Commercial Insurance - New York State Chiropractic Association

UHC Medicare Advantage: Request for Redacted Denials

by Insurance Committee | Jul 2, 2025 | Insurance Updates, Medicare Advantage, Members Only, UHC

Have you received a UHC Medicare Advantage claim denial indicating ‘precertification/ authorization/ notification absent’ for cases where clinical submission was not required? Did you follow the correct process? If so, we...

Additional Webinars Scheduled Regarding BCBS Settlement

by Insurance Committee | May 20, 2025 | Commercial Insurance, Insurance Updates, Members Only

Many of you attended the last Webinar regarding the BCBS settlement which includes the largest monetary payment ($2.8 Billion) in any healthcare antitrust action in history in addition to injunctive relief valued at more than $17.3 Billion for healthcare providers who...

Important Deadlines in BCBS Class Action Settlement

by Insurance Committee | Apr 2, 2025 | Commercial Insurance, Insurance Updates, Members Only

For well over a year, the NYSCA Insurance Committee (the NIC) has reported on an antitrust class action lawsuit due to the overlap of Blue Cross Blue Shield (BCBS) plans. The settlement has been approved, including $2.8 Billion in a settlement fund. It is important to...

Excellus BCBS and Univera Healthcare Medicare Advantage Erroneous Payment

by Insurance Committee | Mar 14, 2025 | Excellus, Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, Univera

Last week Excellus BlueCross BlueShield and Univera Healthcare sent letters to their Medicare Advantage members receiving chiropractic care. In those letters, both organizations identified they have been ‘processing chiropractic claims...

UnitedHealthcare Modifies Manual Review Process for Medicare Advantage members

by Insurance Committee | Jan 13, 2025 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

If you participate with UnitedHealthcare / Optum you may have received notice of the change in the aforementioned prior authorization program. Based upon the volume of calls, texts and emails received by the NYSCA Insurance Committee (NIC), there has been several...

CDPHP awaiting approval to join Lifetime Healthcare

by Insurance Committee | Nov 20, 2024 | CDPHP, Commercial Insurance, Insurance Updates, Members Only

Mergers. Acquisitions. Affiliations. Increasingly common and complex. These relationships may have no bearing or influence on our practice and ability to provide high quality care to our patients, while others can have a profound impact. ...