Aetna, a CVS Health company, insurers about 39 million people.
Category: ASC Coding, Billing and Collections
Anthem in the headlines: 6 updates from last 60 days
Anthem is one of the country’s largest health insurers.
Physician found guilty in $12M Tricare fraud scheme
Arkansas physician Joe May, MD, was convicted on 22 counts over his involvement in a scheme to defraud Tricare of $12 million, the Justice Department said June 10.
Optum, Anthem invest in value-based care: What ASCs need to know
Optum Ventures, CVS Ventures, Anthem and HLM Venture Partners announced they are investing in CareBridge, a value-based care company for patients receiving home and community-based services.
Michigan physician pleads guilty to fraudulent billing, to pay $500K
A Muskegon, Mich., physician has pleaded guilty to billing Medicare, Medicaid and Blue Cross Blue Shield for services she didn’t perform, the U.S. Justice Department said June 7.
‘Our business model would implode’: Why a physician group exited a payer’s network
David Kowalski, MD, a physician with Springfield (Ill.) Clinic, a physician group with ASCs that dropped out of network with Blue Cross Blue Shield of Illinois last year after a pay dispute, shed light on the details of the dispute and what lies ahead …
ASCs find new strategies to avoid reimbursement woes
Many ASCs are facing increasing obstacles in the payer landscape, but ASC administrators and executives are developing strategies like direct-to-employer contracting and attracting patients to bypass them.
WakeMed’s UnitedHealthcare contract ends, but ASCs are unaffected
After months of negotiations, Raleigh, N.C.-based WakeMed and UnitedHealthcare failed to reach an agreement on a new contract, The News and Observer reported June 1.
Physician group severs contract with Anthem & 5 more payer updates
From a Maine physician group ending its contract with Anthem to Blue Cross Blue Shield updating its colonoscopy policy, here are six payer updates from the last 60 days:
Why orthopedic ASCs, physician groups should get on the direct-to-employer train
As the healthcare industry continues to move away from fee for service and toward value-based care, alternative payment models are expected to become more popular among patients, insurers and providers.
