Tools & Resources
How the AAN—and You—Can Influence Payer Policy Have you ever wondered how you can impact change or help influence a payer’s medical policy? The AAN works with commercial payers by responding to payer requests seeking comments from our members to help them understand how a service is performed by neurologists. Commercial payers reach out for both procedure and medication coverage policies and look to specialty societies like the AAN to provide their clinical practice expertise. Academy members play a crucial role in helping influence these medical policies. To help facilitate these requests, the AAN Coding and Payment Policy (COPAY) Subcommittee works closely with payers like UHC, Anthem, and Cigna, among others. COPAY receives draft medical policies, determines which are relevant to neurology, and identifies the appropriate SynapseSM community to provide input on the subject matter input. Member comments and expertise helps the AAN provide payers with the most current information and treatment options for patients. Your expertise and knowledge of new and emerging studies can help influence changes in medical policies! It is important to note not all procedures, medications, or services are covered by a payer. Generally, this is due to a lack of procedure or medication outcomes, medical evidence, or medical necessity requirements. Responding to payers’ requests for feedback provides them with the most up-to-date information and context on the medical necessity of these procedures to help patients.
What if you have a payer that is not currently covering a service you regularly perform or is important for the care of your patients? Review the current coverage policy and see if there is any new evidence or studies that would support the coverage of the service. Contact AAN payer relations and coverage staff at practice@aan.com and they will connect you with the payer or reach out on your behalf. The AAN works hard to build and maintain positive relationships with payers and is happy to contact them to review new evidence or studies that would help support the coverage of a neurology service. There is no guarantee this will change a coverage policy but getting the information in front of the payer could provide them with helpful information to influence future decisions when a medical policy comes up for review.
CESC: 21_NeuroByte Ad—Half Page Horizontal> AN Placed in AANnews 8.25 x 5.25 +0.125 bleed, 4C
BYTE-SIZED LEARNING
Videos on a variety of topics in neurology Free with membership at AAN.com/NeuroBytes
