Aetna

Aetna Launching Patient-Facing Physician Performance Designation - 11/15/2021

Aetna Health Insurance is instituting a physician comparison system for its self-insured members in 2022, in which primary care physicians, obstetrician-gynecologists, and orthopedic hip-and-knee specialists can earn a “designation” based on their performance in two categories.


Collecting Payment for Noncovered Services - 10/15/2020

Can you charge a patient for a service the patient’s health insurance plan doesn’t cover? Answer: It depends.


Commercial Risk Adjustment: One More Reporting Requirement - 07/28/2017

As part of Aetna’s commercial risk management initiative, a medical records vendor will contact you twice this year on behalf of Aetna. Here are some details about this process, required for all payers.


Guide to Preventive Services Covered Under the ACA - 08/31/2016

Can you name all the preventive health services that commercial health plans must cover under the Affordable Care Act (ACA)? Here are some lists, tips, and FAQs, including links to payers’ guides.


Global Surgery: Where to Find Payer Policies - 06/01/2016

When it comes to global surgery — all necessary services a surgeon normally furnishes before, during and after a procedure are included in the payment for the surgery — every payer has its own policies about coding and billing.  Here is a quick guide to payer rules.