Providers
August 7, 2023
UnitedHealthcare: August 2023 Community Plan Talking Points
Access the latest literature from Community Plan for provider offices caring for UHC-CP members.
August 3, 2023
Priority Health: New payment process for BHCC & CM telephone management services
In response to provider requests, we’re updating how we pay PCPs for behavioral health collaborative care (BHCC) services and care management telephone management services.
July 24, 2023
Humana exiting commercial market
Humana announced this morning that effective October 1, 2023, they no longer will be quoting their Commercial product in Michigan.
July 17, 2023
UnitedHealthcare: July 2023 update
UnitedHealthcare has shared its July 2023 Network News with all of our offices.
July 17, 2023
Priority Health: Enhanced security coming to prism
To ensure your data and your patient’s data are as secure as possible, we’ve implemented additional security for prism accounts.
July 14, 2023
Blue Care Network hosts upcoming webinar on new pharmacogenomics program
Dear BCN-Affiliated Medical Care Group Business Administrator:
We’d like to invite you, your primary care physicians, clinicians, pharmacists and support staff to an upcoming webinar discussing Blue Care Network’s precision medicine pharmacogenomics (PGx) program called Blue Cross Personalized MedicineSM.
July 13, 2023
Cofinity: New employer group added effective 6/1/23
Loeks Theatre (via Lucent Health) is now a new employer group that has joined the Lakeland Care Network.
June 28, 2023
Priority Health: Working to fix incorrectly denied claims for Cigna members
Some Cigna member claims submitted electronically by Michigan providers are being incorrectly denied due to a clinical edit. (The remittance advice will usually mention a missing or invalid diagnosis code.) We’re working hard to fix this as quickly as possible.
June 27, 2023
Priority Health: Recall of Multiple Drugs Manufactured by Akorn Pharmaceuticals
On June 1, 2023, Akorn Pharmaceuticals initiated a voluntary recall of various products as a result of bankruptcy and discontinuation of quality assurance activities of these marketed products. The discontinuation of the quality assurance program means the company is not able to support or guarantee that the products meet all intended specifications.
June 27, 2023
Priority Health: Recall of multiple drugs manufactured by Akorn Pharmaceuticals
On June 1, 2023, Akorn Pharmaceuticals initiated a voluntary recall of various products as a result of bankruptcy and discontinuation of quality assurance activities of these marketed products. The discontinuation of the quality assurance program means the company is not able to support or guarantee that the products meet all intended specifications.
June 9, 2023
UnitedHealthcare offers claim denial prevention training
Would you and your team like to learn more about a method of Claim Denial Prevention? We would like to help. Please join us to learn more about the Optum Communication Gateway, which delivers payer-specific rules within the billing workflow and could significantly cut down on your administrative costs of rework.
June 9, 2023
InterQual outage impacts prior authorizations nationwide
InterQual, managed by Change Healthcare, is experiencing a national outage. This outage impacts prior authorization processes for providers and payors across the country.
June 5, 2023
Priority Health: Update to Medicaid claims incorrectly being rejected in May 2023
The issue with Medicaid edit 5167 incorrectly front-end rejecting claims, first discovered on May 23, was resolved on May 30. All impacted claims have been reprocessed.
June 5, 2023
UnitedHealthcare: June 2023 update
United Healthcare has shared their Network News updates for June 2023
June 1, 2023
Priority Health: Virtual office advisory webinars
Priority Health is offering an one hour webinar on thursday, June 8, 2023 at noon on the topic of Virtual Office Advisory.
May 31, 2023
Blue Care Network: May 2023 Partners in Care
This issue of BCN, Partners in Care, introduces BCN’s Chief Medical Officer Peter T. Graham, M.D., and focuses on how we’re working to improve the experience you and your providers have with us and collaborate with you to improve your patients’ health care experience.
May 26, 2023
Priority Health‘s Medicaid claims incorrectly rejecting
Priority Health is experiencing an issue with their Medicaid claims front-end rejecting for “Claim Type Requires a Referring/Ordering NPI” when they shouldn’t. Priority Health teams are working to find the root cause and fix the issue as quickly as possible. Until then, they recommend you don't rebill those claims!
May 26, 2023
New care management codes for chronic pain management
On Jan. 1, 2023, CMS released two new care management codes for chronic pain management – G3002 and G3003 – which allow providers helping chronic pain patients to bundle key services and bill monthly rather than a’ la carte.
May 24, 2023
Priority Health: May 2023 policy updates including NEW prior authorization requirements
An update from Priority Health on a series of medical policies.
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