Administered Claims on Behalf of Horizon

Dear ANJC Membership,The ANJC Insurance Team has been in active communication with Horizon regarding the market-based pricing for out-of-network claims administered by their third-party company on behalf of Horizon BCBS NJ. We have been aggressively pushing for...

Investigating Aetna-MA Recoupment Notices—UPDATE

Dear ANJC Membership, The ANJC Insurance Team has been aggressively seeking a resolution to the denials and recoupment requests of members’ orthotic claims.Today, the ANJC Insurance Team received an update from Aetna regarding your concerns. The Aetna contact has...

Investigating Aetna-MA Recoupment Notices

As part of our commitment to ANJC members, the ANJC Insurance Team monitors a variety of issues that affect the practice of chiropractic in New Jersey. It has come to our attention that members are receiving recoupment notices from Aetna-Medicare Advantage State Plans...

Virtual Credit Card Legislation Amended

On May 22nd virtual credit card legislation (A4913) was amended on the floor. This floor amendment replaced the language in the bill with new provisions concerning the method and manner of payment for reimbursement by carriers, or a carrier’s contracted vendor, to...

NJ PIP News: Providing Notice to PIP Insurers

As a review for members who are new or who may have new office staff:A treating healthcare provider must provide notice to the PIP insurer no later than 21 days following the date of the commencement of such treatment.  Below is the link for the 21-Day...

Aetna Update: 97140-59

As a reminder for ANJC membership: Manual therapy (97140), when performed on a separate anatomic site on the same date of service as a chiropractic manipulative treatment (98940—98942), must include a modifier -59. Below is the list of Aetna-approved ICD-10 codes that...