Jun 17, 2026 | Insurance News, News for Members
Some ANJC members may have seen denials of some services for Aetna Medicare Advantage SHBP/SEHBP members from January through April 2026. Claim denials may have said “chiropractors are not authorized to provide certain services” or wording similar. Aetna has informed...
Jun 10, 2026 | Insurance News, News for Members
July 8, 2026 UpdateHorizon is working directly with Anthem to review the provider files and ensure alignment. Horizon is also actively reviewing denials to ensure the appropriate root cause is determined with Anthem due to the multiple scenarios we are seeing. Anthem...
May 8, 2026 | Insurance News, News for Members
Providers using third-party vendors to check Medicare beneficiary eligibility must now enroll these vendors with CMS by May 11, 2026. This is only for checking Medicare eligibility through your clearinghouse! If you opt not to attest, you may still verify eligibility...
Apr 2, 2026 | Insurance News, News for Members
Dear ANJC Members, We want to make you aware that we have received information that Aetna has begun issuing retroactive reprocessing and overpayment notifications for acupuncture services provided to SEHBP/SHBP retirees enrolled in the Aetna Medicare Advantage Plan....
Mar 17, 2026 | Insurance News, News for Members
The Office of Management and Budget (OMB) has approved the control number for the Advance Beneficiary Notice of Non-coverage (ABN) (CMS-R-131). The updated ABN is effective now and expires March 31, 2029. Providers may continue to use the expired version of the ABN...
Mar 8, 2026 | Insurance News, News for Members
In another ploy to restrict your ability to practice safely, Anthem Blue Cross/Blue Shield and others have attempted to dictate when you, as a trained professional, should or should not perform medically necessary X-ray studies. Several of our doctors throughout the...
