by NCCA | Dec 5, 2024 | Billing, Insurance
Courtesy of Sheri Frost You cannot convert a patient to cash if their condition meets medical necessity based on the payer guidelines. If you do not receive the requested number of visits for prior authorization, then you must submit for more based on medical...
by NCCA | Nov 26, 2024 | Billing, Insurance
Courtesy of ChiroHealthUSA Recently, Healing Place Medical, P.C. and its owner, chiropractor Dr. Gregory Thomas White Jr., had to pay $170,000 to settle allegations of improper billing. The issue? They were accused of billing Medicare for treatments involving the...
by NCCA | Nov 25, 2024 | Billing
The North Carolina State Health Plan will transition to Aetna, its new third-party administrator effective January 1, 2025. Additional information including the fee schedule can be found here. NCCA member, Liz Nieland, has compiled general CPT Codes that are billable...
by NCCA | Sep 23, 2024 | Billing, Insurance
Beginning Feb. 1, 2025, we’re adding the following GA modifier requirement for UnitedHealthcare commercial plan claims to our Charging members for non-covered servicesopen_in_new protocol. This requirement should help improve health care transparency by ensuring...
by NCCA | Aug 22, 2024 | Insurance, Legislative News, Member News
Utilize the Patient Advocacy Flyer This flyer includes vital information about the prior authorization changes and guidance on how patients can advocate for themselves by contacting their insurance providers directly.It clearly instructs your patients on how to...
by NCCA | Jun 14, 2024 | Insurance
Providers will need to join the NC State Health Plan Network as a Clear Pricing Project (CPP) provider before member open enrollment September 30th. Please note – Current CPP providers will need to rejoin through Aetna for 2025. Go.Aetna.com/joincpp
