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Latest news

NEW Medicare Cards Soon to be Mailed

February 14, 2018

The Health Insurance Claim Number (HICN) is a Medicare beneficiary’s identification number, used for processing claims and determining eligibility for services.

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires removal of the Social Security Number (SSN)-based HICN from Medicare cards to address current risk of beneficiary medical identity theft.

MACRA requires that CMS mail out new Medicare cards with a new Medicare Number by April 2019. Medicare will start mailing new cards in April 2018.

K&M Machine Terms from NAA

February 13, 2018

North America Administrators (NAA) was one of Lakeland Care's Employer-Specific payors. Lakleand Care providers participated with NAA only for the K&M Machine covered employees.  Lakeland Care just received notice that K&M Machine terminated with NAA effective 8/31/17. We are not aware of what payor they might have moved to.  Therefore, please ask K&M patients for an updated insurance card.

Healthy Michigan Plan MI Marketplace Option - Why an HMP HRA Matters

January 31, 2018

Effective April 2018, individuals age 21 and older who have incomes above 100% of the Federal Poverty Level and have been enrolled in a Healthy Michigan Plan health plan for at least one year without choosing a healthy behavior through a Health Risk Assessment (HRA) may move to the MI Marketplace Option.

Important notes:

CHAMPS Enrollment Enforcement- Deadline Approaching

January 31, 2018

CHAMPS Enrollment Enforcement

CHAMPS is Michigan Medicaid’s Provider Enrollment System

  • January 1, 2018, all providers furnishing services to Medicaid beneficiaries must enroll in Michigan Medicaid per federal requirements.

                        – Includes providers participating in a managed care organization’s provider network.

Meridian CHOICE

January 12, 2018

Meridian Choice is a new commercial product that is offered on the Health Insurance Exchange.  All Lakeland facilities and all Lakeland Care credentialed providers participate with this new product.  This contract became effective October 1, 2017.

 

LMOA Monthly Meeting - January 2018

January 2, 2018

The Lakeland Medical Office Association (LMOA) invites you to attend our January luncheon and meeting.

 

PROGRAM:  Epic Olympics     

Join us for a FUN, interactive insight into some of the latest features, trends and information related to Epic. This presentation pertains not only to those who use Epic as their EHR everyday - but to all practices in the Lakeland Care Community who want to learn more about the latest trends and best practices in healthcare technology, security and communication.  IT Topics to be discussed are:

 

Priority Health - NEW Automated Phone System for Claims Calls

December 6, 2017

Effective January 1, 2018, our Provider Helpline representatives will direct callers with claims questions to our automated phone system or their provider account on priorityhealth.com. This change should reduce the wait times for speaking to a representative.

Our representatives will still assist with all other concerns, including those regarding claim denials.

 

Priority Health - Medicaid Pharmacy NEW Narrow Network

December 4, 2017

Effective December 1, 2017 Priority Health will utilize a select, limited group of pharmacies as preferred for all outpatient Medicaid prescription fills.

In our Medicaid service regions (West Michigan and Southwest Michigan) there will remain approximately 220 approved pharmacies where patients can have prescriptions filled.   Many large retail stores will continue to be in the Priority Health Medicaid pharmacy network, such as:

·         Walmart

·         Meijer

·         Walgreens

·         Costco

·         SAM’s club

Priority Health - Call Center Services Changes

November 27, 2017

Our online accounts and self-service automated phone system allow you to have 24/7 access to information about claims, benefits and authorizations. One of the most popular features of these tools is being able to look up simple claim information, including check numbers, amount applied to a deductible or coinsurance, or the amount being paid to you.

To reduce our hold times for our provider call center, we’re going to direct those who have basic claims questions to self-service tools.

CHAMPS Requirement for UHC Community Plan

November 1, 2017

All current and new UnitedHealthcare Community Plan Michigan Medicaid providers, including out-of-state providers, are now required to access CHAMPS to register in the Michigan Medicaid program. Registering in the Michigan Medicaid program does not require you to be a Medicaid FFS provider.  Effective January 1, 2018, failure to enroll in CHAMPs will result in claim denials.

