UnitedHealthCare (UHC) postponed a plan that would require Texas physicians to substantially increase their professional liability insurance coverage in order to participate in its networks. The move comes after the Harris County Medical Society and Texas Medical Association expressed serious concerns about the new policy.

Blues to Expand HMO Network in January; Check Your Status - 10/21/2022

Blue Cross and Blue Shield of Texas (BCBSTX) will expand its MyBlue Health HMO network to six Texas counties starting in January.

UnitedHealthcare Eliminates Copay Costs on Insulin, Other Life-Saving Medications - 08/05/2022

Some patients struggling with the cost of medications like insulin and epinephrine just got a small-but-important break from one of the nation’s largest health insurers.

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.

United Walks Back Payment Cut on Nonphysician Billing - 08/05/2021

Following strong pushback from the Texas Medical Association, UnitedHealthcare (UHC) has effectively reversed its payment-cutting policy change on “incident-to” billing for services performed by nonphysician practitioners (NPPs).

Did You Subscribe to UHC’s Premium Payment Program? Check By March 31 - 03/29/2021

TMA reminds practices that now is a good time to determine whether you are enrolled in UnitedHealthcare’s (UHC) Optum Pay Premium program, which charges a fee for access to certain electronic data. Physicians and practices who wish to opt out of the program should do so by March 31.

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.

See Blue Cross Referral Chart, Colonoscopy Coding Tips - 10/14/2020

As a result of “feedback from the provider community,” Blue Cross and Blue Shield of Texas has removed 111 procedure codes from its preauthorization requirements related to additional care categories of codes.

Charging Concierge Fees to BCBSTX Patients - 09/23/2020

Although Blue Cross and Blue Shield of Texas (BCBSTX) places limits on the additional fees participating network physicians can charge BCBSTX patients, some are allowed when you provide concierge services.

Dos and Don’ts of Using Modifier 22 - 04/25/2019

Sometimes the work to provide a service is “substantially greater” than typically required on the date of services. When this happens, document the extra work by adding modifier 22 to the procedure code.

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