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FAQs – Transparency in Coverage and Consolidated Appropriations Act

Transparency in Coverage (TIC) Final Rules In October 2020, the Departments of Health and Human Services, Labor, and Treasury released the Transparency in Coverage Final Rules (TIC). TIC requires that: Non-grandfathered health plans disclose, on a public website, three machine-readable files disclosing health care rates. The machine-readable

Dec 23, 2021 | News

UPDATE – Consolidated Appropriations Act

On December 27, 2020, President Trump signed Consolidated Appropriations Act, 2021 (“Act”). The voluminous appropriations and COVID-19 relief package also includes the most significant health care legislation since the Affordable Care Act, addressing balancing billing and cost transparency, as well as extending the COVID-related FSA relief measures

Nov 29, 2021 | News

Deferral of Enforcement of Transparency Rules

Introduction In October 2020, the Departments of Health and Human Services, Labor, and Treasury (collectively referred to as the “Departments”) released the Transparency in Coverage Final Rules (TIC) requiring, among other things, that non-grandfathered health plans disclose, on a public website, three machine-readable files disclosing health care

Aug 30, 2021 | News

Anthem Blue Cross and Dignity Health (“Dignity”) Contract Update

To our valued clients: We are pleased to announce that Anthem Blue Cross (“Anthem”) and Dignity Health (“Dignity”) have reached a new contract agreement that returns Dignity facilities to the Anthem network. The agreement is retroactive to July 15, 2021, and any care provided and received through

Aug 17, 2021 | News

Consolidated Appropriations Act 2021

Dear Valued Clients, On December 27, 2020, President Trump signed Consolidated Appropriations Act, 2021 (“Act”). The voluminous appropriations and COVID-19 relief package also includes the most significant health care legislation since the Affordable Care Act, addressing balancing billing and cost transparency, as well as extending the COVID-related

Aug 16, 2021 | Blog

Hospital Contract Termination: Anthem Blue Cross and Dignity Health (“Dignity”)

Anthem Blue Cross and Dignity Health (“Dignity”) have been engaged in negotiations for several months to reach a new contract agreement in California and Nevada for hospital and physician services. Unfortunately, to date, Anthem Blue Cross and Dignity have been unable to come to terms on a new contract that provides greater affordability for our members, and their commercial hospital contract with Dignity may terminate effective July 15, 2021. Anthem Blue Cross continues to negotiate in good faith with Dignity Health in an effort to reach an agreement before the termination date.

Jul 16, 2021 | News

PCMI Portal login pages have a NEW look starting July 1st

Pinnacle Claims Management, Inc. (PCMI) portals login pages are getting a refreshed look! Starting July 1st, 2021, when you visit PCMI Portal sites HealthView for employees, PERC for employers and OPIS for providers, you’ll see a fresh new look for the login pages.

Jun 30, 2021 | Portal Updates

Pinnacle Claims Management, Inc. Expands Services to Include Health Care Delivery

IRVINE, Calif. (June 8, 2021) – Pinnacle Claims Management, Inc., part of the Western Growers Family of Companies (WGFC), has announced it will facilitate patient care as a managing services organization at the Cedar Health and Wellness Center located in Oxnard, California. This continued venture in the

Jun 08, 2021 | News

Q&A with Debbie Bellenger, Manager of Health and Wellness, Pinnacle Health Management

Q&A with Debbie Bellenger, Manager of Health and Wellness, Pinnacle Health Management Health and wellness benefits are evolving because of COVID-19. An estimated 57% of senior leaders are assigning a higher priority to care benefits to better support employees’ work/life balance due to the pandemic, according to

May 12, 2021 | Blog
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