Tagged with Humana

Humana Claim Processing Edits

Humana has released several claims processing edits, including updates to Outpatient Prospective Payment System (OPPS), Modifiers 96 and 97, HCPCS Drugs & Biologicals, and other policies.

Humana – Cardiology Code Edits

Humana released three Cardiology code edits that will be effective as of August 31, as well as significant revisions to certain medical coverage policies.

IL – Blue Cross Blue Shield Awaits State Review

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.

Humana and Tenet Agree on New Contract

Humana and Tenet have renewed a multiyear agreement to keep all of Tenet’s U.S. hospitals and outpatient centers in Humana’s coverage network.

Anthem Ends Cigna Merger Agreement

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 to Exit all ACA Insurance Marketplaces in 2018

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.

Uninsured Rate Swells to 11.3% in Q1

Gallup-Healthways Well-Being Index poll shows uninsured rate increased to 11.3% in the first quarter of 2017 from a record low of 10.9% in the last half of 2016.