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.
On April 1, 2023, our payment reference IDs that accompany claim and capitation payments will change.
As Michigan’s Prior Authorization Reform legislation (SB 247 / PA 60) goes into effect on June 1, 2023, we’ll implement new requirements for some of our prior authorizations to help ensure timely, appropriate care for our members, your patients.
An outline of the new clinical edits for professional and facility claims.
As you may know, in April 2022, Governor Whitmer signed the prior authorization reform bill, Public Act 60 (PA 60), into law. We’re excited that this legislation supports streamlining how we work with each other, making it easier for our members – your patients – to get the care they need when they need it.
Changes to our National Precertification List (NPL) applying to both our commercial and Medicare members.
We have received multiple questions regarding the impact the Blue Cross Personalized Medicine℠ program has on your annual Product Exhibits. As a reminder, this is the program that uses genetic testing to personalize medication treatments.
Welcome to the Department of Veterans Affairs Community Care Network (VA CCN). You are invited to attend a Veterans Affairs Community Care Network Overview educational session. Join us for one of the following virtual one hour educational presentations to learn more about VA CCN, treating Veterans and doing business with VA and Optum.