Tagged with Humana

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.

Humana to Exit ACA Exchanges by 2018

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.

Judge Denies Aetna-Humana Merger

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.

FL – Major Insurers Join New Value-Based Prescription Drug Model

Humana, UnitedHealthcare, WellCare, Blue Cross and Blue Shield of Florida and CVS Health are among those participating in a Medicare Part D model that gives insurers financial incentives to offer innovative programs that encourage patients to take their medications.

Humana Updating Surgery Claim Processing Edits

Effective September 19, Humana will update claim processing edits for Surgery procedures, including: sigmoidoscopy, colonoscopy, other medical and surgical service during the postoperative period, FL Medicaid services included in delivery, birth center non-covered services, Florida Medicaid, and extracorporeal photopheresis.

Humana Updating Internal Medicine Claim Processing Edits

Effective September 19, Humana will update claim processing edits for Internal Medicine procedures, including: Sequential IV push, Telephone assessment and management, Home visit, Polysomnography, and Immune globulin.

Humana Updating Anesthesia Claim Processing Edits

Effective September 19, Humana will update claim processing edits for Anesthesia procedures, including: Medical supervision and medical direction of anesthesia services, Consistency of reduced or discontinued anesthesia services between professional and facility providers, Discontinued anesthesia services between professional and facility providers, and Anesthesia for colorectal cancer screening.

Humana Updating Lab/Pathology Claim Processing Edits

Effective September 19, Humana will update claim processing edits for Lab / Pathology procedures, including: prenatal screening, Independent Labs – Covered Services and frequency limits, and services included in prenatal care.

Humana Updating Radiology Claim Processing Edits

Effective September 19, Humana will update radiology claim processing edits, including: procedure code guidelines policy, obstetric ultrasound frequency,Zika virus, radiation treatment delivery, computed tomographic colonography, consultation on x-ray, magnetic resonance spectroscopy, and radiological examination of the hips and lower extremities.