Elizabeth Key

Elizabeth Key

Davis Wright Tremaine LLP

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Anthem's New Chargemaster-Based Claim Edits: Which Charges and Providers Will Anthem's New Process Target and How Will It Impact...

Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims...more

7/24/2025  /  Anthem Blue Cross , Emergency Rooms , Fraud , Health Insurance , Hospitals , Insurance Claims , Insurance Industry , Insurance Regulations , Medicare Advantage , Reimbursements

Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025

Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more

6/27/2025  /  Health Insurance , Hospitals , Insurance Claims , Insurance Industry , Medicaid , Medicare , New Regulations , Physicians , Reimbursements
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