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Anesthesiologists said Anthem’s policy would have added a significant amount of undue strain to providers and patients and reflects a great misunderstanding of how things work in the operating room.
Anthem Blue Cross Blue Shield said Thursday that the health insurance provider is reversing a policy that was set to go into effect in February that would have limited anesthesia coverage during ...
In Anthem’s announcements, the insurer advised people who disagree with claims filed under the new policy to “follow the claim dispute process as outlined in the Provider Manual.”
In 2007, the California Department of Managed Health Care (DMHC) investigated Anthem's policies for revoking (rescinding) health care insurance policies. The DMHC randomly selected 90 instances where Anthem canceled the insurance of policy holders who had been diagnosed with costly or life-threatening illnesses, to find how many of these ...
Blue Shield was developed by employers in lumber and mining camps of the Pacific Northwest to provide medical care by paying monthly fees to medical service bureaus composed of groups of physicians. [9] [10] In 1939, the first official Blue Shield plan was founded in California. In 1948, the symbol was informally adopted by nine plans called ...
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 ...
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