Anthem software upgrade caused widespread claims payment errors in March Anthem Blue Cross recently announced that a software upgrade the weekend of March 19 resulted in a zero allowance for some provider claims. According to Anthem, approximately 130,000 claims were affected. The error was resolved on Thursday, March 24. The California Medical Association (CMA) was made aware of this problem by calls from members to our reimbursement help line. Anthem advised CMA that all impacted claims will automatically be reprocessed within 90-120 days and physicians do not need to resubmit claims or file appeals. Interest and penalties will automatically be ... April 18, 2016 Managed Care Commercial Insurance, Anthem Blue Cross 0 0 Comment Read More »
State issues new report cards for HMOs, PPOs, and large medical groups The California Office of the Patient Advocate (OPA) recently released its 15th annual “California Health Care Quality Report Cards,” which rates the state's health plans and medical groups on a four-star scale. Available in English, Spanish and Chinese, the report cards allow consumers to compare the quality of care that more than 16 million commercially insured consumers receive from the state’s 10 largest HMOs, six largest PPOs and more than 200 medical groups. The data for the report cards is drawn from claims data and patient surveys from 2013. Users can ... October 31, 2015 General, Managed Care Quality of Care, Commercial Insurance, HMOs, PPOs 0 0 Comment Read More »
