10/02/2018

Newsletters of Interest

A Few Articles You Won’t Want to Miss:

• Submit your precertification clinical information online
• Clinical payment and coding policy changes
• Our office manual keeps you informed
• Don’t let your network status change — complete your FDR attestation today
• Changes to commercial drug lists begin on January 1, 2019

And Much More….SEPTEMBER Mid-America Region Qtly Issue Available HERE

A Few Articles You Won’t Want to Miss:

• Check to see if you have a new professional provider consultant
• Important information about the new audit process
• How to request peer‑to‑peer review of inpatient admissions
• Effective Oct. 1, Prolia and Xgeva are subject to a site‑of‑care requirement for BCN HMO members
• Clinical editing billing tips
• How to submit a replacement or void claim

And Much More…SEPTEMBER/OCTOBER Bi-Monthly Issue Available HERE

Current Issue Available HERE

Current Issue Available HERE   (once on the site, choose NEWS on the left side)

A Few Articles You Won’t Want to Miss:

• Use Web Tools to Request Preauthorizations for Radiology Services
• Reminder: Prepare Now for Portal Closure
• New and Revised Pharmacy and Medical Coverage Policies Available

And Much More…Latest Issue Available HERE

 A Few Articles You Won’t Want to Miss:

• Front & Center
  • Link Self-Service Updates and Enhancements
  • Pharmacy Update: Notice of Changes to Prior Authorization Requirements and Coverage Criteria for UnitedHealthcare Commercial and Oxford
  • Join Our New Data Exchange and Medical Record Collection Programs
  • Updates to Notification/Prior Authorization Requirements for Specialty Medical Injectable Drugs for UnitedHealthcare Commercial, Community Plan and Medicare Advantage Members
  • Requesting a Peer to Peer
  • Retiring Fax Numbers Used for Medical Prior Authorization - Phase 2 Fax Numbers Released

• UnitedHealthcare Commercial
  • Medical Record Review - ACA-Covered Commercial Plans for 2018 Dates of Service

• UnitedHealthcare Community Plan
  • UnitedHealthcare Community Plan Significantly Expanding Dual Special Needs Program - UnitedHealthcare Dual Complete
  • UnitedHealthcare Community Plan Outpatient Injectable Cancer Therapy Authorization Program for UnitedHealthcare Community Plan - Process Change

• UnitedHealthcare Medicare Advantage
  
  • Step Therapy Prior Authorization Requirements for Medicare Advantage Plans - Effective Jan. 1, 2019
  • UnitedHealthcare Medicare Advantage Policy Guideline Updates

And Much More…OCTOBER Monthly Issue Available HERE

Oncology Related Articles You Won’t Want to Miss:

Medical Benefit Drug Policy Updates

Updated:

• White Blood Cell Colony Stimulating Factors – Effective Oct. 1, 2018

Utilization Review Guideline (URG) Updates

New:

• Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Care – Effective Jan. 1, 2019

Updated:

• Chemotherapy Observation or Inpatient Hospitalization – Effective Oct. 1, 2018

Quality of Care Guideline (QOCG) Updates

Updated:

• Hospital Readmissions – Effective Oct. 1, 2018

OCTOBER Monthly Issue Available HERE