february Updates Medicare Advantage

- Quality Reporting Program retired on Jan. 1st Unitedhealthcare Hospital Quality Reporting (Pg. 5) - Quality Reporting Program retired on Jan. 1st CAHPS Surveys February-June Pg. 22) New Technical & Professional Reimbursement Policy May 2018 New Lab Services Policy May 2018

Unitedhealthcare Outpatient Injectable Chemotherapy Notification required for Florida, Georgia & Wisconsin March 1st (Pg. 26) Medical Policy Updates (Pg. 27) https://www.uhcprovider.com/en/policies- protocols/medicare-advantage-policies/medicare- advantage-coverage- sum.html?sort=dateDesc&%3Acq_csrf_token=undefined Medical Coverage Summary Updates (Pg. 29) Coverage Determinations (Pg. 31)

humana Claim numbers will be 15 digits https://www.humana.com/provider/support/whats-new/new- 15-digit-humana-claim-numbers Updates to preauthorization requirements for Therapy https://www.humana.com/provider/support/whats- new/therapy-preauthorization-updates Formulary changes for 2018 https://www.humana.com/provider/support/whats-new/2018- formulary-changes Updates to Code Editing Software https://www.humana.com/provider/support/whats- new/code-edit-updates Screening mammo info.

humana Flu Vaccinations Pneumonia Vaccines https://www.humana.com/provider/support/whats-new/flu-vaccines Pneumonia Vaccines https://www.humana.com/provider/support/whats- new/pneumonia-vaccines Reimbursement information for Hospitals https://www.humana.com/provider/support/whats- new/hospital-reimbursement Claim processing edits https://www.humana.com/provider/support/claims/processing- edits/search/recent-notifications?=recent- notifications&SearchTerm=,&num=10&offset=3 Medical and Pharmacy Coverage Policies http://apps.humana.com/tad/tad_new/Search.aspx?sortfield=reviewdate&p olicyType=medical Screening mammo info.

aetna Find a Form Medical Policy Updates Educational Webinars https://www.aetna.com/health-care-professionals/health-care- professional-forms.html Medical Policy Updates https://www.aetna.com/health-care-professionals/clinical-policy- bulletins/medical-clinical-policy-bulletins/changes.html Educational Webinars https://www.aetna.com/health-care-professionals/provider-education- manuals/educational-webinars.html Surgical dressings,

cigna Submitting Documentation on Pending Claim (Pg. 3) Clinical, Reimbursement & Administrative Policy Updates (Pg. 4) Precertification Updates (Pg. 7) Updates to CignaforHPC.com (Pg. 9) Webinar schedule (Pg. 10) Surgical dressings,

cigna Cigna exiting selected markets (Pg. 15) Georgia provider directory data validation (Pg. 22) Quick guide to ID cards (Pg. 26) Surgical dressings,

cigna Coverage Policy Update https://cignaforhcp.cigna.com/web/public/resourcesGuest/!ut/p/z1/hY3BDoIwEES_h QNH2SVGxCMxETAmknCA9mJqXbEGKCkI- veWDyDsbWbezgCHEngrRlWJQelW1FYzHtyucRj4SY5JfM5OmGZ4TP0832KIUKwB3Ma4cNH8z9cQ Zif2yxM7KEZFE-Rzk6EnMBd7NVDvonzJzkVDvf4YSRd1N8L8rK1HMqKiTNdKqhlU7YO- Xme9ueQtRmGVNkNNgyd6YAfomhI3rAmnyHH- dMsoJA!!/dz/d5/L2dBISEvZ0FBIS9nQSEh/p0/IZ7_OG861HS0HGJPF0IP0CI1SS3085=CZ6 _OG861HS0HGJPF0IP0CI1SS3080=LA0=Eref!QCPsitesQCPchcpQCPresourceLibrary QCPcoveragePoliciesQCPmedical_a-z.page==/#G Medical Policy Update https://cignaforhcp.cigna.com/web/public/resourcesGuest/!ut/p/z1/hY3BCsIwEES_xUOPdldF7 VUEtSJYKKLJRdYa60rbhCRW_XuTDxD3MuzumxmQcALZUc81edYdNWEXcnber7PZaFPiZr0tVpgXu MxHZTnBDOH4D5DhjT9mEf3yHyJCxfx3xRSOPasXlDHJqhuIBB175RKs7pVJ0Cqnn7ZSO75Ysp9w1r2y VKtCN1xxBBsKvD-Ya9QdO89dnZqAxMwH9fROjba- UT4lB2IMpj3hULTZazEYfAEyPIdv/dz/d5/L2dBISEvZ0FBIS9nQSEh/p0/IZ7_OG861HS0HGJPF0IP0CI1SS 3085=CZ6_OG861HS0HGJPF0IP0CI1SS3080=LA0=Eref!sitesQCPchcpQCPresourceLibraryQCPco veragePoliciesQCPpolicyUpdatesQCPcoveragePoliciesLatestUpdatesJanuary2018.page==/# Z7_OG861HS0HGJPF0IP0CI1SS3085

Thank you!!! Email: Leanne_layne@yahoo.com Phone: 706.318.5302 Take all of these documents back to your commercial billers so they can read thru these updates as well. And please remember that there could be exceptions to the timely filing guidelines in your contract. So please also check to see what your contracts have in them about timely filing.