Take the challenge. A—The commercial insurance coverage is primary in this situation. Medicare should be billed secondarily because it will not become primary until after the first 30 months of ESRD Medicare entitlement. After that, Medicare will be primary no matter the patient’s employment status. C—Unless the patient has a qualifying condition, such as ESRD,…
Search results for: health insurance
UnitedHealthcare Delays Policy Changes Affecting Physician-Administered Treatments
Changes announced at the beginning of October have now been delayed for Actemra, Benlysta, Cimzia, Orencia and Simponi Aria, but changes to the Stelara policy remain in effect.
One-Quarter of Every U.S. Healthcare Dollar Wasted
(Reuters Health)—About a quarter of the dollars spent on healthcare in the U.S. may be wasted, a new analysis suggests. Six types of waste in healthcare could be costing as much as $935 billion annually, according to the study published in JAMA.1,2 The biggest source of waste is “administrative complexity,” says the study’s lead author…
Healthcare Professionals Can Tap the ARP for Assistance
The ARP has a lot to offer members, including training and professional development, patient resources and volunteer match opportunities.
UnitedHealth Boosts Earnings Forecast, Set to Pass Price Discounts to Patients
July 18 (Reuters)—UnitedHealth Group Inc. will stick with its decision to pass on drug maker discounts to patients to help them beat rising medicine prices despite the U.S. government having withdrawn a similar proposed policy in its health programs, its top executive said on Thursday. “You can expect us not to change our stance on…
Top 2020 Contenders Snipe over Healthcare Policy
WASHINGTON (Reuters) – Democratic presidential front-runner Joe Biden and rival Bernie Sanders are waging a public battle this week over universal healthcare, staking out competing turf on an issue that has become the most divisive in the party’s primary campaign. The sniping between the two White House contenders, highlighted on Wednesday when Sanders delivered a…
New Wins, Ongoing Challenges for ACR Insurance Subcommittee
Corrections to reimbursement system errors with Aetna and a Medicare contractor demonstrate the latest wins for all providers by the ACR’s Insurance Subcommittee. But the committee remains hard at work advocating for rheumatologists on several fronts.
Democrats Clash on Healthcare in Scrappy First U.S. Presidential Debate
MIAMI (Reuters)—Democratic presidential contenders battled over healthcare coverage and border policy on Wednesday during a surprisingly heated first debate that laid bare the party’s divisions on whether to abolish private insurance and shift to a Medicare-for-All system. In the first round of back-to-back debates, several of the lesser-known candidates vied for attention in the crowded…
Table Stakes: The Right to Healthcare
Table stakes. It took me a moment to register what they were talking about. I was listening to Pod Save America, a wildly popular podcast put together by some of Barack Obama’s former speechwriters. It is, I imagine, what an MSNBC podcast might sound like if Rachel Maddow and Chris Hayes were allowed to swear….
Bringing a Frontline Perspective to Insurance Advocacy
Early in his career as a resident at Washington University in St. Louis, Mo., Christopher Phillips, MD, felt a connection to his patients battling rheumatic diseases. Today, Dr. Phillips balances time with his solo private practice in Paducah, Ky., to help rheumatologists fight insurance battles for their patients in his role as chair of the…
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