In Billing
Aug 5th, 2019
Anthem has sent out a notice to all providers who have signed non-Medicare or Medicare Advantage contracts with them, stating: “Effective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. 1, 2019, your Anthem Blue Cross and Blue Shield (Anthem) Provider Agreement(s) will be amended to require the ...
In CMS
Nov 1st, 2018
Anthem paid a $16 million settlement resulting from a series of attacks in both 2014 and 2015 that had the potential to expose personal health information (PHI) of 79 million people.  Although they paid the $16 million settlement, Anthem does not admit to any wrong doing.  This represented the largest PHI breach in US history ...
Jul 9th, 2018
A former fraud investigator for Anthem, Inc. is one of five people indicted on federal healthcare fraud charges. Those indicted participated in a multi-year scheme to commit fraud against at least eight health insurance companies. The fraud investigator from Anthem provided the other defendants with confidential Anthem information that assisted them file fraudulent claims to ...
In Billing
Mar 1st, 2018
Anthem has sent a letter to the AMA to announce  they are rescinding the policy reducing payment for physicians when billing an E/M with a modifier 25 and a procedure that has zero or 10 global days. Anthem was planning on taking a 25 percent reduction on all 25 modified services billed with minor procedures as ...
On November 19, one of the nation’s largest insurers announced they were second guessing their choice to sell coverage in the Affordable Care Act’s individual markets for 11 states. According to MSN, UnitedHealth’s “Losses from the plans this year and next will total more than half a billion dollars.” Although UnitedHealth was late to join ...