Author Archives: tandersen

Aetna 25 visit max

I’ve discussed Aetna before…their covering only specific conditions, etc.  but I’ve never talked about how “unlimited visit” policies work. For starters, there are hurdles to jump to get “unlimited visits.”  Typically with Aetna, after a patient has 25 visits of a … Continue reading

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Medicare policies may cover acupuncture

As many medicare beneficiaries opt out of straight medicare to go with an alternative insurance, acupuncture benefits are more and more creeping into what is covered.  Let me back up for those of you unfamiliar with medicare plans…. First of … Continue reading

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Calif. work comp claim completion changes

There were some changes made a few months ago as to how claims are filled out specific to California Worker’s Comp billing only.  Relative to a CMS1500 claim form, box 1a no longer has the claim #, instead it has the patient’s … Continue reading

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Aetna Paper EOBs no longer as of March 1!

Starting March 1, 2012, Aetna will no longer be mailing paper EOBs!  You’ll have to go on-line to print or view them yourself  – otherwise, you don’t know who or what a payment is for.  To do this, you’ll need to … Continue reading

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Election to participate with Cigna

I’ve had some questions from providers asking if they need to send back the “election to participate with Cigna” form that providers received in their in-box on ashlink.  I will say that in order to continue seeing ANY Cigna patients … Continue reading

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Happy New Year! It’s deductible time again!

Most patient’s benefits start over at the beginning of the year. A small handful have a “benefit” year which is something other than a calendar year, typically July to June.  For those that have the majority calendar year policies, this means … Continue reading

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Insurance at the end of the year….

As we approach the end of the year, there are a few things to keep in mind with regards to patient’s health insurance. 1) For many people, their deductibles may actually, finally, be met! This means they should use their … Continue reading

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COBRA-why so problematic?

I don’t know about you, but I have horrible luck getting COBRA to pay claims the first time.  For some reason, when this special, expensive coverage is supposed to kick in, it doesn’t – time and time again.  Patients always say they’ve … Continue reading

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The trouble with using outcome assessments

Nowadays you need to use more and more objective findings to document a patient’s improvement and response to treatment. A major tool to substantiate a patient’s need for care are objective measurement tools such as Oswestry disability indexes, pain questionnaires, … Continue reading

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PI Case Clarification

I was pleasantly surprised last week when I had a patient sign an addendum to our PI Policy without complaining.  Although she had previously signed the more generic policy stating that, if she became responsible for her bill (if it … Continue reading

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