Appealing An Insurance Company Claim Decision

from our friends at: Healthcare.gov Internal appeals There are 3 steps in the internal appeals process: You must file your internal appeal within 180 days (6 months) of receiving notice that your claim was denied. If you have an urgent health situation, you can ask for an external review at the same time as your internal appeal. If your insurance … Read More

Dental Insurance: What’s Covered, What’s Not

from our friends at: WebMD What Is Dental Insurance? Dental insurance is insurance that covers dental health and care. Because dental health, also called oral health, is important to your overall health, you may want to get dental insurance to help you pay for the cost of your dental care. You can purchase dental insurance as part of a medical … Read More

AI May Not Be So Smart When Payors Use It To Deny Medical Claims

from our friends at: Specialty Pharmacy Continuum Concerns are growing about the increasing use of artificial intelligence to review—and in many cases deny—healthcare claims, sparking a congressional inquiry and lawsuits. Thirty-two legislators sent a letter to the Centers for Medicare & Medicaid Services (CMS) on Nov. 3, 2023, urging increased oversight of the use of these tools in Medicare Advantage … Read More

CA Bill Introduces Food Additive Ban

from our friends at: CNBC A state legislator introduced a first-of-its-kind bill Tuesday that would ban seven additives from the foods that are served in California’s public schools. Assembly Bill 2316 would prohibit school cafeterias from offering foods containing six artificial food dyes that have been linked to hyperactivity and behavioral issues in some children. It would also outlaw titanium … Read More

More Than Half of Californians Skip or Delay Medical Care Due to Cost

February 13, 2024 | Source: Capital & Main, by Mark Kreidler For most California residents, and the vast majority of the state’s lower income workers, the cost of health insurance has been running away from them for years. That’s hardly news to anyone who has actually used their health policy in the recent past. But the health care squeeze is … Read More

International Health Insurance 101

Growing demands lead to trusted, top-notch international health insurance availability. You only have to scan social media or the news to see that globalization is at the epicenter of the new world order. As global lifestyles continue, the demand for comprehensive international health insurance has increased. In response to this demand, superior health plans are now available to serve expatriates … Read More

Important information for patients with Anthem Blue Cross health insurance plans

from our friends at: UCLA Health Feb. 5, 2024 – UPDATE Anthem Blue Cross and University of California Health have reached a preliminary agreement on a contract that will preserve access to UC health care for patients with Anthem health insurance, as Anthem and UC Health finalize the details in the coming weeks. This means UCLA Health will remain in-network … Read More

Important Information For Patients With Anthem Blue Cross Health Insurance Plans

Anthem Blue Cross has terminated its agreement with UC Health, including UCLA Health, jeopardizing in-network access to care for millions of Californians. It is Anthem’s decision alone to terminate the agreement without cause. If a new agreement is not in place by February 29, 2024, UCLA Health will be considered out-of-network beginning March 1, 2024, for the following Anthem-covered patients:Patients … Read More

When You Need to See the Dentist: 6 Signs You Should Visit

from our friends at: www.aetna.com Young children, a demanding job, a friend in need ― many things can cause preventive health care to fall by the wayside. Until a nagging symptom reminds you it’s been a while since your last checkup. It’s tempting to put off seemingly minor dental issues until your schedule lightens up. But the warning signs below … Read More

No Surprises Act: Has The Law Had The Desired Impact On Surprise Billing?

from our friends at: www.benefitspro.com Here’s a surprise: The No Surprises Act (NSA) passed by Congress in 2020 is working. That’s the word from a research report from the Urban Institute. Several researchers from the Urban Institute and Georgetown University’s Center on Health Insurance Reforms (with backing from the Robert Wood Johnson Foundation) conducted interviews with 32 regulators and stakeholders representing … Read More