News

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.  

The Lakeland Medical Office Association invites you to attend our September season kick-off luncheon and seminar.  

Program:  Enhancing the A/R Management Cycle and Reducing Bad Debt

  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 authorizations and our partnership with eviCore will launch on June 19, 2017.

The partnership with eviCore  will optimize health outcomes through a focus on clinical appropriateness includes new authorizations for the following services:

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

PROGRAM:  Office Practice Risk Management: Lessons Learned from Claims

The Lakeland Medical Office Association (LMOA) invites you to attend our March luncheon and meeting presented by the Michigan State Medical Society.

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

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

Achieving Population Health Through

        Behavioral Health Integration

            March 7, 2017 | 12-1 p.m.

                       Register now!

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.

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:

Beginning on Monday, January 23, 2017, Priority Health has a new online prior authorization automation tool, Clear Coverage™.  This NEW system will replace their original fax process; the patient services which need a prior authorization will remain the same, but the way they are obtained is made easier.

Clear Coverage lets you request authorizations online, and offices will  receive immediate responses, including automatic authorizations for some procedures, all while making the authorization process quicker and easier.

LANSING, Mich. – On January 25, 2017, Gov. Rick Snyder announced the appointment of Michael Kolinski of Kalamazoo to the Michigan Board of Athletic Trainers. Housed within the Department of Licensing and Regulatory Affairs, the 11-member board assists in overseeing the licensure and practice of athletic trainers.

“I thank Michael for his willingness to serve on this board and am confident he will have a positive impact within the athletic training community,” Snyder said.

Here's a quick guide that Cigna is offering to help medical offices understand Cigna ID card information.

This tool can help define and clarify information that appears on Cigna's most common customer ID cards. It can also help you understand the requirements associated with their various plans, allowing you to quickly and efficiently serve your patients.

Effective 1/1/17, Kruger Plastic Products will no longer use Heritage Consultants as their payor.  They will continue to have access to the Lakeland Care Network, but will use Professional Benefit Administrators as their payor. Look for new ID cards and update your system so claims go to PBA instead of Heritage.

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

Program: HIPAA Now

Quick Summary

Complete Network Bulletin Available Here

TABLE OF CONTENTS

Front & Center

• Tell Us About Your Experience With Us

• New National Drug Code (NDC) Requirement Policy

• Communication Effectiveness Survey

Please read the attached newsletter from Affirmant Health Partners, our state-wide clinically integrated network.  These newsletters will available monthly, and will serve to provide the most up to date information on our network.

Thanks to all who spent the afternoon with us yesterday 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.

(Aetna's presentation and handouts will be attached in a separate news article as we are limited to 10 attachments per article.)

Meridian Health and McLaren Health Plan have also confirmed with Lakeland Care that physicans who see any Medicaid, or even simply refer Medicaid patients to Lakeland for any services, MUST ENROLL and ATTEST to their information within the CHAMPS System.  Please note that enrolling in CHAMPS does not require you to be a Medicaid FFS Provider.

Here's how you enroll in CHAMPS:

1.            Go to www.michigan.gov/mdhhs

2.            Click on “Doing Business with MDHHS” Icon (top of page)

United Healthcare has announced that they will no longer be participating in the individual insurance marketplace for 2017 for both Michigan and Indiana, as well as 24 other states.  This will leave only Blue Cross Blue Shield and Priority Heath as options for Michigan residents looking to sign up for insurance on the exchange.  For Indiana residents, PHP of Northern Indiana has also opted to exit the Indiana individual marketplace as well as its Individual Product line for 2017.