Providers

Updated Medicaid Managed Care Plan Provider Enrollment Timeline

August 29, 2018: Health care providers that serve Medicaid beneficiaries are facing an upcoming enrollment deadline that is necessary for them to continue to receive payments from Medicaid. 

While the Michigan Department of Health and Human Services (MDHHS) has revised the timeline to give providers more time to enroll, the department is urging providers to complete the screening and enrollment process as soon as possible.

The Centers for Disease Control and Prevention (CDC) recommends that patients 6 months and older receive an annual flu vaccine.

This year’s seasonal flu vaccine will cover the three most common strains in the Northern Hemisphere, as identified by the CDC:

• A/Michigan/45/2015 (H1N1)pdm09-like virus

• A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus

• B/Colorado/06/2017-like (B/Victoria/2/87 lineage) virus

Please read the attachment for additional information.

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

This is a repeat of an article originally posted on July 23, 2018 on the LCN website

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

ABH has provided new informational handouts on the following topics:

• Provider Notification on Urine Drug Testing
• Urine Drug Testing: Evidence-based Test Ordering

Peer-to-Peer Reviews – Improved Scheduling

In an effort to respond to network provider feedback with respect to the scheduling process of peer-to-peer reviews, there is a new effort underway at UHC to improve the provider experience with our Peer-to-Peer review process.

The Lakeland Medical Office Association invites you to attend our October luncheon and half-day meeting, sponsored by the Lakeland Care Network.

Program:          Lakeland Care Network’s Annual Payor Conference

This year’s Payor Conference will feature the major payors in our market – including those who have Commercial, Medicare, Medicaid and dual eligible products.  Lakeland Care will also provide an update on our network's current projects and future initiatives.

Meridian has provided some informational handouts on the following topics:

• Influenza Vaccination
• BMI Measurement and Counseling for Nutrition and Physical Activity
• Prenatal Care/ Scheduling Postpartum Care
• Chlamydia screening

Starting October 1, 2018, UHC-CP is changing their Obstetrical Ultrasound Policy to further align with Medicaid guidelines. Medicaid doesn’t consider ultrasounds to be medically necessary if they’re done only to determine the fetal sex or provide parents with a photograph of the fetus. A detailed ultrasound fetal anatomic examination is also considered medically unnecessary for a routine screening of a normal pregnancy.

What’s Changing

UHC-CP willl implement these guidelines for claims processed on or after October 1, 2018:

Meridian has provided some informational handouts on the following topics:

• Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
• Dental Care Information
• Appropriate Treatment for Children with Upper Respirator Infection/ with Pharyngitis
• Well Child Exams and Lead Screening
• Potentially Harmful drug-Disease  Interactions in the Elderly
• Childhood and Adolescent Immunizations
• Colorectal Cancer Screening
• Medication Reconciliation Post Discharge

LMOA is an independent, non-profit organization dedicated to providing quality education to southwestern Michigan's healthcare community.