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Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Text of Aetna Health Inc. v. Davila, 542 U.S. 200 (2004) is available from: Cornell Findlaw Google Scholar Justia Library of Congress Oyez (oral argument audio) Section $1132, ERISA Civil Enforcement; Pilot Life Insurance v. Dedeaux Supreme Court case; Aetna Health Inc. ERISA preempts the THCLA by Kim Rankin
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Hackensack Meridian Health, locked in a contract dispute with Aetna, has sent letters to the insurer's customers warning them that they may lose in-network coverage if the two sides can't reach a ...
Enroll by phone. Call the marketplace toll-free at 800-318-2596. ... The number is available 24 hours a day, 7 days a week (except holidays). ... a Wall Street Journal investigation found that ...
HEDIS results must be audited by an NCQA-approved auditing firm for public reporting. NCQA has an on-line reporting tool called Quality Compass that is available for a fee of several thousand dollars. It provides detailed data on all measures and is intended for employers, consultants and insurance brokers who purchase health insurance for groups.
Health insurance company Aetna is suing the state of Kansas after losing its managed care organization contract with KanCare. Aetna Better Health of Kansas filed the lawsuit July 24 in Shawnee ...
AD&D insurance is offered by group insurers and provides benefits in the event of accidental death. It also provides benefits for certain specified types of bodily injuries (e.g., loss of a limb or loss of sight) when they are the direct result of an accident. [25] Insurance companies have high administrative costs. [148] [149]