In Billing
May 29th, 2019
Consumers overspent $18.5 billion on diagnostic imaging in 2017, according to a UnitedHealth Group (UHG) research brief, released May 23. The health insurer attributes the overspending to price gouging by some providers. Echocardiograms in 2017, for example, cost patients anywhere between $210 and $1,830, according to the brief. The average was $480, but UHG says ...
In Billing
Feb 1st, 2019
The Eight Circuit Court of Appeals upheld a lower court’s ruling regarding out-of-network payments by UnitedHealthcare (UHC). How Ruling Got Started UHC has a policy of offsetting payments for patients in a different plan when they are trying to recover what they considered an overpayment. These policies were put into effect in 2007 and were ...
In CMS
Nov 13th, 2018
Proton therapy has been a tough sell for payers, but recent $25 million Oklahoma decision against Aetna may make them reconsider coverage for the spreading radiation therapy technique. Proton Tx Considered Best Choice According to the Associated Press, jurors believed Aetna reckless disregarded its duty to deal fairly and in good faith with Orrana Cunningham.  ...
Oct 10th, 2018
UnitedHealthcare (UHC) has issued a clarification to its Skin and Soft Tissue Substitutes medical policy (2018T0592A) in regards to DermACELL®. Behind the Decision DermACELL® (LifeNet Health®) is advanced human acellular dermal matrix intended for the treatment of chronic wounds and soft tissue reconstruction such as implant-based breast reconstruction. A recent report for DermACELL concluded that ...
In Billing
Dec 28th, 2017
In August 2017, UnitedHealthcare (UHC) indicated they would no longer reimburse inpatient and outpatient consultation codes, as of Oct. 1, 2017. When the implementation date came, UHC indicated they would delay the consultation services revision until 2018: We previously announced that certain revisions to the Consultation Services Reimbursement Policy would become effective for UnitedHealthcare Co...