Apr 26, 2018 | Insurance News
04/26/2018Appellate Division Ruling in SHBP Case The ANJC today received the Appellate Division’s decision in the State Health Benefit Plan $35 cap on out-of-network chiropractic reimbursement appeal. Unfortunately, the decision is not in our favor. The...
Mar 28, 2018 | Insurance News
03/28/2018Horizon 98943 Issue Update As previously reported, we have seen many denials of 98943 from Horizon with the denial reason code: U702: “This service is not paid. This denial occurred because the procedure code has a status indicator of N, I, P, M, R or C....
Mar 14, 2018 | Insurance News
03/14/2018Horizon 98943 & 97014 Denials We have recently heard from many members that CPT codes 98943 and 97014 are being denied on various (but not all) Horizon plans. We have seen these denials with two different reason codes. The more common is reason...
Mar 7, 2018 | Insurance News
03/07/2018Horizon NJ Health (Medicaid) to Stop Reimbursing 98943 Horizon NJ Health, Horizon’s Medicaid managed care subsidiary, has announced that it will no longer reimburse CPT code 98943, extra-spinal manipulation, as of April 1, 2018. Click here to see the...
Mar 6, 2018 | Insurance News
03/06/2018Medicare Audit Request Audits of all kinds have been expanding in both frequency and depth. The ANJC is seeking to understand what is being sought in these audits and how doctors can best pass them. We are currently focusing on the wide variety...
Feb 14, 2018 | Insurance News
02/14/2018Medicare Advantage – Clover Audit Letter Many ANJC members have received letters from Clover, a Medicare Advantage insurance carrier, stating that files had been audited, overpayments were issued to the doctor and will be recouped. The letter was...
