Requirements for Billing With Taxonomy Codes

Dear ANJC Membership, Some of you have been asking for clarification on a recent requirement by most carriers related to taxonomy codes. The ZZ qualifier identifies the provider taxonomy code in the carriers’ software. This has been required for over a year;...
2024 Medicare Fee Schedule Is Available

2024 Medicare Fee Schedule Is Available

Be sure to review the newly released 2024 Medicare Fee Schedule!Details like the deductible ($240) and specific PAR and NON-PAR fees for various codes and localities have been updated. Whether in the 01 Region or the 99 Region, make sure you’re aware of the...

The Back Channel: The Medicare Edition

Medicare’s recent updates on how they process claims have caused some confusion about how to submit a clean claim and respond to rejected claims. We thought using this entire edition of The Back Channel dedicated to your Medicare questions and concerns was in...

Inovalon Risk Adjustment Reviews & Your Obligations

Over the years, members have reported receiving a letter, fax, or phone call from Inovalon on behalf of Horizon. Inovalon is a company that has historically performed what are called Risk Adjustment Reviews for various carriers.Risk Adjustment Reviews essentially...

Third-Party Repricing Concerns — Update

Dear ANJC Membership,As we have shared, the ANJC Insurance Team is actively communicating with insurance carriers on a variety of issues, including reimbursement and third-party repricing companies.While we cannot disclose the details of conversations with carriers,...