Insurance issues dealing with CMS to private insurance.
If you can’t find the information you are looking for or need help with a question, contact the FCA Insurance and Legal Liaison Office.
(From the Sept. 3 ACA Member Update) In the July 9 and July 30 issues of Week in Review, ACA notified members about CIGNA’s new supporting documentation requirements for certain services reported with the -25 and -59 modifiers.
The FCA thanks our members for sending examples of Blue Cross Blue Shield (BCBS) reimbursement limitations. These examples have been collected, reviewed, sorted and organized into the different issues. The FCA legal team may still request documentation on issue-specific claims; however, they will make these requests on a case by case basis.
Despite a very costly Blue Cross Blue Shield-sponsored blitz of statewide media advertising urging otherwise, yesterday Gov. Charlie Crist signed into law Senate Bill 1122.
As if their latest assault on in-network providers wasn't enough, now BlueCross BlueShield is aiming for out-of-network providers, urging Governor Crist to veto a bill recently approved by the Florida Legislature requiring insurers to honor patients' assignments of benefits.
Your immediate help is needed to urge Governor Crist to approve this important legislation and reject the deceitful campaign BlueCross is waging now on the airwaves. We also ask that you engage your patients in this important pro-consumer, pro-choice endeavor at once.
THE FCA NEEDS YOUR INPUT!
The FCA legal team has been researching the many issues surrounding the recent policy changes by Blue Cross Blue Shield of Florida. A plan of action has been developed and we now need specific information in writing from our members in order to move forward. PLEASE, remember to sanitize or redact all protected health information, such as the patient’s name or identity. You may also wish to redact your provider identification information (except for your degree), which might include Remittance Advice or Claim Numbers.
What do you do if you receive a letter from a health insurance carrier requesting a refund due to overpayment? Do you have to pay it?
The FCA has been researching the many concerns members have voiced regarding BCBSF changes in reimbursements.
According to a notice from CMS (Centers for Medicare Services), the new ABN will NOT be required September 1.
In a July 2 message, ACA asked state associations to convey a request for input and assistance in addressing complaints about certain Aetna policies relating to chiropractic care.
CMS issued yet another bulletin on April 24 expressing concern about the pending May 23 deadline for use of the NPI alone on Medicare claims.
