Anthem BlueCross BlueShield and UnitedHealthcare: New Worries for Patients and Providers

Monday, March 19, 2018
News Alert Broadcast
10-10:30 a.m. EST; 7-7:30 a.m. PST

SPECIAL GUEST
Erica E. Remer, MD, FACEP, CCDS

FEATURING
Nancy Beckley, MS, MBA, CHC; Frank Cohen, MPA, MBB;|
Shannon DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA®,
David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM; and Mary Inman, Esq.

Patients and providers are reeling in Ohio, given the new Anthem BlueCross BlueShield emergency department (ED) policy, allowing the payer to decline claims for non-emergency ED visits. Advocates caution that Ohio patients might not visit the ED, fearful of not having their visits covered. Former ED physician-turned healthcare consultant Erica Remer, herself an Ohioan, will report on this developing story in the next edition of Monitor Mondays.

 Another headline grabbing story is the reported lawsuit filed by Envision Healthcare against UnitedHealthcare (UHC). Envision is using the giant insurer alleging the UHC “unilaterally” lowered payments of Envision’s contracted physicians, according to Axios. Healthcare attorney Mary Inman, a partner at Constantine Cannon, will report on this developing story, calling in from the firm’s London office.

Yet another story about UHC will be reported by Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS). UHC, DeConda will report, is cracking down on emergency ED service codes of Level 4 and 5.

The broadcast rundown also will include:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.
• Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO for Nancy Beckley and Associates, will return and report on all the latest hot topics and the Monitor Mondays Listener Survey.
• Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron will report on a developing story that some facilities are receiving CERT letters containing misleading information.

Register now for this news alert broadcast coming up at 10 a.m. EST on Monday, March 19.