As of July 1, 2023, the State of Michigan is now covering diabetes prevention program (DPP) participation for Medicaid enrollees statewide. This means that more than 18,000 eligible Priority Health Medicaid members may now participate in this important, free lifestyle change program.
A summary of the September news and talking points from UnitedHealthcare.
Our Medical Advisory Committee (MAC), comprised of network physicians contracted with Priority Health, met this month and approved a series of medical policy updates. All updates are outlined in our policy updates webpage; below is a new policy we want to draw your attention to.
Effective Jan. 1, 2024, Tezspire® coverage will shift from a medical benefit to a pharmacy benefit for commercial and individual lines of business.
Blue Care Network mailed additional letters in August 2023, to primary care physicians and prescribers with BCN patients who are being offered the opportunity to receive a pharmacogenomics, or PGx, test as part of BCN’s new Blue Cross Personalized MedicineSM program.
Lakeland Care Network offices have just today been notified of upcoming changes that will affect new credentialing applications this last quarter of 2023. This is due to new credentialing software implementation being implemented in late September 2023. Please read below the statement from the Corewell Health Medical Staff Office.
Access the latest literature from Community Plan for provider offices caring for UHC-CP members.
In response to provider requests, we’re updating how we pay PCPs for behavioral health collaborative care (BHCC) services and care management telephone management services.
Humana announced this morning that effective October 1, 2023, they no longer will be quoting their Commercial product in Michigan.
UnitedHealthcare has shared its July 2023 Network News with all of our offices.
To ensure your data and your patient’s data are as secure as possible, we’ve implemented additional security for prism accounts.
Dear BCN-Affiliated Medical Care Group Business Administrator:
We’d like to invite you, your primary care physicians, clinicians, pharmacists and support staff to an upcoming webinar discussing Blue Care Network’s precision medicine pharmacogenomics (PGx) program called Blue Cross Personalized MedicineSM.
Loeks Theatre (via Lucent Health) is now a new employer group that has joined the Lakeland Care Network.
Some Cigna member claims submitted electronically by Michigan providers are being incorrectly denied due to a clinical edit. (The remittance advice will usually mention a missing or invalid diagnosis code.) We’re working hard to fix this as quickly as possible.
On June 1, 2023, Akorn Pharmaceuticals initiated a voluntary recall of various products as a result of bankruptcy and discontinuation of quality assurance activities of these marketed products. The discontinuation of the quality assurance program means the company is not able to support or guarantee that the products meet all intended specifications.
On June 1, 2023, Akorn Pharmaceuticals initiated a voluntary recall of various products as a result of bankruptcy and discontinuation of quality assurance activities of these marketed products. The discontinuation of the quality assurance program means the company is not able to support or guarantee that the products meet all intended specifications.
Would you and your team like to learn more about a method of Claim Denial Prevention? We would like to help. Please join us to learn more about the Optum Communication Gateway, which delivers payer-specific rules within the billing workflow and could significantly cut down on your administrative costs of rework.
InterQual, managed by Change Healthcare, is experiencing a national outage. This outage impacts prior authorization processes for providers and payors across the country.
The issue with Medicaid edit 5167 incorrectly front-end rejecting claims, first discovered on May 23, was resolved on May 30. All impacted claims have been reprocessed.