Tagged with Humana
Effective August 1, Humana will implement changes to the time frame for peer-to-peer review process for its Medicare Advantage (MA) health plans.
Humana has published new and updated medical claims payment policy for certain CPT and diagnosis codes as well as correct coding updates, scheduled to take effect in July.
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 has released a number new pharmacy coverage policies, as well as significant revisions to its medical coverage policies.
On January 22nd, Humana will update its preauthorization and notification lists for all commercial fully insured, Medicare Advantage plans and dual Medicare-Medicaid plans.
Humana has released two new medical coverage policies and several updates to policies effective at the start of the new year.
Humana has issued several CPT code edits for specialties including Surgery, Pathology, and Radiology.
Humana and the Cleveland Clinic have created two $0 premium Medicare Advantage health plans for people with Medicare in Cuyahoga County, intended to improve experience and care by providing affordable access patient-focused expert doctors, nurses and facilities.
Humana and Community Care Physicians (CCP) in New York have signed a value-based agreement that will allow in-network access to Humana’s Medicare Advantage members at CCP facilities.
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.
Humana released three Cardiology code edits that will be effective as of August 31, as well as significant revisions to certain medical coverage policies.
Humana has updated its policy concerning Anesthesia modifiers for anesthesia services to comply with the Illinois Medicaid Practitioner Handbook.
Humana has updated it list of correct coding for certain procedure, effective July 6, 2017.
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 have renewed a multiyear agreement to keep all of Tenet’s U.S. hospitals and outpatient centers in Humana’s coverage network.
CMS has lifted enrollment and marketing sanctions against Cigna for its Medicare Advantage and prescription drug plans.
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.
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.
Starting July 1, Cigna will require prior authorization for physicians prescribing a long-acting opioid that is not being used for cancer treatment, palliative, and end-of-life care.