Get Serious About Credentialing To Avoid New Penalties

Get Serious About Credentialing To Avoid New Penalties

Starting January 1, 2026, Elevance Health will consider “corrective measures” that penalize healthcare facilities in 11 states for using out-of-network providers to deliver care for the large insurer’s Anthem Blue Cross Blue Shield commercial health plan members. Health systems may be subject to an administrative penalty of 10% of the allowed claim amount and potential network termination, and the penalty cost cannot be passed on to the patient, according to an Anthem memo. Emergency care …

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WellNow Returns to In-Network Status With Excellus BCBS 

WellNow Returns to In-Network Status With Excellus BCBS 

Breaking a 10-month stalemate, WellNow Urgent Care and Excellus BlueCross BlueShield (BCBS) have at last executed a new contract agreement, putting WellNow back in-network as of November 15, 2024, according to an email from WellNow. Excellus insurance plans covered about 300,000 WellNow visits in New York last year. At least 40 centers are located in Central New York where hospital closures in recent years have provided WellNow opportunities to fill gaps in access. “At WellNow …

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