Lakeland team members and their covered family members have a new co-pay structure for 2020!
PCP co-pays are remaining at $30, but the co-pay for a specialist visit has increased from $30 to $45.
Please make sure your front desk staff is aware of the change. If you are seeing anything different while looking at Real Time Eligibility, please let us know at (269) 927-5207 or (269) 985-4474.
Effective 1/1/20, Lippert Components is a new employer group who has access to the Lakeland Care Network. This employer group has been added to the LCN Listing of Contracted Payors under the "Employer-Specific Payors" section. The payor that Lippert has chosen to use is Key Benefit Administrators. Therefore, all Lakeland Care Network providers are considered participating for all Lippert Components covered members.
Medicaid claims that do not meet the Michigan Department of Health and Human Services (MDHHS) billing requirements are being rejected as of Jan. 1, 2020.
Based on the feedback we received at the Payor Conference in October, Lakeland Care Network has planned this special breakfast meeting and invites you to attend so we can bring you information on the new VA Contract with Optum, along with very helpful information directly from Priority Health Claims Department. This presentation would be helpful for office/practice managers, billing staff, and appeal team members.
In an effort to streamline the authorization process for the MeridianComplete services managed by H3, providers can submit requests directly to H3/Innovista via the submission options below.
LMOA is an independent, non-profit organization dedicated to providing quality education to southwestern Michigan's healthcare community.
The Lakeland Medical Office Association invites you to attend our January luncheon and seminar.
Program: De-Escalation Techniques for ‘Bad’ Behavior in Physician Offices
Effective Jan. 1, 2020, substance use disorder intensive outpatient services will no longer require authorization or clinical review for commercial members.
Why we’re making this change
We’re removing the authorization requirement to improve members’ access to substance abuse intensive outpatient services to ensure they’re able to get the right care at the right time.
How services will be monitored
Attention offices! The preventive lab benefits for Spectrum Health Lakeland (SHL) plan members has changed quite a bit for the new 2020 plan year.
Please refer to the attached Preventive Healthcare Guidelines publication from Priority Health.
In 2019, Spectrum Health Lakeland (SHL) was under their own pharmacy benefit plan with Express Scripts.
In 2020, pharmacy benefiit coverage will still be processed through Express Scripts - but under Priority Health's plan.
See the attached FAQ for more pharmacy benefit information. Be advised that the formulary has changed from 2019 to 2020.
Attached you will find the monthly handouts relating to the following topics:
Please visit the Meridian website for more detailed information.
