Providers

July 18, 2025

LMOA Needs Assessment Survey Launched

The Lakeland Medical Office Association's mission is to bring quality educational programming to our medical office community in Michigan's Great Southwest. Please take a few minutes to complete a short 3-minute survey as we try to continue to listen to your needs.
 Click on 'READ MORE' below to take the survey.

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July 18, 2025

Cardiology Services Now in Watervliet

Watervliet hospital is proud to expand their heart care services, now offering services five days per week in addition to cardiology testing for patients who previously had to travel to Niles and St. Joseph.

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July 18, 2025

Cass Family Clinic Offers New Mobile Health Clinic

CASSOPOLIS, Mich.– Cass Family Clinic held a ribbon-cutting event on Tuesday, July 15, for its new Mobile Health Clinic. The event took place at Cass Family Clinic’s Cassopolis location, 261 M-62 North. The year-round Mobile Health Clinic will offer health and wellness exams, sports physicals, substance use disorder (SUD) behavioral therapy, acute musculoskeletal issues, blood pressure checks, influenza vaccinations, patient education, and other medical resources.

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July 8, 2025

National Registry of Certified Medical Examiners Final Rule Book Takes Effect

This is a reminder that the FMCSA's National Registry II (NRCME II) Final Rule took effect on June 23, 2025. As a Certified Medical Examiner, your role is critical in ensuring commercial drivers remain in compliance and avoid unnecessary disruptions to their driving privileges. Beginning 6/23/25, all exam results for CDL and CLP applicants/holders must be submitted electronically through the National Registry by midnight of the next calendar day following the examination.

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June 18, 2025

Priority Removes Coverage for Stelara IV

Beginning July 1, Stelara® IV will be removed from coverage under the medical benefit for Priority Health's commercial and individual members. This change will only impact members who aren’t currently being treated with Stelara IV. Members already approved for Stelara IV under the medical benefit will remain covered.

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June 18, 2025

Updated PIP Manual for Priority

Priority Health recently made the following update to their 2025 PCP Incentive Program (PIP) Manual: 

Care Management codes (pg. 20-21) - The code table has been corrected to reflect that Priority doesn’t pay for 99490 for commercial plans. 

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June 13, 2025

Meridian Sends Letter to Physician Practices in Error

Lakeland Care has learned from several of our physicians that Meridian sent a letter directly to them asking to amend their contract to include two new products including Meridian Medicare Advantage plans and another Dual-Eligible plan. This is time sensitive as Meridian has made it so you will automatically be participating into these two new products in 30 days from the date of your letter.

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April 24, 2025

Clarification on Mental Health for United Healthcare Patients

Lakeland Care network has had several contracts with United Healthcare for 15 years. We have a Commercial contract, a Medicaid contract with United's Community Plan, a Medicare contract for Veterans Affairs Community Care Network, and a Duals contract for their UHC Dual Complete Medicare Advantage.  However, through all these contracts, mental health has been very difficult for UHC to administer correctly. Therefore, Lakeland Care network providers who wish to see United Healthcare patients for any of their products need to contract directly with Optum.

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April 3, 2025

Auth Appeals - Important Change for Priority Health

Effective June 2, 2025, Priority Health will NOT review post-claim appeals for medical necessity when a denied authorization is on file for the following authorization types, for all lines of business:
• Outpatient, home health & DME
• Elective inpatient
• Behavioral health

Note: This change doesn’t apply to inpatient acute / urgent / emergent or post-acute authorizations.

This applies when you’ve requested an authorization, received a denial for medical necessity and performed the service or procedure. Services / procedures performed with a denied authorization become provider liability. This change is in alignment with industry standards.

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April 3, 2025

Prior Auths for Priority Change to InterQual

Beginning June 2, 2025, Priority Health will use 2025 InterQual® criteria to make medical necessity determinations on prior authorization requests to ensure their members are getting the right care, at the right place and at the right time. The types of authorizations that are affected are below.

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April 2, 2025

Ambulatory Care Pharmacists Available

Lakeland Care Network together with Corewell Health Lakeland have pharmacists available to serve your patients. Our clinical pharmacists can help with medication reviews, adjustments, and savings all while reducing potential side effects. We manage a variety of conditions from diabetes and high blood pressure to COPD, osteoporosis and others. Call us to schedule or ask your physician for a referral.

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April 2, 2025

Corewell Health Lakeland Offers Diabetes & Nutrition Guidance

Corewell Health Lakeland's diabetes and nutrition team is ready to help you take control and manage your health. We offer everything from diabetes education and nutrition guidance, to group classes and personalized health plans. Our education team offers our services in St. Joseph, Niles, and Watervliet.

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March 3, 2025

ABH: February 2025 Newsletters

Please review the Aetna Better Health attachments sent via fax blast or USPS mail to all providers.  Please share with your staff. 

  • Provider Letter: Prior Authorization change  - Codes now requiring prior authorizations effective 2.15.2025

     

  •  Provider Letter:  Aetna Better Health new physical address change only– effective 1.15.2025

    2 Towne Square Suite #275

    Southfield, MI 48034

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February 18, 2025

UHC - Network News for February 2025 Mid-month Updates

Please read the following UHC Network News mid February update to catch up on the latest UHC changes.
* Prior authorization changes
* UHC Provider Portal updates
* Miscellaneous news
* Support Black History Month through health equity
* Electronic submission required for claim reconsiderations

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