Leslie Murphy

May 21, 2024 | jdsupra.com | John Barnes |Leslie Murphy

Aetna recently announced that it is rolling out a national protocol under which it will be reviewing both physician and hospital emergency department claims that include Level 4 or 5 evaluation and management (E&M) codes, and after that review, "may adjust your payment if the claim details don't support the level of service billed." The process will apply to both fully insured and self-funded benefit plans, and will go into effect on July 8, 2024.

May 21, 2024 | mondaq.com | John Barnes |Leslie Murphy

Aetna recently announced that it is rolling out a national protocol under which it will be reviewing both physician and hospital emergency department claims that include Level 4 or 5 evaluation and management (E&M) codes, and after that review, "may adjust your payment if the claim details don't support the level of service billed." The process will apply to both fully insured and self-funded benefit plans, and will go into effect on July 8, 2024.

May 20, 2024 | lexology.com | John Barnes |Leslie Murphy

Aetna recently announced that it is rolling out a national protocol under which it will be reviewing both physician and hospital emergency department claims that include Level 4 or 5 evaluation and management (E&M) codes, and after that review, "may adjust your payment if the claim details don't support the level of service billed." The process will apply to both fully insured and self-funded benefit plans, and will go into effect on July 8, 2024.