News

To our offices from Aetna Better Health:

Attached are the February 2022 monthly updates on the following topics:

• Provider Bulletin No 199: Prior Auth Update Ordering Practitioner

• Provider Bulletin No 200:   ABH Shutdown Retraction - Sunset of the ABH Medicaid Web Portal is being delayed at this time.

Dear BCN Medical Care Group Business Administrator:

United Health care wants to make offices aware of a recent change that will impact your current process.  As of December 1, 2021, providers for most plans are no longer required to submit observation notification after a patient has been discharged home from observation level of care.

Priority Health has provided the process and documentation to follow if your staff is having any technical difficulties with PRISM:

Dear Medical Care Group Business Administrator:

Due to the persistence of COVID-19 cases in your area, UnitedHealthcare is extending and expanding the temporary program provisions outlined in the attachment below.  This announcement is applicable to all in-network hospitals and skilled nursing facilities (SNFs) in Michigan statewide.

Priority Health has scheduled the 2022 Behavioral Health Collaborative Care meetings. Practices interested in earning the incentive for this measure should plan to attend at least 3 out of 4 quarterly virtual meetings to discuss collaborative care activities, share best practices and discuss barriers to implementation.

A repeat of information provided by Meridian, since offices have experienced difficulty navigating the Meridian current system of portals:

Priority Health - Get your Questions Answered

 PH has provided a resource to our offices that may help navigate and answer typical questions that arise during the normal day-to-day operations in your offices.

Please read the attachment and even print this handy resource. 

Since the COVID-19 pandemic began, Cigna has taken important steps to deliver timely accommodations to providers and customers, helping to ensure that customers have continued access to COVID-19 diagnostic services, testing, and treatment in safe settings.

Attached is the announcement of our Meridian Medicaid portal as the old portal at mhplan.com will no longer exist after 4/1/2022. Please register for the new portal by 3/1/2022 to avoid delays however if you are already registered with Meridian Complete portal you will not have to re-register. Members will receive new membership cards before 4/1/2022. After 4/1/2022 auths will be processed through the new provider portal.

You may need to resubmit rejected claims for your Medicaid patients who also have other insurance. 

Hello Hospital Partner-

COVID is surging across the US with many providers requesting assistance because of the rise in cases and shortage of staff.  Aetna recognizes the need to move to a National SNF Waiver effective today, January 6, 2022 through January 31, 2022. The attached communication has been updated to reflect the expansion.

From our Parrtners at Humana:

Michigan - Humana is suspending authorization requirements for skilled nursing facilities (SNFs)for Medicare Advantage and commercial fully insured members discharging from hospitals in the state of Michigan through Jan. 16, 2022. NaviHealth will continue to work with SNF facility-based teams on concurrent review for length of stay and appropriate level of care, including discharge planning.

Please share with your team and providers.

Do you see PriorityMedicare patients? Take 15 minutes to complete your D-SNP Model of Care training

Training must be completed by Dec. 31, 2021.

Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That’s why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who treat our PriorityMedicare D-SNP™ members are trained on our Model of Care.

From our partners at AETNA:

Hello Hospital Partner- an update that only applies for acute hospitals and SNFs

Attached noticed was supposed to go out to hospitals but in case you haven’t received or info didn’t make its way to you yet I wanted to make you aware that Aetna has liberalized Initial SNF Auths from Acute Care Hospitals since 11/22/21 and goes through 1/10/22.  I attached a notice if need to share as has all the details.  Please share as needed within your system.

Dear Physician Organization and Medical Care Group Business Administrator:

The Oxford school incident has had a significant impact on our members. Blue Cross Blue Shield of Michigan and Blue Care Network have been working with first responders to assist our members. We recognize that the shock waves of this tragedy have been felt across the state and combined with the approaching holiday season and the ongoing pandemic, your physicians likely have patients who could use behavioral health services.