Anthem BlueCross BlueShield and UnitedHealthcare: New Worries for Patients and Providers

Monday, March 19, 2018
News Alert Broadcast
10-10:30 a.m. EST; 7-7:30 a.m. PST

SPECIAL GUEST
Erica E. Remer, MD, FACEP, CCDS

FEATURING
Nancy Beckley, MS, MBA, CHC; Frank Cohen, MPA, MBB;|
Shannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA®,
David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM; and Mary Inman, Esq.

 

Patients and providers are reeling in Ohio, given the new Anthem BlueCross BlueShield emergency department (ED) policy, allowing the payer to decline claims for non-emergency ED visits. Advocates caution that Ohio patients might not visit the ED, fearful of not having their visits covered. Former ED physician-turned healthcare consultant Erica Remer, herself an Ohioan, will report on this developing story in the next edition of Monitor Mondays.

 Another headline grabbing story is the reported lawsuit filed by Envision Healthcare against UnitedHealthcare (UHC). Envision is using the giant insurer alleging the UHC “unilaterally” lowered payments of Envision’s contracted physicians, according to Axios. Healthcare attorney Mary Inman, a partner at Constantine Cannon, will report on this developing story, calling in from the firm’s London office.

Yet another story about UHC will be reported by Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS). UHC, DeConda will report, is cracking down on emergency ED service codes of Level 4 and 5.

The broadcast rundown also will include:

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.
  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO for Nancy Beckley and Associates, will return and report on all the latest hot topics and the Monitor Mondays Listener Survey.
  • Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron will report on a developing story that some facilities are receiving CERT letters containing misleading information.

 

Register now for this news alert broadcast coming up at 10 a.m. EST on Monday, March 19.

Facebook
Twitter
LinkedIn
Email
Print

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering Good Faith Estimates Under the No Surprises Act: Compliance and Best Practices

Mastering Good Faith Estimates Under the No Surprises Act: Compliance and Best Practices

The No Surprises Act (NSA) presents a challenge for hospitals and providers who must provide Good Faith Estimates (GFEs) for all schedulable services for self-pay and uninsured patients. Compliance is necessary, but few hospitals have been able to fully comply with the requirements despite being a year into the NSA. This webcast provides an overview of the NSA/GFE policy, its impact, and a step-by-step process to adhere to the requirements and avoid non-compliance penalties.

Mastering E&M Guidelines: Empowering Providers for Accurate Service Documentation and Scenario Understanding in 2023

Mastering E&M Guidelines: Empowering Providers for Accurate Service Documentation and Scenario Understanding in 2023

This expert-guided webcast will showcase tips for providers to ensure appropriate capture of the work performed for a visit. Comprehensive examples will be given that demonstrate documentation gaps and how to educate providers on the documentation necessary to appropriately assign a level of service. You will gain clarification on answers regarding emergency department and urgent care coding circumstances as well as a review of how/when it is appropriate to code for E&M in radiology and more.

June 21, 2023
Breaking Down the Proposed IPPS Rule for FY 2024: Top Impacts You Need to Know

Breaking Down the Proposed IPPS Rule for FY 2024: Top Impacts You Need to Know

Set yourself up for financial and compliance success with expert guidance that breaks down the impactful changes including MS-DRG methodology, surgical hierarchy updates, and many new technology add-on payments (NTAPs). Identify areas of potential challenge ahead of time and master solutions for all 2024 Proposed IPPS changes.

May 24, 2023

Trending News