Oct 27, 2025 | Insurance News, News for Members
January 7, 2025 Update Horizon completed a second internal report on December 30, 2025, and has begun the bulk adjustment process for the remaining affected claims. As part of this process, some claims will be excluded if they fall outside the finalized scope of the...
Oct 21, 2025 | Insurance News, News for Members
Automobile insurers file hundreds of lawsuits in state and federal courts against doctors under the NJ Insurance Fraud Prevention Act (NJIFPA) and NJ RICO. They seek repayment of six years of claims multiplied by three plus attorney’s fees and costs and have the...
Sep 30, 2025 | Insurance News, News for Members
Important Notice Provider Directory Management—Ensure Your Directory Listings Are Accurate Under the No Surprises Act (NSA), health plans must maintain an accurate database provider website and verify the accuracy of the information at least every 90 days. The health...
Aug 9, 2025 | Insurance News, News for Members
Medicare CMS Phishing Scheme The Centers for Medicare & Medicaid Services (CMS) have become aware of a scheme to obtain patient records through fax requests. The faxes sent to providers demanding all patient information and medical records for Medicare patients....
Aug 4, 2025 | ANJC News & Updates, Insurance News, News for Members
By Dr. Richard C. Healy, ANJC Medicare Consultant As Medicare Advantage plans gain popularity, many providers question the process of filing an appeal when they receive an organizational determination resulting in an adverse denial of a claim. An Organizational...
Jul 11, 2025 | Insurance News, News for Members
July brings two critical deadlines for New Jersey chiropractors. Please review the information below to keep your practice compliant and up to date. Additional Prohibitions Under Medical Debt Relief ActTuesday, July 22, 2025 As a reminder, on July 22, 2024, New Jersey...
