UnitedHealthcare is updating a number of temporary provisions that were established as part of the COVID-19 response. Here’s a high-level summary of the changes:
Locating patient benefit information should be quick and easy. Providers logged into a provider portal account can see eligibility, benefits and deductible balances using the Member Inquiry tool.
With the Member Inquiry tool you can:
Humana on September 2, 2020 will launch a new program.campaign.
Members with Medicare Advantage who have not had breast cancer screening or a comprehensive eye exam will be encouraged to schedule their mammogram and/or comprehensive eye exam in consultation with their doctor to keep their health and safety top of mind during the pandemic.
Eligible Members will be receiving an email or leter from Humana duirng the campaign period of September 2, 2020 through November 2020.
The Andrews Unverity student medical insurance changed for this new academic year. Previously they had Commercial Travelers through National Guardian Life insurance company. Effective 8/17/20, the Commercial Travelers/National Guardian Life medical insurance terminated.
Effective 8/18/20, Andrews Univeristy student insurance is now with AETNA Student Health Plan for the 20-21 academic year.
Virtual Office Advisory
Thursday, September 17, 2020
Noon – 1 p.m. EST
Join us for our upcoming September Virtual Office Advisory webinar and learn about:
You now have the option to submit pharmacy prior authorizations for Priority Health members electronically.
Save time and get faster pharmacy decisions
We know you spend substantial time on prior authorizations and that it’s a common pain-point for many practices. That’s why we’ve partnered with Surescripts to implement an electronic prior authorization (ePA) solution for Rx drugs that will eliminate the need for time-consuming paper forms, faxes and phone calls, and allow us to return faster decisions to you.
The entire bulletin can be found at: www.UHCprovider.com > Network Bulletin.
LANSING, MICH. A $25 million grant program for personal protective equipment (PPE) will allow medical facilities and other providers to keep their staff and patients safe, the Michigan Department of Health and Human Services (MDHHS) announced.
Aetna Better Health has sent a Provider Bulletin informing us of a NEW lockbox changes as of 6/15/2020; please see the attachment below
They also have sent a letter regarding an E & M coding letter explaining current practices and policies; please also see that attachment.
Attached below is Aetna's First Tier, Downstream and Related entities (FDR) Q2 Compliance newsletter.
The current healthcare landscape is rapidly changing. We understand the extraordinary challenges our Members face daily and how difficult it can be to keep up with the most recent COVID-19 developments. With this weekly newsletter, we will provide you the latest news trending in healthcare.
If you haven't visited our site in a while, we have also added a few new focus areas:
We’ve revised our PCP Incentive Program (PIP) and Comprehensive Primary Care (CPC+) Program to reflect updated HEDIS information. Several measures have added additional opportunities for gap closure and/or exclusion criteria. In addition, we’ve made changes to the Healthy Michigan Plan: HRA measure which will be effective with the next Filemart report release. HEDIS measure changes are effective July 1, 2020.
You’re busy, so this quick read will provide you with useful updates from UnitedHealthcare. This brief is designed to:
Lakeland Partners-
As we shared earlier, we’re launching a new authorization tool called GuidingCare on September 14 that will replace Clear Coverage. Make sure you’re ready to successfully request authorizations this fall by registering for training.
MDHHS is hosting a series of CHAMPS 101 Webinars over the next several weeks for interested providers and billers. MI Operations & Regulatory Affairs wanted to share in the event that we’d like to share with any of our provider community .
The current healthcare landscape is rapidly changing. We understand the extraordinary challenges our Members face daily and how difficult it can be to keep up with the most recent COVID-19 developments. With this weekly newsletter, we will provide you the latest news trending in healthcare.
If you haven't visited our site in a while, we have also added a few new focus areas:
Frequently Asked Questions – Monday, August 10
Overview
1. What is Humana announcing?
In September, we’re launching GuidingCare, a new authorization request tool that will replace Clear Coverage and fax requests.
Make sure you're ready
Priority Health has provided their Summer 2020 Provider and Practice Digest with all of the latest Priority Health information.
Please see the attachment for details.
