June 1, 2023
Priority Health: Virtual office advisory webinars
Priority Health is offering an one hour webinar on thursday, June 8, 2023 at noon on the topic of Virtual Office Advisory.
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
From Humana: In a continued effort to optimize care for our members and ensure prompt delivery of quality DME, Humana has entered into enhanced partnerships with DME provider— Rotech. Effective July 1, 2023.
Blue Cross Blue Shield of Michigan and Blue Care Network have implemented a monthly data feed to inform you of your group’s assigned BCN AdvantageSM members who are eligible for the Landmark Health high-intensity in-home care program for members with multiple chronic conditions.
This newsletter is for physicians, specialists, clinicians and office staff to deliver the latest news, resources and administrative information to support them in the care of their patients.
On June 1, 2023, the state of Michigan will restart full eligibility reviews for D-SNP, Healthy Michigan and Medicaid members. Medicaid redetermination is the process by which Medicaid members must reapply for their Medicaid benefits and prove they qualify for Medicaid.
Aetna Better Health is excited to announce that we’re moving to Phase 2 of the Availity Appeals Enhancement Pilot. What we need are Providers (office staff), that are willing to participate in the Pilot. The above attachment gives a high level overview of what the Enhancement is about.
We want to make sure you stay informed about your patients and practices who are offered the opportunity to receive a free pharmacogenomics test as part of BCN’s new Blue Cross Personalized MedicineSM program. Please sign up to receive regular reports by emailing RXQualityPrograms@bcbsm.com with the names and email addresses of desired recipients for your group.
Medicaid redetermination is the process that states use to ensure that Medicaid enrollees continue to be eligible for Medicaid coverage. Typically, redetermination happens once a year; however, the rules changed during the pandemic.
Lakeland Care Network (LCN) was recently informed by Humana that certain taxonomy codes are no longer accepted by their Medicare product as of 10/31/2022. Per Humana, providers with the attached taxonomy codes are no longer eligible for Medicare reimbursement.
The PHE allowed for member cost share flexibility within their health plan for COVID-19 related claims. The end of PHE will mark several cost share and coverage changes for testing, vaccines and more.
The Second Quarter 2023 issue of Cigna Network News is now available. Network News is easy to navigate and it is easy to find what you’re looking for, including policy and network updates, as well as industry tools and resources.
PHPs new partnership with Valenz Health for prior authorization services goes live May 1, 2023.
A new employer group, AZO Services, now has access to the Lakeland Care Network through our Confinity contract. Effective May 1, 2023, AZO Services will be using the payor Auxiant.
Attached you will find the monthly updates for April 2023 from our partners at UnitedHealthcare.
Humana has made significant changes to their commercial products in regards to preauthorization and notifications in 2023.