of 2017 open enrollment approximately 66,000 people in Wisconsin signed up for plans.
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.
Anthem Blue Cross and Blue Shield plans have become the first health plans to offer providers incentives for getting integrated care certification (ICC) from the Joint Commission. The ICC will help Anthem in 14 states meet its care coordination measure under its Quality-In-Sights hospital incentive program, its performance-based reimbursement program for hospitals.
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.