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