As Negative Prior Auth Accounts Mount, Blues Plans Get Caught in Provider Fray
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Nov 07, 2024
As reports continue to emerge of major insurers deploying prior authorization to boost profits, contract disputes between health systems and Medicare Advantage plans across the U.S. also persist. While it’s not unusual for negotiations to heat up this time of year, the ones that are playing out in the public eye appear to have more do to with payment delays and care denials than with payment rates, which historically have been the sticking point. Rochester, New York-based Excellus BlueCross BlueShield (BCBS), for one, was caught by surprise when one major network provider publicly accused it of routinely denying claims. Read more
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