![]() ![]() Look for “outpatient mental health services” to see your coverage for therapy. Within this document, you’ll find the different rates of coverage - including copayment or coinsurance amounts - for each type of service available. You’ll likely find this document through your online Anthem Blue Cross account. To check if your Anthem Blue Cross health insurance plan covers therapy services, head over to your Summary and Benefits document. How do I check if my Anthem Blue Cross plan covers therapy? For this reason, they provide coverage across the majority of their health insurance plans. However, Anthem Blue Cross and Blue Shield is dedicated to whole-person health, which includes mental health care. This means that coverage for outpatient mental health services also varies widely. Because Anthem Blue Cross and Blue Shield is such a large health insurance company, they offer many different types of plans across their various geographies. ![]() However, the amount of the therapy cost they cover depends on your unique health insurance plan. ![]() Yes, Anthem Blue Cross and Blue Shield does cover therapy services. Is Mental Health Treatment covered by Anthem Blue Cross? As a subsidiary of Blue Cross Blue Shield, Anthem has an incredibly expansive provider network for physical health as well as specialty behavioral health options - which includes many excellent therapists. In other words, Anthem is reaping large profits while failing to accurately and timely pay hospitals.Anthem Blue Cross for Therapy Anthem Blue Cross and Blue Shield for TherapyĪnthem Blue Cross and Blue Shield is one of the largest health insurance companies in the country, with plans offered across multiple states. The Kaiser Health News article further reports that in 2020, Anthem profits were $4.6 billion, and in just the first half of 2021 that figure was $3.5 billion. Two years later, that figure rose to 53%-representing a difference of $2.5 billion. The Kaiser Health News article reports that on June 30, 2019, 43% of Anthem’s medical bills for that quarter were unpaid. VCU Health says Anthem owes it $385 million dollars, and that 40% of those claims are more than 90 days old.Īnthem’s regulatory filings reflect the issues about which the providers are complaining and that the situation may be getting worse because of the COVID-19 pandemic. Out-of-network payments that are not reasonable value.Īnother example was discussed in the Kaiser Health News article regarding VCU Health, a healthcare system in Virginia. Improper downcoding of DRGs or CPT codes ĭenials for lack of authorization for services that do not need prior authorization or for which authorization was received ĭenials of claims as the financial responsibility of IPAs or other payors ĭelays in processing and payment of claims and Line-item denials of charges on claims on the grounds that such charges are “routine” or included in other charges Tooch is representing a number of hospitals that are owed tens of millions of dollars from Anthem for a variety of reasons, including:ĭenials for outpatient infusion medications for hospital refusing to comply with Anthem’s Specialty Pharmacy or “White-Bagging” policy This is nothing new to King & Spalding’s healthcare partner in Los Angeles, Daron Tooch, who has represented providers for almost three decades to recover underpayments from insurers like Anthem. An Anthem spokesperson was quoted, saying “e recognize there have been some challenges” and “e apologize for any delays or inconvenience this may have caused.” Hospitals cite a variety of causes to the payment delays and denials, including “new layers of document requirements, prior-authorization hurdles for routine procedures and requirements that doctors themselves-not support staffers-speak to insurance gatekeepers.” According to hospital officials in multiple states, Anthem Blue Cross is behind on billions of dollars in payments to hospitals because of new reimbursement rules, computer problems, and mishandled claims-this according to an article in Kaiser Health News published on Octoavailable here.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |