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Hackensack Meridian Health, locked in a contract dispute with Aetna, has sent letters to the insurer's customers warning them that they may lose in-network coverage if the two sides can't reach a ...
The potential move to out-of-network — which would increase what Aetna customers pay for health care at more than 19 NewYork-Presbyterian sites across the New York City metro region, or force ...
Aetna, the company’s health care benefits segment, reported about $939 million in the second quarter, down from about $1.5 billion in the second quarter of 2023.
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 ...
As Pilot Life challenged a disability insurance claim denial, the equitable remedies that are provided by ERISA might still have been available to Mr. Dedeaux despite this ruling, as ERISA provides several equitable Injunctive remedies to challenge denials of benefit claims, such mandating that the wrongfully denied benefit be provided.
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Almost two weeks after their contract lapsed, WakeMed and insurance giant Humana have yet to reach a deal, leaving many Medicare patients out of network. WakeMed and Humana contract dispute could ...
After all, Meier's insurance card, which he brought to the appointment, stated out-of-network care was covered. And his plan was offered through HealthCare.gov , which he assumed covered ...
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