ASC Coding, Billing & Collections

Humana Advantage Plan members in North Carolina will no longer be in network with Raleigh-based WakeMed and Greenville-based ECU Health, according to an Oct. 19 report from CBS affiliate WNCT.

UnitedHealthcare Group, which has an annual revenue of $324 billion, is the largest health insurance company in the U.S. by market share, according to a report from ValuePenguin updated in October. 

Zanesville, Ohio-based Genesis HealthCare System will no longer accept Anthem or Humana Medicare Advantage plans beginning in 2024. 

Columbia, Tenn.-based payer Farm Bureau Health Plans has added Nashville, Tenn.-based Ascension Saint Thomas to its Medicare Advantage provider network. 

CMS settled a record-breaking $9.29 million in Stark law voluntary self-referral disclosure settlements in 2022, according to recent CMS data.

Morgantown-based West Virginia University Medicine has launched an in-house health insurance services company, Peak Health, which has been serving WVU Medicine employees. Now, the system is expanding its offerings to Medicare-eligible patients throughout the state, according to an Oct. 19…

HHS' Office of the Inspector General has confirmed broad protection of employee safe harbor under anti-kickback laws in a recent ruling involving physician ownership of an ASC, according to an Oct. 17 article in JDSupra written by law firm Sheppard…

CMS is floating the implementation of a separate add-on payment for healthcare common procedure coding system code G2211 in its 2023 Medicare Physician Fee Schedule, according to an Oct. 13 report in JDSupra written by law firm Reed Smith. 

From negotiating new contracts to expanding plans, here are five moves from these three major payers since Oct. 2: 

Health insurer Cigna has been ordered to pay over $172 million to settle claims that it submitted false diagnosis codes to Medicare Advantage, according to an Oct. 2 report from CBS News.