Aetna Better Health of Michigan would like to invite you to their Virtual Provider Town Hall designed exclusively for Primary Care Providers (PCPs). Please join us on June 11, 2026. We have a morning session and an afternoon session to accommodate your schedule.
Health Alliance Plan, known simply as HAP, is changing their name and want you to be the first to know. They are announcing their new name, new look and will have the same commitment to high-quality, connected coverage.
HAP is now Health Alliance Plan by Henry Ford Health.
Priority Health is working with Optum Financial (Optum) and ECHO Health Inc (ECHO) to offer you more payment options for dates of service starting Aug. 1, 2026. They want to make sure you understand your payment options and any actions you may need to take.
In an effort to serve you better, Lakeland Care Network has created a new email address for payor issues that Lakeland Care credentialed offices may need extra assistance with.
Effective 8/1/26, Priority Health is partnering with Epic to replace their current provider portal, Prism, with a new provider portal intended to simplify the experience and allow us to work together better. They are also replacing GuidingCare with a new authorization process* embedded directly in the portal.
On Wednesday, March 18th, the Lakeland Medical Office Association invites you to attend a seminar presented by Mark Fatum of Rhoades McKee on best office practices to avoid medical liability and risk.
United Healthcare announces preauthorization changes that are effective March 1, 2026.
The changes are for Medicaid/Healthy Michigan, Marketplace, and Health Advantage unless otherwise indicated
You are invited to join MIOSHA and Lakeland Care Network, in collaboration with Corewell Health Lakeland Hospitals, for a morning of coffee, conversation, and workplace safety insights.
Due to the forecasted snowfall overnight and the potential for unsafe road conditions, we are cancelling the Coffee with MIOSHA event scheduled for Wednesday, January 21, 2026.
Join MIOSHA and Lakeland Care Network, in collaboration with Corewell Health Lakeland Hospitals, for a morning of coffee, conversation, and workplace safety insights.
The Lakeland Medical Office Association (LMOA) invites you to attend their January luncheon & seminar on January 21, 2026. The topic is "Through the Glass - Looking at Things from the Other Side of the Window.
McLaren has announced multiple changes to their pre-authorization process which will become effective on March 1, 2026.
Aetna Better Health is offering a couple of webinars on understanding the CAHPS Survey.
Corewell Health Lakeland, in collaboration with Lakeland Care Network, has once again been awarded a MIOSHA Consultation Education and Training (CET) grant, allowing us to offer FREE First Aid, CPR/AED, and Bloodborne Pathogen training to employers and their teams.
The Lakeland Medical Office Association invites you to attend our November event, sponsored by the Lakeland Care Network.
The event will showcase the major payors in our market – including those who have Commercial, Medicare, Medicaid and Dual-eligible products.
There is no Lakeland Medical Office Association luncheon this month.
Please mark your calendars for November 12th from 11 a.m. - 2 p.m. at Lakeland Care's Administrative Office Atrium where the Annual Lakeland Care Payor Showcase will be held.
EviCore announces an enhancement to the authorization process for members of Aetna Better Health® for the following programs:
• Radiology Advanced Imaging
• Cardiology Advanced Imaging
• Musculoskeletal Pain Management
Services performed without authorization may be denied for payment, and you may not seek reimbursement from members. Under the enhanced process, you will be directed to submit requests electronically via the CareCore National portal at www.EviCore.com.
Lakeland Care Network is looking forward to our annual Lakeland Care Network Annual Showcase coming up November 12, 2025. The date has moved from October to November, and the format will be a little different. Each payor will be set up in a trade show/scramble format which will allow you to go to any payor you'd like to talk to.
LMOA is an independent, non-profit organization dedicated to providing quality education to southwestern Michigan's healthcare community.
Title: Addicted & Afflicted - Why We Do What We Do
Speaker: Maggie Palmer, MSA, CPCS, CPMSM, Vice President, Professional Medical Affairs, Parkland Health, Dallas Texas
Effective October 1, 2025, Humana is transitioning from a regionally-based UM model to a centralized national structure for inpatient and post-acute Medicare services. Centralizing UM operations will streamline processes and enhance consistency in supporting providers across all markets.
The Corewell Health Flu Shot Clinic poster is available if you'd like to post this in your offices or give to friends, etc.
Corewell Health, in collaboration with Lakeland Care Network, will offer Community Flu Clinics in Southwest Michigan beginning in September 2025. Flu vaccines are available for adults at drive-thru and walk-in clinics, with no appointment necessary.
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.
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.
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.
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.
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.
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.
Effective July 28, 2025, claims submitted with the CS modifier will be denied. You’ll see denial code “E1J – Modifier used inappropriately” in prism.
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.
Effective 5/1/25, the Andrews University employee plan (not the student plan) is using a TPA through Priority Health called HMA. These patients should be considered IN-network with Lakeland Care.
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.
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.
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.
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.
United Healthcare provides updates on their Specialty Medical Injectable Drug Program and their Prescription Drug List.
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.
On April 16, 2025 the Lakeland Medical Office Association invites you to join us for lunch and a presentation on "Disclosure of Unanticipated Outcomes." Details are below.
LMOA is an independent, non-profit organization dedicated to providing quality education to southwestern Michigan's healthcare community.
The Lakeland Medical Office Association invites you to attend our March luncheon and seminar presented by WPS**