Recent news

Here is the news from the past month. For older news, click any news category.

(March 05) Learn how to use our new tool to manage provider information for PIP settlement 

(March 02) We’re moving to eviCore criteria for certain multi-gene panels

(February 19) Facilities: Starting March 1, you'll see newborns on mothers' remits

(February 15) Telehealth billing process and policy updates coming March 1

(February 11) Use our online portal to submit your post-claims appeals and medical records

(February 11) eviCore is now processing retrospective radiology and musculoskeletal authorizations up to 360 days

(February 10) Register for the behavioral health collaborative care (BHCC) meetings to remain eligible for the BHCC incentive measure

(February 5)  We’re making it easier for you to manage your provider data for PIP

(February 2) 2021 PriorityMedicare D-SNP Model of Care provider training is now available

(January 29) We’re transitioning our retrospective genetic lab authorizations to eviCore for in network providers and labs

(January 25) Preferred biosimilars for pegfilgrastim effective April 1 

(January 25) Supporting mental wellness with myStrength

(January 19) Expanding outreach for osteoporosis gaps in care

(January 19) 2021 PCP Incentive Program (PIP) webpage updates

(January 6) New scam alert: fraudulent prescription and certificates of medical necessity (CMN) requests

(January 6) COVID-19 vaccine billing and reimbursement

(December 30) Class I Drug Recall: Anagrelide Capsules, USP 1 mg

(December 30) The Center for Medicare Services (CMS) is updating the Medicare outpatient therapy threshold

(December 24) 2021 CPC+ and PCP Incentive Program manual available

(December 15) Update on our Strategic Alliance with Cigna, effective Jan. 1

(December 11) We’ve made our guidelines for billing Medicare outpatient therapy service easier for you

(December 11) We‘ve updated the Provider Information Form

(December 11) Drug recall: Paroex® Oral Rinse

(December 11) New 2021 changes to E/M codes

(December 8) Reminder: D-SNP Model of Care training due Dec. 31, 2020

(December 2) Extensions for $0 cost share for telehealth, COVID-19 treatment and a commitment to $0 vaccine coverage

(November 24) Ongoing support for you and your patients in the fight against COVID-19

(November 20) Medicare and Medicaid member engagement and support programs

(November 16) Update to salpingectomy coverage

(November 13) Inovalan to begin chart reviews for commercial members

(November 6) Updated PIP and CPC+ manuals

(November 5) Reminder: D-SNP Model of Care training due Dec. 31, 2020

(November 3) Jan. 1, 2021 commercial and Medicare product information

(November 3) Turnaround times for processing your credentialing and enrollment requests now available

(October 29) 2021 commercial fee schedules now available

(October 27) Jan.1, 2021 commercial and Medicare formulary changes

(October 20) Drug recall: Nature Throid® and WP Thyroid®

(October 15) Reminder: Submit post-claim appeals and medical records through the Claims tool

(October 6) Reminder: D-SNP Model of Care training due Dec. 31, 2020

(October 2) ePA for pharmacy now available through the Surescripts portal

(October 1) 2021 PIP preliminary manual 

(September 29) Claims processing for providers at temporary locations for COVID-19 ends Sept. 30

(September 22) GuidingCare tips: InterQual® and expedited authorization requests

(September 21) Do you provide acupuncture services? Let us know.

(September 16) GuidingCare reminder: no longer accepting in-network authorization faxes and tips for quicker authorization processing

September 13) Alert message displaying in error for PriorityMedicare Edge PPO members in GuidingCare

(September 8) 2020 AHA claims submission deadline is Feb. 28, 2021

(September 4) New authorization tool launches September 14

(September 3) Reminder: Cost Estimator available to all providers

(September 3) MDHHS announces $25M PPE grant 

(September 2) Mandatory blood lead testing for children covered under Medicaid and WIC