AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral.

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Presentation transcript:

AUGUST UPDATES Medicare Advantage

UNITED HEALTHCARE - Release notice: July 30 th, The member’s primary physician must submit and electronic referral to UnitedHealthcare for network specialty care. - Referral required should appear on the member’s card - Delay in prospective NCD and LCD implementation - Electronic Payments & Statements (EPS) & Electronic Remittance Advice (ERA) - WelcometoEPS.com - InstaMed Patient Payments Medical Policy Updates - Routine review of Skilled Care

CARE IMPROVEMENT - Reminder: the ability to upload documents via website

CARE IMPROVEMENT - Also offers EFTs & ERAs - On-site visits - Summer training: August 18 th 1:00EST 527ddd8983a August 27 th 1:00EST b66714d90

HUMANA - Aetna acquired Humana - Offers interactive Webinars: - Thurs, Aug 13 th at 11:00EST: CLAIMS - Thurs, Aug 20 th at 11:00EST: ELIGIBILITY - Thurs, Aug 27 th at 2:00EST: MEDICAL RECORDS - Thurs, Sept 1 st at 11:00EST: REFERRALS Provider Compliance update: Deadline Dec. 1 st, Centers for Medicare & Medicaid Services (CMS) mandates that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements

THANK YOU -

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