Providers

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.

United Healthcare has shared their Network News updates for June 2023

Priority Health is offering an one hour webinar on thursday, June 8, 2023 at noon on the topic of Virtual Office Advisory.

This issue of BCN, Partners in Care, introduces BCN’s Chief Medical Officer Peter T. Graham, M.D., and focuses on how we’re working to improve the experience you and your providers have with us and collaborate with you to improve your patients’ health care experience.

Priority Health is experiencing an issue with their Medicaid claims front-end rejecting for “Claim Type Requires a Referring/Ordering NPI” when they shouldn’t.  Priority Health teams are working to find the root cause and fix the issue as quickly as possible. Until then, they recommend you don't rebill those claims!

On Jan. 1, 2023, CMS released two new care management codes for chronic pain management – G3002 and G3003 – which allow providers helping chronic pain patients to bundle key services and bill monthly rather than a’ la carte.

An update from Priority Health on a series of medical policies.

A summary of the United Healthcare May 2023 Network News