The prior authorization burdens associated with the process have long been a source of frustration for healthcare providers and patients. These burdens can impede optimal care by creating delays in treatment and increasing administrative tasks. However, recent legislative changes and insurer policies aim to alleviate these concerns and streamline the prior authorization process. A radiation […]
AI represents a promising frontier, especially in healthcare, where leveraging vast information could revolutionize problem-solving. However, a shadow looms over AI, as anticipated by many. In the realm of health insurance and patient care denials, AI has already stirred controversy, leading to a notable class action lawsuit. According to reports from healthcare News, Health Insurance […]
Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]
CPT code 99214. Is that Jean Valjean’s number? No. It is an evaluation and management (E&M) code of moderate complexity. Few CPT® codes cause goosebumps, a chill in the air, and a pit in your stomach besides CPT code 99214. It is an E&M code of moderate complexity. For a low-complexity visit, the code decreases […]
The Affordable Care Act (ACA) introduced significant changes to the U.S. health insurance market, including requirements that affect small-group health coverage. For small employers, understanding these requirements is important when selecting health plans, evaluating employee coverage, and maintaining compliance with applicable federal and state regulations. The ACA established standards for many small-group health plans and […]
UnitedHealth Group, Anthem, Aetna, and Cigna returned to the list of the top five largest health insurers and one newcomer joined the list. UnitedHealth Group, Anthem, Aetna, and Cigna held onto their status as the top four largest insurers, but in 2020 Kaiser rose to fifth place. AMA was careful to point out that data […]






