News

There has been some confusion on the proper forms to send into Meridian for Prior Authorizations. At times, the form is sent to the incorrect fax number, which results in delays of getting the needed authorization approvals in a timely manner.  The Meridian Team must then route the form to the correct intended department, and this causes unneeded delay for the patient.

Humana has added a number of Availiaty webinars which can be viewed thru the Availity.com Provider Portal

Hosted By: Jason L. Johnson, Humana eBusiness Consultant

Each person in your organization must register separately.

The webinar lasts approximately 50-55 minutes.

Webinar Agenda

• Administrator Dashboard

• Payer Spaces

• Authorization & Referrals

• Eligibility & Benefits

• Claims Management

• Code Edit Simulator

• Medical Records Management

Measles can be dangerous for babies and young children.

Symptoms include:

• High fever (can spike to more than 104 F)
• Cough
• Runny Nose
• Red and watery eyes
• Rash breaks out 3-5 days after the symptoms begin

The MMR  (measles- mumps-rubella) vaccine can provide children  protection.

For additional informaiton, please visit these sites:

Meridian has provided these informational monthly handouts:

• Comprehensive Diabetes Care and Controlling High Blood Pressure
• Chlamydia Screening
• MeridianCare :  a Message from the Stars and Medicare Stars Overview
• Breast and Cervical Cancer Screening and The American College of Radiology BI-RADS Atlas and Mammography Quality Standards Act (MQSA)
• Notification of Change to Inpatient Claim Submission Requirements

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey includes a wide range of questions, some of which are tied to care coordination. This very important topic was identified by the Institute of Medicine (IOM) as one of the national priorities for action to improve quality and make care safe, effective, patient centered, timely, efficient and equitable.1

Meridian has provided informational handouts on the following topics:

• Prenatal Care; Scheduling Postpartum Care
• Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
• Colorectal Cancer Screening Plan
• The Health Outcomes Survey (HOS)
• Access to Care
• Annual Wellness Visit

In addition, there are informational sheets on:

• HealthHelp Implementation
• Provider Notification: New Quality Review Program for Radiology and Cardiology

As you know, Cofinity is migrating to a new claims repricing platform that requires a change in the traditional Cofinity claim submission workflow. The new platform will streamline their administrative processes and help improve the service they provide to you and their payer clients.

How this impacts you

The Lakeland Medical Office Association invites you to attend our March luncheon and seminar.  This month’s seminar is two presentations in one and will include role-playing scenarios for clarity at the end. 

Dr. Birris will be speaking first on how medical stressors affect how patients react to medical staff. Then, Norma Tirado will be talking about how we react to those stressed patients and why - what triggers our bad reactions.

Lakeland Care Network Employer Services is offering you a chance to hear more about how to navigate the new law while maintaining a safe work environment at our upcoming breakfast forum. Hurry, registration ends Friday, February 15, 2019.

Will Marijuana Legalization Change Workplace Drug Policies?
Does the New Law Require Employers to Allow Use at Work?
What Does it Mean for Testing?

Please remember that all labs requested for Lakeland associates, need to go to Lakeland laboratories, not Quest. 

Although the plan administrator changed from ASR to Priority Health for the Lakeland employees on 1/1/19,  the requirment for Lakeland covered plan members' labs stays the same - they must be sent to Lakeland for in-network consideration.

The Lakeland Care Network has added an additional Medicare contract to its panel. Effective 1/1/19, all Lakeland Care Network providers and offices participate with Blue Care Network's Medicare Advantage HMO plan.  This new contract will join Lakeland Care's two other existing Medicare Advantage contracts that are held with Humana and Priority Health. As this is a new contract, membership numbers will be low, so you may not see very many patients come in with this new coverage this year.

Effective on January 1, 2019, Gaishin Manufacturing and Supreme Casting have changed their insurance coverage from Ameraplan to ClaimChoice. 

At this time, please continue to send claims to Cofinity until further notice of changes.

Meridian has provided informational handouts on the following topics:

• Meridiancare - 2018 Recap
• Osteoporosis Management in Women and Preventing Fractures
• Initiation and Engagement of Alcohol and Other Drug Dependence Treatment/ Antidepression Medication Management
• Annual Monitoring for Patients in Persistent Medications

Please read the attachements for details.

LMOA is an independent, non-profit organization dedicated to providing quality education to southwestern Michigan's healthcare community.

The Lakeland Medical Office Association invites you to attend our November luncheon and seminar.  

Program:  Safety in Physician Offices

Nearly half of all non-fatal injuries that occur at work, take place in either Health Care or Social Services settings.

Please see the attached notification of upcoming ASR changes impacting the areas of:

• Pre-certification for Outpatient Infusion & Injection Therapy
• Increased dollar threshold for medical equipment requiring pre-certification

The updated version of these requirements will also be included in a revision to the Provider Administrative Manual, which is available online through the ASR Provider Portal.

Also attached, is a revised “At-A-Glance” page, reflecting these changes. 

On September 28, 2018, Cigna changed how providers will register for, and obtain the appropriate level of access to, the Cigna for Health Care Professionals website (CignaforHCP.com).* Now, newly assigned website access managers at each practice will manage these functions.

Thanks to all who spent the afternoon with us this 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.  The link to ASR's summary is here.

The Centers for Disease Control and Prevention (CDC) recommends that patients 6 months and older receive an annual flu vaccine.

This year’s seasonal flu vaccine will cover the three most common strains in the Northern Hemisphere, as identified by the CDC:

• A/Michigan/45/2015 (H1N1)pdm09-like virus

• A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus

• B/Colorado/06/2017-like (B/Victoria/2/87 lineage) virus

Please read the attachment for additional information.

ABH has provided new informational handouts on the following topics:

• Provider Notification on Urine Drug Testing
• Urine Drug Testing: Evidence-based Test Ordering