June Updates Medicare Advantage.

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Presentation transcript:

June Updates Medicare Advantage

Unitedhealthcare Feedback on Network Bulletin (Pg. 3) Colorectal Cancer Screening Webinars (Pg. 7) UnitedHealth Premium Designation Letters (Pg. 8) Overpayment Mailing Address (Pg. 10) CIP Provider Portal will no longer be effective as on July 1st (Pg. 10) Telemedicine (Pg. 32) Timely Filing: Administrative Guide (Pg. 88) Medical Policy Updates

humana Medical and Pharmacy Coverage Policies Policy for billing services when an Inpatient was not covered Time Frame: 1 calendar year https://www.humana.com/provider/medical- providers/education/claims/electronic-submission Immediate Preauthorization determination https://www.humana.com/provider/medical- providers/education/whats-new/online- preauthorization-tool Medical and Pharmacy Coverage Policies http://apps.humana.com/tad/tad_new/Search.aspx?sortfield= reviewdate&policyType=pharmacy

aetna Medical Policy Updates https://www.aetna.com/health-care-professionals/clinical-policy-bulletins/medical- clinical-policy-bulletins/changes.html Newsletter - Respond quickly to medical record requests (Pg. 11) - Organization determinations (Pg. 12) - Reminder to keep contact information updated (Pg. 13) - Precertification response timeline (Pg. 13) Time Frame: 120 days (https://www.aetnaeducation.com/ihtml/application/upload/9513.pdf) Educational Webinars https://www.aetna.com/health-care-professionals/provider-education- manuals/educational-webinars.html

cigna Timely filing requirements https://www.cigna.com/healthcare- professionals/resources-for-health-care- professionals/clinical-payment-and-reimbursement- policies/claim-policies-procedures-and- guidelines/when-to-file?WT.z_nav=healthcare- professionals%2Fresources-for-health-care- professionals%2Fclinical-payment-and-reimbursement- policies%2Fclaim-policies-procedures-and- guidelines%2Fclaim-policies-and- procedures%3BBody%3BTimely%20Claim%20Filing%20P olicy

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