03/04/2019

Newsletters of Interest

A Few Articles You Won’t Want to Miss:

• Changes to our National Precertification List (NPL)
• Changes to commercial drug lists begin on July 1, 2019

And Much More….MARCH OfficeLink Updates Qtly Issue Available HERE

A Few Articles You Won’t Want to Miss:

• Clinical review decisions are based solely on appropriateness of care
• Network guidelines for member access
• BCN medical directors are a resource for physicians
• Medical policy updates
• Blue Care Network evaluates appropriateness of E&M coding
• Starting May 1, additional radiology services require authorization by AIM for BCN and Blue Cross members

And Much More…MARCH/APRIL Bi-Monthly Issue Available HERE

Current Issue Available HERE

Current Issue Available HERE 
(Once on the site, scroll to the bottom and choose NEWS on the left side)

A Few Articles You Won’t Want to Miss:

• Humana Updates Preauthorization and Notification Lists for 2019
• Changes Announced for 2019 Humana Formularies
• 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
  • Changes in Advance Notification and Prior Authorization Requirements
  • Prior Authorization Required for Therapeutic Radiopharmaceuticals
  • Clinical Practice Guidelines Updated on UHCprovider.com

• UnitedHealthcare Community
  • Peer Comparison Reports to be Mailed in April

• UnitedHealthcare Commercial Reimbursement Policies
  • Revision to the Consultation Services Policy

And Much More…MARCH Monthly Issue Available HERE

Oncology Related Articles You Won’t Want to Miss:

Medical Benefit Drug Policy Updates

Take Note:

• Medical Benefit Drug Policy Template Update

Revised:

• Complement Inhibitors (Soliris® & Ultomiris™) – Effective Mar. 1, 2019
• Ilumya™ (Tildrakizumab-Asmn) – Effective Mar. 1, 2019
• Immune Globulin (IVIG and SCIG) – Effective Mar. 1, 2019

Utilization Review Guideline (URG) Updates

Revised:

• Chemotherapy Observation or Inpatient Hospitalization – Effective Apr. 1, 2019
• Immune Globulin Site of Care Review Guidelines for Medical Necessity of Hospital Outpatient Facility Infusion – Effective Apr. 1, 2019
• Office Based Program – Effective Apr. 1, 2019

Quality of Care Guideline (QOCG) Updates

Revised:

• Hospital Readmissions – Effective Apr. 1, 2019

MARCH Monthly Issue Available HERE