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    Anthem Blue Cross to reduce timely filing requirement to 90 days

    August 05, 2019
    All claims submitted on or after October 1, 2019, will be subject to the new 90 day filing requirement.

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    CMA continues advocacy on recent Anthem modifier 25 policy

    June 24, 2019
    CMA along with other state and specialty societies continue to voice concerns with the recent implementation of the Ant...

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    Reminder: Physicians encouraged to review changes to Anthem fee schedule

    May 08, 2019
    Anthem will be increasing payment for the more commonly billed Evaluation and Management (E/M) services.

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    Anthem announces fee schedule and contract changes effective July 1

    April 10, 2019
    According to a notice issued to approximately half of its PPO network, the plan will be increasing payment for the more...

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    Two health plans move patients to other delegated group effective April 1

    April 05, 2019
    This transition affects approximately 2,000 patients covered by Western Health Advantage or SCAN Health Plan.

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    Anthem Blue Cross to deny certain E&M services billed with modifier 25

    March 13, 2019
    Modifier 25 allows separate payment for a significant, separately identifiable E&M service provided on the same day as a...

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    Anthem issues new ID numbers for some patients

    January 30, 2019
    New ID cards containing the new ID number were mailed to all affected members in late December.

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    UnitedHealthcare delays outpatient advanced radiology policy until February 1

    January 14, 2019
    The new UHC policy—originally scheduled for implementation on Jan. 1—requires prior authorization for advanced imaging ...

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    Reminder: Blue Shield/Care1st to complete integration Jan. 1, 2019

    December 12, 2018
    On January 1, 2019, Blue Shield of California will complete the integration of Care1st Health Plan into its operations,...

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    Anthem Blue Cross correcting ultrasound recoupment issue

    December 11, 2018
    The California Medical Association has learned that Anthem Blue Cross is correcting a system error that has resulted in...

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    UnitedHealthcare to implement outpatient advanced radiology policy

    October 30, 2018
    Effective January 1, 2019, UnitedHealthcare (UHC) will require prior authorization for certain advanced imaging procedu...

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    First-ever TRICARE open enrollment begins November 12

    October 18, 2018
    Beginning November 12 and running through December 10, 2018, TRICARE will initiate its first ever open enrollment perio...

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    IEHP completes termination of Vantage contract; three plans extend termination dates

    October 09, 2018
    The California Medical Association (CMA) has confirmed that Inland Empire Health Plan (IEHP) completed its contract ter...

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    Updated payor profiles for 2018 now available

    October 01, 2018
    CMA's Center for Economic Services is publishing updated profiles on each of the major payors in California.

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    Health Net addresses problems with explanation of payment

    September 11, 2018
    This problem prevented providers from properly reconciling the amount Health Net is responsible for or the patient cost...

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    UnitedHealthcare to discontinue use of fax numbers for medical prior authorization requests

    September 11, 2018
    UnitedHealthcare announced in its September 2018 Network Bulletin that it will begin retiring fax numbers utilized for ...

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    Health Net Federal Services continues to address TRICARE transition issues

    September 10, 2018
    As previously reported, Health Net Federal Services (HNFS) has experienced implementation issues since taking over as t...

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    UnitedHealthcare Community Plan preps for entry into additional Medi-Cal and Medicare Advantage markets

    August 23, 2018
    Looking to increase its presence in the Medi-Cal and Medicare Advantage marketplace by 2021, UnitedHealthcare (UHC) Com...

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    SB 1156 takes California back to the bad old days

    August 05, 2018
    Not long ago, health insurance companies limited access to insurance and quality health care for millions of California...

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    UnitedHealthcare releases latest Premium Designation physician results

    August 03, 2018
    UnitedHealthcare (UHC) recently released its latest Premium Designation assessment results to California physicians on ...

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    United Healthcare Smart Edits go live August 16

    August 03, 2018
    UnitedHealthcare (UHC) will implement its Smart Edits program for professional claims for all of its commercial, Medica...

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    CMA applauds California Department of Insurance in opposing CVS/Aetna merger

    August 02, 2018
    Today, the California Medical Association (CMA) applauded the finding of the California Department of Insurance that ...

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    UnitedHealthcare updates emergency department facility E/M coding policy

    May 07, 2018
    Citing the need to address inconsistencies in coding, UnitedHealthcare (UHC) recently altered its Emergency Department...

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    Act now to avoid costly virtual credit card fees on Aetna physician payments

    May 01, 2018
    The California Medical Association (CMA) has learned that Aetna will no longer allow contracted physicians to receive p...

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    Reminder: Health Net policy changes to Medicare Advantage and Medi-Cal managed care products take effect May 16

    April 30, 2018
    Health Net notified physicians in March of new payment policies for its Medicare and Medi-Cal lines of business, effect...

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    Health Net announces policy changes to Medicare Advantage and Medi-Cal managed care product lines

    March 23, 2018
    Health Net recently announced several new payment policies for its Medicare and Medi-Cal lines of business, effective M...

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    CMA asks DMHC to require Anthem to publish effective dates for clinical policies

    March 07, 2018
    Unlike all other major payors in California, Anthem Blue Cross does not disclose on its website the effective dates for ...

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