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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

Anything But Routine: New UnitedHealthcare Line-Item Denial Process May Significantly Impact Hospital Reimbursement

UnitedHealthcare recently announced that it will implement a process effective December 1, 2024, under which United may deny charges for inpatient and outpatient facility services that United considers "routine."...more

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