Providers

The Affirmant's Third Annual Leadership Retreat was recenlty held.

Attached is a newsletter highlighting the events.

Priority Health is making changes to their eviCore prior authorization program based upon your feedback to better serve you while ensuring our members are getting high quality, cost effective care.

Starting on Sept. 5, a subset of the high-tech radiology CPT codes will stop auto approving and will require authorization.

This means:

Some requests may pend for additional information. Once the information is received a decision will be made within two (2) business days.

Humana’s secure medical provider portal is closing. Please make the switch to Availity now.

On Oct. 3, 2018, the Humana.com secure medical provider portal will close. Use the Availity Provider Portal instead to work with us online.

Take action today to avoid interruption to your work

The most up-to-date tools for working with Humana online are already available on the Availity Provider Portal. Please make the switch to Availity now to ensure continued access to Humana’s secure online tools.

In October 2018, Humana will be permanently closing their secure portal on Humana.com and migrating to Availity.com. 

Attached you will find an Availity Webinar Schedule if anyone in your office needs assistance, as well as an informative PDF about the upcoming switch.

Meridian has provided informational handouts on the following topics:

• The American College of Radiology BI-RAD ATLAS and Mammography Quality Standards Act (MQSA)
• Breast and Cervical Cancer Screening
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Care for Older Adults
• Preventing Readmission: Following up with Discharged Patients
• Meridian Provider Portal Update

New Medicare Card: MBI Look-up Tool Available through your MAC

Attached you will find a listing of all services that require pre authorization for your Patients with Meridian Choice coverage.  A PCP visit does not require a prior authorization.  Meridian Choice is a option offerered on the Health Insurance Exchange.  LCN does PAR with this this plan.

We’re committed to making it easier for you to do business with us. Our new Precertification web page is one of the many ways we are working to deliver on that commitment. On this new page, you’ll find:

Meridian has provided information sheets on the following topics:

• Comprehensive Diabetes Care
• Controling High Blood Pressure
• Healthy Michigan Plan - Health Risk  Management
• Medication Management for People with Asthma
• Tips for Improving Medicatieon Adherence
• Well Care Exams
• Lead Screening
• Meridian - What We Do

Beginning July 1, 2018, Priority Health will be preferring the use of biosimilar infliximab products over Remicade for commercial, individual and Medicaid products:

Prior to July 1: