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For-profit insurers, like Aetna, continue to reap the benefits of multi-year contracts that do not reflect the current health care landscape, with reimbursement increases substantially lower than ...
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 ...
Aetna has about 200,000 Medicare Advantage customers in the state. And it has begun to offer plans to nearly 600,000 state employees and teachers for coverage that would go into effect July 1 ...
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.
Self-funded health care, also known as Administrative Services Only (ASO), is a self insurance arrangement in the United States whereby an employer provides health or disability benefits to employees using the company's own funds. [1]
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This year, women at risk of breast cancer began receiving reimbursement denials from Medicare for identical ultrasound screenings Medicare approved in 2023, patient documents show.
Aetna is taking multiple Kansas state agencies to court in Shawnee County in an appeal over the company ... The MCO contracts were rebid in 2023 and seven entities responded to the request for ...