 

Please see the attachment for further details.

2017 Annual Payor Conference Reference Tools

October 25, 2017

Thanks to all who spent the afternoon with us last week at the annual Lakeland Care Network Payor Conference. We hope it was a valuable day for you and your office or department.  Attached are presentations for your reference.

Priority Health: eviCore Additional Education and Pay Information

October 12, 2017

We greatly appreciate your patience as we continue to optimize the eviCore experience. As you know, we are currently in the "educate and pay" phase, which gives you an opportunity to become more familiar with eviCore's clinical criteria. During this time we are also diligently working with eviCore to improve operational challenges.

Our process remains the same

As a reminder, our processes communicated on 8/22/17 remain the same, and will continue through the end of the calendar year:

Humana Requests for Provider Directory Updates

September 25, 2017

You get them all the time.. the faxes from Humana asking your office to update your provider information with Humana in accordance with federal provider directory standards.  Good news!  If your providers are part of the Lakeland Care Network, you do not have to respond to these anymore. Lakeland Care will take care of that for you!  If you are an LMP practice, you don't need to send them to the Medical Staff Office either.  

Priority Health - Update on eviCore Processes and Solutions

September 20, 2017

Educate and Pay Program

As we continue to work with eviCore to identify solutions and address issues we have faced since the program implementation this summer, we are moving into a new phase, the Educate and Pay program. With the new program there are new communications you will be receiving from eviCore and there are new actions you will need to take.

Priority Health - New changes for some eviCore prior auths

July 26, 2017

  Priority Health has suspended  some criteria for spine/joint procedures.

The eviCore prior auth tool went live in June for all in-network musculoskeletal and spinal procedures, genetic testing, and advanced diagnostic imaging. Since the launch, Priority Health has identified some technical issues that need to be resolved to follow the guidelines originally outlined. 

New claimsLink App for United Healthcare

March 30, 2017

claimsLInk will be rolled out to UnitedHealthcareOnline.com users. Offices will be emailed when the new app is available to your office. After you receive the email, please sign in to the UnitedHealthcareOnline.com using your Optum ID and click on either Claim Status or Claim Reconsideration on UnitedHealthcareonline.com.  A pop-up box will give you the option to try claimsLink.

With claimsLink, you can:

ACA & MACRA in the New Political Environment: How to Thrive in Value-Based Health Care - Follow Up

March 16, 2017

The Michigan State Medical Society presented yesterday at the March 2017  Lakeland Medical Office Association (LMOA) meeting. Upon numerous requests, we have included the PPT presentation given at this meeting by our presenter.  A thank you to Joshua Richmond, Director of Physician Engagement & Membership, Michigan State Medical Society.

The program topic:   ACA & MACRA in the New Political Environment: How to Thrive in Value-Based Health Care

2017 myHealth Biometric Screening Forms for Lakeland Employees

February 15, 2017

Lakeland offers associates and spouses, on the medical plan, to earn a wellness incentive through participation in the myHealth program.   The myHealth program is a voluntary program, and it is the participants responsibility to submit their biometrics.  The myHealth program is an outcomes based health contingent program where participants must meet biometric goals.   If the targets are not met, participants may earn the same reward by participating in Alternate Satisfaction Activities.   Members who wish to participate must submit biometrics by 5/31/2017.

MPIE Webinar - Using Informed Consent and Advance Directives to Improve the Physician/Patient Relationship and Mitigate Loss

February 9, 2017

You are invited to attend Michigan Professional Insurance Exchange’s webinar titled….

USING INFORMED CONSENT AND ADVANCE DIRECTIVES TO IMPROVE THE PHYSICIAN/PATIENT RELATIONSHIP AND MITIGATE LOSS

February 22, 2017 | 12-1 p.m.

Register now!

The lack of informed consent: