Providers

Specialist Co-pays for Lakeland Plan Members has Changed for 2020

January 14, 2020

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.

New Employer Group: Lippert Components

January 13, 2020

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.

LCN Breakfast- Special Topics from UHC and PH

January 7, 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.

Priority Health - Auth Requirements Changes for Commercial Substance Use Disorder Outpatient Services

January 6, 2020

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

Info for Offices on 2020 Pharmacy Benefits for SH Lakeland Plan Members

December 20, 2019

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.

 

Meridian Monthly Handouts

December 18, 2019

Attached you will find the monthly handouts relating to the following topics:

  • Tobacco Cessation
  • Osteoporosis Management in Women and Preventing Fractures
  • Persistence of Beta-Blocker Treatment After a Heart Attack
  • Appropriate Screening for Prostate Cancer
  • Prescribing Antipsychotic Medications

Please visit the Meridian website for more detailed information.