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Aetna -25 & -59 Modifier Claim Edits

by matt@anjc.info | Dec 1, 2020 | ANJC News, Health Insurance Carriers, Industry News, Insurance News, Uncategorized

If you recall, in early 2019 Aetna began blanketly denying codes with the -25 and -59 modifiers.  After the ANJC took the matter to Aetna and the NJ Department of Banking and Insurance (DOBI), Aetna ceased the practice and reprocessed effected fully-funded...

Aetna Moves to Availity for Provider Portal

by matt@anjc.info | Apr 1, 2020 | Health Insurance Carriers, Insurance News

Aetna Moves to Availity for Provider Portal Aetna has announced it is moving its provider portal services from Navinet to Availity.  Per its March 2020 newsletter, as of April 30, 2020, Availity will be its sole provider portal.  Aetna has advised that if you use...

Inovalon-Horizon Update

by matt@anjc.info | Mar 17, 2020 | Health Insurance Carriers, Insurance News

Inovalon-Horizon Update As we have previously reported to you, Inovalon is a company that is collecting patient records to perform risk adjustment reviews on behalf of Horizon.  Risk adjustment reviews are reports required by and provided to the government as dictated...

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