×

Status message

Providers, please log in to access all news and updates

Latest news

Blue Care Network to Utilize AIM

August 24, 2018

Katie Rogers, our SW Michigan Provider Relcations Consultant for Blue Cross, has informed us that beginning 10/1/18, Blue Care Network (BCN) will utilize AIM for cardiology and high-tech radiology prior authorizations. If your office or department requests prior authorizations, please take advantage of several webinars that BCN has created for you.

 

Priority Health - Changes to High-Tech Radiology Authorization in eviCore

July 26, 2018

Priority Health is making changes to their eviCore prior authorization program based upon your feedback to better serve you while ensuring our members are getting high quality, cost effective care.

Starting on Sept. 5, a subset of the high-tech radiology CPT codes will stop auto approving and will require authorization.

This means:

Some requests may pend for additional information. Once the information is received a decision will be made within two (2) business days.

Humana - Important Provider Portal Change

July 23, 2018

Humana’s secure medical provider portal is closing. Please make the switch to Availity now.

On Oct. 3, 2018, the Humana.com secure medical provider portal will close. Use the Availity Provider Portal instead to work with us online.

Take action today to avoid interruption to your work

The most up-to-date tools for working with Humana online are already available on the Availity Provider Portal. Please make the switch to Availity now to ensure continued access to Humana’s secure online tools.

Humana: Change of Provider Portal Coming

July 2, 2018

In October 2018, Humana will be permanently closing their secure portal on Humana.com and migrating to Availity.com. 

Attached you will find an Availity Webinar Schedule if anyone in your office needs assistance, as well as an informative PDF about the upcoming switch.

Meridian Informational Handouts

June 28, 2018

Meridian has provided informational handouts on the following topics:

  • The American College of Radiology BI-RAD ATLAS and Mammography Quality Standards Act (MQSA)
  • Breast and Cervical Cancer Screening
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Care for Older Adults
  • Preventing Readmission: Following up with Discharged Patients
  • Meridian Provider Portal Update

Meridian Choice - Authorization Requirements

June 5, 2018

Attached you will find a listing of all services that require pre authorization for your Patients with Meridian Choice coverage.  A PCP visit does not require a prior authorization.  Meridian Choice is a option offerered on the Health Insurance Exchange.  LCN does PAR with this this plan.

LCN - Employer Services Hosts Conference on Aging Workforce

June 5, 2018

 

Preparing for an Aging Workforce

Are you prepared for an aging workforce? Does your organization have resources available to employees with aging or ill family members? Many people do not know where to turn for help when faced with challenges related to aging, retirement, illness, palliative care or end-of-life related situations. Learning about the aging workforce is an opportunity to better prepare your organization and your employees for this change of life.

Meridian Informational Handouts

May 24, 2018

Meridian has provided information sheets on the following topics:

  • Comprehensive Diabetes Care
  • Controling High Blood Pressure
  • Healthy Michigan Plan - Health Risk  Management
  • Medication Management for People with Asthma
  • Tips for Improving Medicatieon Adherence
  • Well Care Exams
  • Lead Screening
  • Meridian - What We Do

United Healthcare Dual Complete Medicare Advantage

April 18, 2018

Attached is information from United Healthcare regarding their new Dual Complete (HMO-SNP) program. Attached are two resources for your reference. There is a powerpoint which explains the program in detail, as well as a Quick Reference Guide for a handy reference.

Human Trafficking Presentation - Apps List

March 26, 2018

Attached is the list of apps that was discussed at the March LMOA presentation on Human Trafficking.  The apps listed are ones that the Michigan Human Trafficking Task Force encourages parents and teachers to know about.

Billing Midlevels for Priority Health Members

March 22, 2018

Lakleand Care has learned that Priority Health has only loaded some of the midlevels that we have credentialed since September of 2016, which is causing billing issues for our practices and hopsitals. Therefore, for Priority Health patients only, please continue to bill services provided by your midlevel practitioners, under their supervising Lakeland Care physician until further notice.

2018 myHealth Program Requirements

March 6, 2018

Lakeland Care Physicians and Advanced Practitioners:

We continuously encourage Lakeland associates and their spouses to have an ongoing relationship with their Primary Care Providers.  A new requirement, for Lakeland’s myHealth Wellness Program in 2018, is for participants to have a wellness visit between 1/1/2016 and 10/31/2018. Participants will receive credit based on the Z billing codes for wellness; additional paperwork is not required.

LMOA - March 2018 Luncheon

March 5, 2018

The Lakeland Medical Office Association (LMOA) invites you to attend our March luncheon and meeting.

