News

Listed below are some links for offices to follow the updates to the Tele Health policies of some of our payors.

Humana:

https://www.humana.com/site-search-results#q=telehealth               

Meridian:

Quick reference guide for providers

Starting January 1, 2021, Priority Health and Cigna have entered a Strategic Alliance which means:

• Cigna commercial group members that get care in Michigan can access the Priority Health preferred provider organization (PPO) network.

• Priority Health commercial group members that get care outside of Michigan have access to the Cigna network.

Attached is the quick reference guide to navigate processes within the Cigna and Priority Health alliance.

Please read the informational handouts from United Healthcare regarding UMR guides and contact information that are attached below.  These will be useful for your practices.

Please see the attached July 21 Informational Handouts from Meridian.  The topics this month include:

• NIA Updates:   Meridian is pleased to announce we are expanding our partnership with National Imaging Associates, Inc. (NIA) to provide utilization management for Interventional Pain Management (IPM), outpatient rehabilitative and habilitative physical medicine services for Meridian’s membership

• Ambetter Policy Implementations:  new policies Ambetter will be implementing effective June 1, 2021

• 2021 Meridian Health PCMH Incentive Program

Below are links to all provider updates related to COVID-19 coverage, including TeleMedicine policies.

COVID-19 Billing Guide - updated July 19, 2021:

https://www.uhcprovider.com/content/dam/provider/docs/public/resources/news/2020/covid19/UHC-COVID-19-Provider-Billing-Guidance.pdf

COVID-19 Guide - updated July 20, 2021:

IMPORTANT INFORMATION FROM CIGNA

COVID-19 public health emergency period extended through October 17, 2021

Since the COVID-19 pandemic began, we have taken important steps to deliver timely accommodations to providers and customers, helping to ensure that customers have continued access to COVID-19 screening, testing, and treatment in safe settings.

Extension of key accommodations

Priority Health has now provided their Spring 2021 Provider and Practice News Digest. The following important informaiton can be found in the links below:

Authorizations

Changes to our musculoskeletal authorizations coming Jan. 1, 2022 | more

UnitedHealthcare Provider Newsletter

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National

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Network Bulletin highlights - July 2021

July Network Bulletin overview

July overview

Medical policy updates

From Priority Health on updated information regarding their Telehealth program, including Doctors on Demand.

Please see link below as well as attachments for detailed information surrounding the telehealth product including co-pays, deductibles, etc.

MyPriority HMO Bronze 8550 - Telehealth PCP | Priority Health

From Meridian on upcoming switch to authorization process:

Beginning July 1, 2021, National Imaging Associates, Inc. (NIA) will provide utilization management for Interventional Pain Management (IPM), outpatient rehabilitative and habilitative physical medicine services for Meridian’s membership. This program is consistent with industry-wide efforts ensuring that IPM and physical medicine services provided to members are consistent with nationally recognized clinical guidelines.

United Healthcare has provided these June 2021 monthly handouts.

• June 2021 Network Bulletin Summary
• UHC HMP HRA Provider Incentive FAQ
• Distance Learning
• COVID- 19 Update
• National Kidney Foundation of Michigan Diabetes Prevention Program Online Workshop 

As of 1/1/21, Lakeland Care Network is no longer contracted with Cigna.  Priority Health is the contracting entity now.  Attached below is a Quick Reference Guide we hope will help clarify this new alliance.

Provider Bulletins for May 2021:

• Provider Bulletin No 185- The Availity Provider Portal is now open to all Aetna Medicaid Providers
• Provider Bulletin No 186 – MI SNF Liberalization Status-  COVID 19 Communication Update ( effective 4.19.2021) Changes in Prior Authorization/Precertification and Admissions Protocols for Aetna Better Health of Michigan.
• Provider Bulletin No 187-Covenry payer ID Number 25133 is No Longer Valid -      Correct Aetna Better Health of Michigan payer ID Number 128MI. 

Please see the below Provider Bulletin from United Healthcare for all of the latest news and updates from UHC.

Quick reference guide for providers

Starting January 1, 2021, Priority Health and Cigna have entered a Strategic Alliance which means:

• Cigna commercial group members that get care in Michigan can access the Priority Health preferred provider organization (PPO) network.

• Priority Health commercial group members that get care outside of Michigan have access to the Cigna network.

Please see the attachment for further details and Sample ID Cards

IMPORTANT INFORMATION FROM CIGNA

Extending key COVID-19 accommodations through July 20, 2021

Since the COVID-19 pandemic began, we have taken important steps to deliver timely accommodations to providers and customers, helping to ensure that customers have continued access to COVID-19 screening, testing, and treatment in safe settings.

Aetna now offers providers ability to submit appeals electronically via Availity as of 1/25/21.  Attached is a handout that has screen shots and tips of the process with explanations that can help provider offices use the new process! 

UnitedHealthcare Prior Authorization  Program Changes – COVID-19

This announcement is applicable to all in-network hospitals and all in-network skilled

nursing facilities (SNFs) in the Detroit-Warren-Dearborn, Kalamazoo-Portage, Lansing-

East Lansing and Flint, Michigan Metropolitan Statistical Areas (MSA).*

During the COVID-19 national public health emergency, UnitedHealthcare is temporarily