Nov 1, 2023 | Insurance News
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...
Oct 25, 2023 | Insurance News
Navigating the intricate world of insurance claims can be daunting. That’s why our ANJC Insurance Team took center stage at the recent 2023 ANJC Fall Symposium to shed light on the complexities of carrier appeals for major providers, including Horizon, UHC,...
Oct 18, 2023 | Insurance News
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,...
Oct 3, 2023 | Insurance News
Effective September 14, 2023, Medicare has updated their Smart Edits which will affect how chiropractic claims are processed. For reference, Smart Edits detect potential errors within electronic claims and send a message back to the submitting care provider to explain...
Sep 20, 2023 | Insurance News
Dear ANJC Membership, The ANJC Insurance Team has received an update from Aetna regarding the status of the reprocessing of incorrectly denied orthotic claims and the necessary software update for all future orthotics claims. As of yesterday, claims prior to May 27,...
Jul 27, 2023 | Insurance News
Dear ANJC Membership, The ANJC Insurance team has been exchanging emails with Horizon for several months regarding third-party administrator-referenced-based pricing of out-of-network claims. Horizon extended an invitation for our team to connect with theirs via Zoom...
