Providers

Meridian - Provider Readmission Review Notice

June 3, 2019

Effective August 1, 2019, Meridian is implementing updates to Meridian Medical Policy B. 05 Readmission Review. This policy outlines Meridian’s processes of reviewing, adjudicating, and adjusting claims payments for inpatient admissions that are deemed to be potentially preventable readmissions. This policy is in alignment with Michigan Department of Health and Human Services’ Medicaid Provider Manual Readmission, Section 9.2. Meridian Medical Policy B. 05 Readmission Review policy is available on the Meridian website under Training & Education Resources.

Meridian - Monthly Informational Handouts

May 29, 2019

Meridian has provided these educational handouts for this month:

  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Medication Reconciliation Post Discharge
  • Antidepressant Medication Management
  • CPTII Codes and HCPCS Billing for Medicare and Medicaid
  • Health Michigan Plan -  Health risk Assessment (HRA)
  • Meridian RX.com

Meridian- Prior Authorization Process Detail

May 29, 2019

There has been some confusion on the proper forms to send into Meridian for Prior Authorizations. At times, the form is sent to the incorrect fax number, which results in delays of getting the needed authorization approvals in a timely manner.  The Meridian Team must then route the form to the correct intended department, and this causes unneeded delay for the patient.

 

Meridian Complete and Concerto Health Update

May 20, 2019

MeridianComplete (Medicare-Medicaid Plan) will be ending their relationship with ConncertoHealth (Concerto), also known as MeridianCare Continuim on May 31, 2019. A new vendor, H3 Management Services, will begin to provide services as of June 1, 2019. There will be no immediate authorization process changes.

For more details, please see attached document.

Humana - Availity training sessions

May 20, 2019

Humana has added a number of Availiaty webinars which can be viewed thru the Availity.com Provider Portal

Hosted By: Jason L. Johnson, Humana eBusiness Consultant

Each person in your organization must register separately.

The webinar lasts approximately 50-55 minutes.

Webinar Agenda

• Administrator Dashboard

• Payer Spaces

• Authorization & Referrals

• Eligibility & Benefits

• Claims Management

• Code Edit Simulator

• Medical Records Management

Meridian - Monthly Informational Handouts

April 22, 2019

Meridian has provided these informational monthly handouts:

  • Comprehensive Diabetes Care and Controlling High Blood Pressure
  • Chlamydia Screening
  • MeridianCare :  a Message from the Stars and Medicare Stars Overview
  • Breast and Cervical Cancer Screening and The American College of Radiology BI-RADS Atlas and Mammography Quality Standards Act (MQSA)
  • Notification of Change to Inpatient Claim Submission Requirements