 

PROGRAM:  The Reality of Human Trafficking in Michigan

 

Sex trafficking does not happen only in big cities. It is an evil that lurks throughout this country and around the world. It’s time to expose the darkness.  Come hear a personal story of survival, from Melinda, a human trafficking survivor.

 

NEW: UHC Dual Complete Medicare Advantage Plan

February 14, 2018

UnitedHealthcare Dual Complete (HMO-SNP) is now offered by UnitedHealthcare Community Plan of Michigan

Effective Jan. 1, 2018, UnitedHealthcare Community Plan of Michigan will begin to serve eligible members in a new Dual Special Needs Plan (DSNP) – UnitedHealthcare Dual Complete Medicare Advantage ‒ in the following counties: Berrien, Branch, Gratiot, Hillsdale, Tuscola and Washtenaw.

NEW Medicare Cards Soon to be Mailed

February 14, 2018

The Health Insurance Claim Number (HICN) is a Medicare beneficiary’s identification number, used for processing claims and determining eligibility for services.

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires removal of the Social Security Number (SSN)-based HICN from Medicare cards to address current risk of beneficiary medical identity theft.

MACRA requires that CMS mail out new Medicare cards with a new Medicare Number by April 2019. Medicare will start mailing new cards in April 2018.

K&M Machine Terms from NAA

February 13, 2018

North America Administrators (NAA) was one of Lakeland Care's Employer-Specific payors. Lakleand Care providers participated with NAA only for the K&M Machine covered employees.  Lakeland Care just received notice that K&M Machine terminated with NAA effective 8/31/17. We are not aware of what payor they might have moved to.  Therefore, please ask K&M patients for an updated insurance card.

Healthy Michigan Plan MI Marketplace Option - Why an HMP HRA Matters

January 31, 2018

Effective April 2018, individuals age 21 and older who have incomes above 100% of the Federal Poverty Level and have been enrolled in a Healthy Michigan Plan health plan for at least one year without choosing a healthy behavior through a Health Risk Assessment (HRA) may move to the MI Marketplace Option.

Important notes:

CHAMPS Enrollment Enforcement- Deadline Approaching

January 31, 2018

CHAMPS Enrollment Enforcement

CHAMPS is Michigan Medicaid’s Provider Enrollment System

  • January 1, 2018, all providers furnishing services to Medicaid beneficiaries must enroll in Michigan Medicaid per federal requirements.

                        – Includes providers participating in a managed care organization’s provider network.

Meridian CHOICE

January 12, 2018

Meridian Choice is a new commercial product that is offered on the Health Insurance Exchange.  All Lakeland facilities and all Lakeland Care credentialed providers participate with this new product.  This contract became effective October 1, 2017.

 

LMOA Monthly Meeting - January 2018

January 2, 2018

The Lakeland Medical Office Association (LMOA) invites you to attend our January luncheon and meeting.

 

PROGRAM:  Epic Olympics     

Join us for a FUN, interactive insight into some of the latest features, trends and information related to Epic. This presentation pertains not only to those who use Epic as their EHR everyday - but to all practices in the Lakeland Care Community who want to learn more about the latest trends and best practices in healthcare technology, security and communication.  IT Topics to be discussed are:

 

Priority Health - NEW Automated Phone System for Claims Calls

December 6, 2017

Effective January 1, 2018, our Provider Helpline representatives will direct callers with claims questions to our automated phone system or their provider account on priorityhealth.com. This change should reduce the wait times for speaking to a representative.

Our representatives will still assist with all other concerns, including those regarding claim denials.

 

Priority Health - Medicaid Pharmacy NEW Narrow Network

December 4, 2017

Effective December 1, 2017 Priority Health will utilize a select, limited group of pharmacies as preferred for all outpatient Medicaid prescription fills.

In our Medicaid service regions (West Michigan and Southwest Michigan) there will remain approximately 220 approved pharmacies where patients can have prescriptions filled.   Many large retail stores will continue to be in the Priority Health Medicaid pharmacy network, such as:

·         Walmart

·         Meijer

·         Walgreens

·         Costco

·         SAM’s club

Priority Health - Call Center Services Changes

November 27, 2017

Our online accounts and self-service automated phone system allow you to have 24/7 access to information about claims, benefits and authorizations. One of the most popular features of these tools is being able to look up simple claim information, including check numbers, amount applied to a deductible or coinsurance, or the amount being paid to you.

To reduce our hold times for our provider call center, we’re going to direct those who have basic claims questions to self-service tools.