Providers

Meridian is providing monthly handout on these following topics:

• Breast Cancer Screening (BCS) and Cervical Cancer Screening (CCS)
• Adult BMI Assessment and Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
• Well-Child Exams and Lead Screening (LSC)
• Timeliness of Prenatal Care (PPC) and Postpartum Care
• Notice Regarding Authorization for Medicare and Turning Point Implementation

Effective Jan. 1, 2020, Medicaid outpatient behavioral health therapy will no longer require prior authorization. You will no longer need to submit clinical documentation for these requests.

Why we’re making this change

We’re removing the authorization requirement to improve members' access to the mental health services they need to ensure they’re able to get the right care at the right time.

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 November luncheon and seminar.  

Program:  Revenue Cycle – Tips & Tricks to Aggressively Monitor your Financial Performance

 Priority Health offers monthly educational Virtual Office Advisory (VOA) webinars to our providers and their staff. Priority encourages participation in regularly viewing these presentations.

Recently, Meridian has been receiving a significant number of claims where a prior authorization was not obtained.  

Attached are the informational handouts from Meridian for October:

• Medication Management for People with Asthma (MMA)
• Comprehensive Diabetes Care (CDC) and Controlling High Blood Pressure (CBP)
• Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
• Preventing Readmission: Following up with Discharged Patients
• Transitions of Care (TRC)
• eviCore Expansion Prior Authorization Overview Training Sessions
• Catching a Breath Program Informationa and Referral Form

All patient reviews will be posted to the Cigna for Health Care Professionals website (CignaforHCP.com). They can only be accessed by the providers for whom they were submitted or their delegated office staff. To view, read, and respond to reviews, providers and their delegated office staff must be registered users of CignaforHCP.com.

Below is Humana's link to Availity. It is optional for providers, but encouraged for easier processes.   Availity is efficient to use rather than traditional calling/faxing when working on the following:

Noted in the September Monthly Provider Notification, the Meridian Medicaid Authorization lookup tool for MI and IL has been updated.

As previously discussed, the following improvements have been made to the tool:

-          Additional Blanket Statements added

-          Both excel and PDF versions posted to our website

-          Accessibility on the website was updated to provide easy access to the tool. Providers now can access directly from the home page through the provider tool “Prior Auth Form and Requirements”.

eviCore healthcare and Meridian are expanding their partnership to include the following programs: physical therapy (PT), occupational therapy (OT), genetic testing, pain management, and sleep studies. eviCore will be leading orientation sessions designed to assist you and your staff with the new programs. You will be able to attend the web orientation session that works best for you and your schedule.