Provider news

2017 flu vaccine updates

Codes and descriptions have changed for 2017
Read more

PCP Incentive Program and CPC+ Program targets, measures updated

Updated manuals for both programs now reflect the changes

Read more

Suspended criteria for spine and musculoskeletal procedure auths in eviCore

We have identified some technical issues that need to be resolved
Read more

Cancelled: Revenue code 0510 reimbursement change

The Oct. 1, 2017 date for no longer reimbursing for revenue code 0510 has been cancelled
Read more
Tags: Billing Coding

Reminder: Requesting behavioral health authorizations

Fax requests for initial authorization of inpatient and partial hospitalization behavioral health services.
Read more

Reminder: Medicare Outpatient Observation Notice (MOON) form required

Notice required by Medicare for observation services beyond 24 hours, effective March 8, 2017
Read more

Altegra risk adjustment chart reviews in progress

Chart reviews are for the Medicare product
Read more

Medical code review fax number has been retired

As of July 17, we've stopped using the 616.975.8881 fax number
Read more
Tags: Billing Coding

Register for the first billing and reimbursement-specific VOA webinar July 27

Webinar takes place from noon to 1 p.m. EDST
Read more

Prior authorization required for insulin pumps Aug. 1

Includes continuous glucose monitors but not supplies
Read more

New updates and enhancements to Auth Request tool

Now authorizations through eviCore healthcare are available using Auth Request, as well as authorizations through Clear Coverage™
Read more

Updated: Newborns must be enrolled to be covered

Applies to group and individual commercial plan members
Read more

Bill Medicaid substance use claims to MDHHS effective July 1

Specifically, bill the Prepaid Inpatient Health Plan (PIHP) for payment
Read more

Webinar on MAPS and opioids July 18

Event is sponsored by the University of Michigan Injury Center and the Michigan Department of Health & Human Services
Read more

Discontinued appeal forms no longer accepted July 1

Current versions are dated 04/2017 and 05/2017

Read more

Effective 7/1: FQHC and RHC must bill Medicaid claims on UB forms

Get details on how and when to bill on UB forms.
Read more
Tags: Billing

Documentation for pended Clear Coverage™ auths no longer accepted by fax

As of June 26, you must submit documentation for pended authorization requests through Clear Coverage™.
Read more

May 2017 formulary update

Many drugs have been reviewed and their coverage/requirements adjusted by the Pharmacy & Therapeutics Committee.
Read more

Shingles vaccine now payable for Medicaid members 50+

MDHHS now recommends a lower age for the Herpes zoster/Zostavax vaccine
Read more

Some analyzers may give false blood lead level results

The US Food and Drug Administration (FDA) issued a safety warning about use of Magellan Diagnostics LeadCare® analyzers.
Read more  1 2 3 4 5 Next