As of Mar. 1, 2023, providers now have 60 days post authorization denial to file a level I appeal. If that appeal is denied, they’ll have 30 days post level I appeal denial to submit a level II appeal.
A patient’s decision about their care can be a big, life-changing decision. 2nd.MD through Accolade is a leader in virtual medical decision-making, connecting people facing high-impact medical scenarios with top specialists through video consultations, to help them make informed health care decisions.
The February tragedy at Michigan State University has had a significant impact on our members and your patients. Your physicians likely have patients who could benefit from behavioral health or care management services.
The Lakeland Medical Office Association invites you to attend our March luncheon and seminar.
Blue Cross Blue Shield of Michigan and Blue Care Network have contracted with Covera Health to launch a radiology-focused quality improvement program to help us better support radiologists and referring providers in their efforts to improve diagnostic quality, overall care and patient outcomes.
Today, Cigna is becoming Cigna Healthcare. This evolution of our brand signifies our renewed focus as an advocate for better health through every stage of life, as well as for improving the health, well-being, and peace of mind of our customers – your patients.
The latest updates provided to us by Cigna.
Attached you will find the latest updates provided to us by Humana. Please read and share the first quarter of 2023 Physician News updates with your offices.
The Lakeland Medical Office Association invites you to attend our February luncheon and seminar.
Physicians with BCN patients are being offered the opportunity to receive a pharmacogenomics test as part of BCN’s new Blue Cross Personalized Medicine℠ program.
From UnitedHealthcare, please read the provided attachments for all updates to UHC as of February 2023.
Effective January 1, 2023, select Ambetter providers will be able to participate in the new Ambetter Virtual Access provider network within Michigan.
The webinar focuses on the primary care physician’s vital role in helping achieve better patient outcomes through medication optimization. It also describes the patient experience from invitation through testing completion and demonstrates how medication treatment options can be tailored to individual needs. It includes specific case study success stories for multiple disease states and specialties.
The latest updates from UnitedHealthcare for January 2023.
Attached is letter that went out to providers early December 2022.
Updates and provider educational opportunities from Humana.
The Lakeland Medical Office Association invites you to attend our January luncheon and seminar.
Effective January 1, 2023, if you have Patient-Centered Medical Home designated providers, or mid-level providers billing under a PCMH-designated provider, these providers can bill for provider-delivered care management services for BCN and BCN AdvantageSM members.
December 2002 Network News and updates from UnitedHealthcare.
If you were unable to attend our Blue Cross Personalized Medicine℠ webinar for primary care physicians that was held on Nov. 10, the recording and presentation are now available on our provider training website. CME credit is available for those who watch the recording.
The latest updates from UnitedHealthcare.
Attached are the PowerPoint slides for the seminar hosted by the Lakeland Medical Office Association on Wednesday, November 16, 2022.
Dear BCN Medical Care Group Business Administrator, Blue Cross Physician Organization Administrator and Blue Cross Risk Based Contracted Entity Administrator:
Blue Cross Blue Shield of Michigan and Blue Care Network’s 2021 BCN Advantage℠ and Medicare Advantage PPO settlements will be delayed due to a delay in Blue Cross receiving the final revenue file from the Centers for Medicare & Medicaid Services.
Please see that attached November 2022 Network News bulletin updates and the UHCCP P4P updates flyer.
We have recently created a new “known claim issues” posted on our MIMeridian website, it provides all the current system issues and that will be updated.
The Lakeland Medical Office Association invites you to attend our November luncheon and seminar presented by Jim Leach.
We’d like to invite you, your primary care physicians, pharmacists and support staff to an upcoming webinar discussing our new end-to-end precision medicine pharmacogenomics (PGx) program called Blue Cross Personalized Medicine℠.
It’s been our priority for more than 25 years to reward the high-quality care you provide our members through our PCP Incentive Program (PIP). We’re excited to usher in opportunities for you to earn incentive payments more frequently throughout the year through our 2023 PIP program.
We’ve redesigned and rebuilt the PIP program from top to bottom for 2023. Starting in January, you’ll:
Presentations by Lakeland payor partners
The Humana Claim Payment Resolution Handbook is attached.
In order to support the transition from fee for service to value-based care, we will be introducing a 1.5% allocation from commercial PPO professional fees to fund the commercial PPO Blueprint provider risk arrangements.
On Oct. 12, 2022, Blue Cross Blue Shield of Michigan and Blue Care Network posted the attached provider alert, ordering transfers from noncontracted (or nonparticipating) ambulance services costs members money.
As a reminder, Cigna members who are under different health plans are covered by Priority Heath through our Strategic Alliance with Cigna. This means that Cigna members traveling in Michigan who have health plans covered under a Cigna Strategic Alliance can see our in-network PPO providers.
October monthly overview
https://www.uhcprovider.com/en/resource-library/news/2022/policy-protoc…
Why Implicit Bias training? Effective June 1, 2022, LARA announced the adoption of new rules that require Implicit Bias Training for all medical licenses and renewals.
All renewing licensees are required to complete 1 hour of this training for each year of their license cycle. The training is required to be interactive.
Please see the attached FAQ sheet for details.
Provided to our office from Aetna:
Sometimes there is a lot of information regarding payors that is confusing to our offices on what is or is not participating.
Aetna Signature Administrator (ASA) are PAR with Lakeland Care Network.
Please read the attachment for details regarding ASA Payers and TPA information that will be helpful to navigate these plan for offices and for providers alike.
There are three websites offered by Ambetter / Meridian Health as resources to providers and their offices:
Medicaid – Mhplan.com
Complete - https://corp.mhplan.com/en/provider/michigan/complete/
Ambetter – ambettermeridian.com