APRIL Updates Medicare Advantage.

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Presentation transcript:

APRIL Updates Medicare Advantage

Unitedhealthcare UHC information is no longer on Availity Use Link Security App to update password Updates to Link (Pg. 5) Update to Outpatient Grouper (Pg. 7) Changes to Advanced Notification (Pg. 13)

Unitedhealthcare ACE Smart Edits (Pg. 16) PA updates for Genetic testing (Pg. 20) IMRT revision June 1st (Pg. 26) Medical Policy updates https://www.uhcprovider.com/en/policies- protocols/commercial-policies/commercial-medical-drug- policies.html?cid=NB-NBApr2018-Apr18-NB_Apr2018

Unitedhealthcare MA policy updates (Pg. 34) Streamline PA https://www.uhcprovider.com/en/policies-protocols/medicare- advantage-policies/medicare-advantage-guidelines.html?cid=NB- NBApr2018-Apr18-NB_Apr2018 Streamline PA

https://www.humana.com/provider/support/claims/address es Streamline authorizations Registering for Availity Claim addresses https://www.humana.com/provider/support/claims/address es 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- No new http://apps.humana.com/tad/tad_new/Search.aspx?sortfield=revie wdate&policyType=medical Screening mammo info.

aetna Infusion information Aetna’s President interview https://www.aetna.com/health-care-professionals/utilization- management/drug-infusion-site-of-care-policy.html Aetna’s President interview https://news.aetna.com/2018/02/aetna-president-karen-lynch-future- health-care/ 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 Card form Coverage Policy Update https://cignaforhcp.cigna.com/web/public/resourcesGuest/!ut/p/z1/hY3BDoIwEE S_hQNH2SUqciUmAsZEEg7QXkytK9YAJQVB_97yAYS9zczbGeBQAm_FqCoxKN2K2mr Gg9s1DgM_yTGJz9kJ0wyPqZ_nWwwRijWA2xgXLpr_- RrC7MRheWIPxahognxuMvQE5mKvBupdlC_ZuWio1x8j6aLuRpiftfVIRlSU6VpJNYOqfd DX66w3l7zFKKzSZqhp8EQPbAddU- KGNeEUOc4fL7vSkw!!/dz/d5/L2dBISEvZ0FBIS9nQSEh/p0/IZ7_OG861HS0HGJPF0IP0CI 1SS3085=CZ6_OG861HS0HGJPF0IP0CI1SS3080=LA0=Eref!QCPsitesQCPchcpQCPres ourceLibraryQCPcoveragePoliciesQCPmedical_a-z.page==/ Medical Policy Updates 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 veragePoliciesQCPpolicyUpdatesQCPcoveragePoliciesLatestUpdatesMarch2018.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.