The cardiovascular care of thousands of Missouri patients is suddenly up in the air. The heart of the issue is a practice's alleged interest in opening up a new private equity-backed clinic.
On Tuesday, a judge formally rejected a motion by the company to have the case dismissed. Carelon Behavioral Health, a subsidiary of Elevance, is accused of publishing an inaccurate directory of providers for those seeking mental health services.
There is no application process, eligible physicians are automatically approved. In order to earn “gold card status” a practice must have a prior authorization approval rate of 92% or higher for at least the last two years.
Physicians using the Paradise Ultrasound Renal Denervation system from Recor Medical or Symplicity Spyral Renal Denervation system from Medtronic will soon be eligible for a much more significant reimbursement when treating Medicare patients in an inpatient setting.
