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The class action lawsuit alleges Aetna Health is claiming reimbursement it isn't entitled to when customers settle medical malpractice cases. Lawsuit claims insurer Aetna is wrongly taking money ...
The settlement couldn't be completed with Aetna's claim pending, and ultimately, McWilliams agreed to pay it. The problem, according to the lawsuit filed last month in Polk County, is that Aetna ...
Aetna, et al., a frustration succinctly summarized in his quote from a previous decision in "Andrews-Clarke v. Travelers Ins. Co., " (a Complaint by a widow for the death of her husband as a consequence of a Managed Care Utilization review decision that cut short her husband's physician's recommended in-hospital treatment plan) as follows:
Rejected Claims. Rejected claims cannot be processed, typically due to errors or omissions in the filing process. Unlike denied claims, rejected claims must be corrected and resubmitted. Failure to address rejected claims can lead to significant revenue loss, making timely rework essential. Step 7: Creating Patient Statements [4]
The EDI Health Care Claim Transaction Set (837) is used to submit health care claim billing information, encounter information, or both, except for retail pharmacy claims (see EDI Retail Pharmacy Claim Transaction). It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims ...
The settlement website says people who change their mailing address after submitting a claim are responsible for alerting the claims administrator about their new contact information. To do that ...
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A Shawnee County judge denied a petition from health insurance company Aetna challenging the new Kansas Medicaid contracts for KanCare MCOs.