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AETNA to introduce a variety of new claim edits effective December 1st, 2021
On December 1st, 2021, Aetna launches a new Third-Party claim and Code Review Program. Providers may receive medical records for…
Empire has implemented new claim edits for bundled conditions
On January 1, 2022, Empire Blue Cross Blue Shield started to apply new claim edits for the diagnosis codes that…
Understanding Safe Harbors: Permissible Business Practices and Arrangements under the Anti-Kickback Statute
In 1987, the “Medicare and Medicare Patient and Protection Act” mandated that the Department of Health and Human Services (HHS)…