From Priority Health:
A Note from Meridian Health:
The Medicaid Targeted Distribution Funding through the CARES Act application deadline was extended for 1.) Phase 2 general distribution to Medicaid, Medicaid managed care, Children's Health Insurance Program (CHIP) and dental providers, and 2.) certain Medicare providers who experienced challenges in the Phase 1 Medicare General Distribution application period. These groups can apply for relief funding through Friday, August 28, 2020 according to the HHS press release issued on July 31.
From the press release:
Physicians, Practice Managers, and Staff,
Welcome to the Department of Veterans Affairs Community Care Network (VA CCN). You’re invited to 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.
During this webinar we will discuss:
• VA CCN Overview
• Referrals and Appointment Scheduling
• Providing and Coordinating Care
As the public health emergency continues, and the country slowly starts to reopen, we continue to look for ways to support our customers and the providers who are dedicating their lives to deliver important care.
United Healthcare has provided their latest provider bulletin for August 2020. Please read the attachment for details.
Attached you will find a quick reference guide on Humana and their contacts and resources for offices. Please see the attachment.
UnitedHealthcare recognizes that the persistence of COVID-19 cases across the country continues to have an impact on the healthcare system – both for COVID-19-related care as well as for regular preventive visits. To provide ongoing support to members and providers, UnitedHealthcare is extending many of the COVID-19 temporary program, process and coverage changes through Oct. 22, 2020.
From Humana:
If your office is working with our vendor, Navihealth, following attachment is a streamlined process for a select set of diagnoses for a rapid approval process
From United Health Care:
Please see the attached Collateral that will inform you on how to apply for additional Relief Funds:
Please note even thought this form stated expires 07/20/20, again the state has extended applications till August 3rd 2020.
Again, please see the attachment for details.
Meridian Health has sent a provider educational handout which explains MDHHS guidelines for getting children caught up on their vaccinations. It has some great tips for your providers at their practices and also has safety protocols. Please pay attention to page 4&5 for the immunization specific guidance.
Plese see the attachment for details.
As we shared earlier, on September 14, we’re launching GuidingCare, a new authorization tool that will replace Clear Coverage. Make sure you’re ready to successfully request authorizations this fall by registering for webinar trainings.
What steps do you need to take to ensure success?
The U.S. Food and Drug Administration (FDA) recently requested that prescription metformin ER products manufactured by Apotex Inc., Amneal Pharmaceutics, Granules Pharmaceuticals and Lupin Pharmaceuticals be removed from the market. This is due to a minor impurity. Recalled strengths vary by manufacturer.
Metformin products treat conditions like type II diabetes.
We’re notifying members
Department of Veterans Affairs (VA) has selected Optum as a third-party administrator for Regions Two of the VA Community Care Network (CCN). This contract became effective on January 20, 2020.
Optum would like to host virtual training sessions before the end of August 2020.
In the meantime, the instructions on the VACCN Referral Process is as follows:
Attached are the Meridian Provider educational handouts for the month of July.
Dental Care Information
Last week Priority Health announced that on July 1, 2020, we would return to paying the standard facility-based rate for expanded services provided via telehealth.
Given the investment our providers have made in telehealth, ongoing concerns about patients not visiting provider offices for needed care, and the rapidly evolving COVID-19 situation, we have reversed this decision. We'll continue to pay at the non-facility rate, using the rest of 2020 to review data on telehealth services to inform our future policies.
Attached is the June 2020 Affirmant newsletter. Please read for all of the latest with Affirmant!
The July 2020 UnitedHealthcare Network Bulletin Summary is attached for your reference. In addition, also attached are informational flyers on:
Later this summer, Priorty Health is launching GuidingCare, a new authorization tool that will replace Clear Coverage. The tool will process authorizations for procedures, inpatient, behavioral health, home care, skilled nursing facilities (SNF) and more. This change will not impact the authorization process for eviCore or pharmacy authorizations.
In response to the COVID-19 pandemic, we implemented several temporary changes to support you and your patients.
The purpose of this communication is to give you an update on which of these changes is ending on June 30, 2020, and what’s being extended. We’ve also made a new change for July 1, 2020.
