Monday, January 07, 2008

Market Conduct Report

[Welcome Industry Radar readers]

If you have health insurance through Mega Life, Mid-West National of Tennessee, or Chesapeake, this is a must read.

Just a few of the findings:

In certain situations, the Company changed the diagnosis code or CPT code in the course of adjudicating a claim.

the Company did not have a claims manual or written claim procedures.

The Examiners found instances where the Company did not adjudicate claims in the correct insurance entity
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