Just what do the Aetna, CIGNA, Health Net, and Anthem/WellPoint settlements in the physicians' national antiracketeering class action lawsuits mean for how physicians do business with these health plans in the future? Here's a side-by-side comparison of the billing, coding, and payment provisions of the four settlements and existing federal law.
Here are the topics the comparison covers:
- E&M Downcoding
- Add On and Modifier -51 Exempt
- Modifier -25
- Supervision and Interpretation
- Indented Codes
- Modifier -59
- Global Periods
- Automatic Downcoding of Service Intensity
- Annual Update of Modifier-51-Exempt Codes
- Non-exclusive Listing of Modifiers
For even more details, see: