Humana - Resource Links and Provider Manual for 2022
May 11, 2022
This article is a repeat of information from Humana on resources that will allow offices to find out answers to their questions:
News
BCBS - E-Referral and Health E-Blue Tools Update
May 11, 2022
Blue Cross Blue Shield of Michigan and Blue Care Network are transitioning to Availity® Essentials for our provider portal.
Humana - Humana Medicare Advantage HIPPS Payment Guides 2022
May 2, 2022
From Humana:
Attached are some resources that help with understanding Humana’s home health determinations. There is a brief webinar offered in the Making It Easier series for Home Health billing (link below).
BCN - 2022 Issue of BCN Partners in Care
May 2, 2022
Dear Medical Care Group Business Administrator:
UHC - May 2022 Policy and Protocol Update, New Portal Info, and Monthly Informational Handouts
May 2, 2022
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BCBS- Pharmacogenomic Webinar Registration
April 26, 2022
Dear Medical Care Group Business Administrator,
Meridian - April 2022 Monthly Handout regarding Homecare Services
April 26, 2022
From Meridian: Below is the MDHHS Bulletin to provide information on Homecare Services; NPs or PAs can no longer order for Homecare Services. Only a physician can place these orders effective January 1, 2022.
Meridian Complete - Phone Numbers for Authorizations Services
April 26, 2022
Meridian has shared some additional phone numbers for offices to utilize if they are finding issues thru the provider portal in obtaining authorizations.
Meridian Complete:
Implicit Bias Training: a LARA Required Training for all Medical Licenses and Renewals
April 25, 2022
Why Implicit Bias training? Effective June 1, 2022, LARA announced the adoption of new rules that require Implicit Bias Training for all medical licenses and renewals.
UHC- Network News for April 2022
April 21, 2022
Please read the latest news from United Healthcare in their attached Bulletin.
PH - Physician and Practice News Spring 2022
April 20, 2022
Priority Health has provided their Spring 2022 Physican and Practice Newsletter; please read the full detail in the attachment
BCN - Personalized Medicine Pilot Program Training for BCN Advantage
April 13, 2022
Dear Medical Care Group Business Administrator:
Priority Health - Change to Referring/Ordering/ Attending Editing for Medicaid Claims
April 12, 2022
From Priority Health:
UHC - April 2022 Policy and Protocol Updates
April 4, 2022
Please see your April 2022 Collateral from United Healthcare, and if you have not signed up for their Network Bulletin to be sent to you on a monthly basis please visit www.uhcprovider.com to sign up.
Meridian - March 2022 Monthly Handouts and Portal PPT on Changes
March 30, 2022
Attached are the March 2022 monthly handouts and process changes from Meridian:
Humana - 2022 Provider Manual and Resource Links
March 28, 2022
Humana has provided the latest provider manual and links to their resources for your office use.
UHC - Sign up for Network News Tailored to Your Office
March 22, 2022
UHC Network Bulletin is Network News -
Please sign up for tailored emails directly to your desk on topics that your office finds valueable from UHC at the below link:
ABH - March 2022 Monthly Handouts
March 22, 2022
From Aetna Better Health - the March 22 Monthly Informational handouts:
- Provider Bulletin No 202: Aetna Better Health of MI Member Support in Pandemic
- Provider Bulletin No 203: New Transportation Provider – Access2Care – effective 4.1.2022
BCN - Medicine Pilot Program Introduced
March 22, 2022
On March 4, 2022, BCN mailed a letter to one or more of your primary care physicians who have BCN AdvantageSM patients who are eligible for a new precision medicine pilot program using pharmacogenomic (PGx) testing.
Aetna FDR Quarterly Compliance Newsletter
March 15, 2022
Attached is the quarterly compliance newletter from Aetna.
Meridian - MI Medicaid Integration on 4/1/2022 Training Sessions and NEW Medicaid Oncology Authorization Vendor
March 7, 2022
Effective April 1, 2022, Meridian’s Medicaid provider portal will be available on a new platform.
Registration for the new portal opens on March 1, 2022 and can be completed at:
provider.mimeridian.com
Meridian - February 2022 Monthly Handouts and Introducing Payspan and Somantus Care Management
February 23, 2022
Attached you will find the Meridian February 2022 Monthly Informational Handouts covering the following topics:
ABH - February 2022 Monthly Updates
February 23, 2022
To our offices from Aetna Better Health:
Attached are the February 2022 monthly updates on the following topics:
- Provider Bulletin No 199: Prior Auth Update Ordering Practitioner
- Provider Bulletin No 200: ABH Shutdown Retraction - Sunset of the ABH Medicaid Web Portal is being delayed at this time.
Aetna - Aetna Signature Administrator (ASA) Information Sheets
February 21, 2022
Provided to our office from Aetna:
Sometimes there is a lot of information regarding payors that is confusing to our offices on what is or is not participating.
Aetna Signature Administrator (ASA) are PAR with Lakeland Care Network.
Blue Cross and BCN - Use of Electronic Prior Authorization Tools for Prescription Drug Authorization Requests
February 16, 2022
Dear BCN Medical Care Group Business Administrator:
Meridian - MI Medicaid System Changes on 4/1/22
February 16, 2022
To our offices,
There are upcoming significant changes that Meridian has informed us about.
Please open the below attachment and read the detailed information regarding these significant changes by the Meridian system being implimented on April 1, 2022.
Please feel free to print and share the attachment with your fellow teams.
Thank you!
UHC - Observation Notification Changes for Most Plans
February 14, 2022
United Health care wants to make offices aware of a recent change that will impact your current process. As of December 1, 2021, providers for most plans are no longer required to submit observation notification after a patient has been discharged home from observation level of care.
UHC Sending Appeal Decisions Digital-only Starting March 4
February 11, 2022
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Priority Health - PRISM Portal Resources
February 10, 2022
Priority Health has provided the process and documentation to follow if your staff is having any technical difficulties with PRISM:
ABH - Provider Type Billing Requirements Update
February 10, 2022
ABH of Michigan has been notified by MDHHS of claims that have rejected for "Provider Type Not Allowed for Referring/Ordering/Attending NPI"
Claims releated to the rejections received by the health plan will be recovered and corrected claims will need to be submitted.
Please review claims billing guidelines to ensure your claims are billed properly.
Please see the attahment for all details from ABH.
Blue Care Network - Notification to PCPs Regarding an Error that Assigned Members to a New PCP
February 10, 2022
Dear Medical Care Group Business Administrator:
Priority Health - Clinical+ Launch Cancellation
February 10, 2022
Priority Health has decided to cancel the March 2022 launch of Clinical+ due to feedback we received from providers who tested this tool for us.
Why are we making this change?
UHC Extends Covid Prior Auth Program
February 8, 2022
Due to the persistence of COVID-19 cases in your area, UnitedHealthcare is extending and expanding the temporary program provisions outlined in the attachment below. This announcement is applicable to all in-network hospitals and skilled nursing facilities (SNFs) in Michigan statewide.
UHC Provider Education Town Hall Coming
February 3, 2022
SAVE THE DATE!
Thursday, February 24th, 2022
1:00pm – 3:00pm CST
Priority Health - Register for the Q1 Behavioral Health Collaborative Care (BHCC) meeting for the BHCC incentive measure
February 3, 2022
Priority Health has scheduled the 2022 Behavioral Health Collaborative Care meetings. Practices interested in earning the incentive for this measure should plan to attend at least 3 out of 4 quarterly virtual meetings to discuss collaborative care activities, share best practices and discuss barriers to implementation.
Centene - Prior Authorization for Post Acute Stays
February 1, 2022
Between 1/1/2022 and 2/28/2022, prior authorizations are NOT required for post-acute stays at skilled nursing facility, long-term acute care hosipital or nursing facility.
- Meridian Medicaid Plan (ie Meridian Health)
- Meridian Medicare-Medicaid Plan ( MMP)
Please read the full attachment for the full details of the policy update.
HAP - January 2022 Monthly Handouts and Tip Sheets
January 31, 2022
HAP has shared the latest monthly handouts for your offices:
Please see the attachments for all of the details:
- Hierarchical Condition Category Gap Program FAQ
- HAP Documenttion Tips - Acute Myocardial Infarctions (AMI), Arthritis,Atrial Fibrillation/Flutter, Active Cancer and much more!