Given unpredictable volume, changing CMS regulations and varying service agreements, managing health insurance appeals and grievances (A&G) is a time-consuming and complex process, especially when done manually.
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Tom Croswell, the CEO of the newly combined Tufts Health Plan and Harvard Pilgrim Health Care, is retiring this summer, according to a Jan. 28 news release.
Premiums for insurance plans offered under the Affordable Care Act are poised to remain stable in 2021, according to ACASignups.net.
Blue Cross Blue Shield of Massachusetts warned members Jan. 27 about COVID-19 vaccine scams that may be attempting to collect personal health information.
Blue Shield of California reached an agreement with Gov. Gavin Newsom to oversee the distribution of COVID-19 vaccines, according to the Los Angeles Times.
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Despite objections, UnitedHealth Group has to reprocess 67,000 medical claims for behavioral healthcare that it previously denied, a federal judge said Jan. 27.
Aetna expanded its coverage of gender-affirming surgery for transgender women, the insurer said Jan. 26.
Health First Health Plans, the insurance arm of Rockledge, Fla.-based system Health First, signed a new administrative services agreement with an Oscar Health subsidiary, the organizations said Jan. 26.
Cigna CEO David Cordani sold 55,176 shares on Jan. 21, at an average price of $230 per share, according to filings with the Securities and Exchange Commission and Yahoo Finance.
Anthem's profit declined in the fourth quarter of fiscal year 2020 as the insurer saw greater expenses related to the COVID-19 pandemic, including higher testing and treatment costs.