2. About Meridian Health Plan
Our Mission:
To continuously improve the quality of care in a low resource environment
We are:
Family-owned and operated treating our employees, members and providers like our own
Dedicated to making a difference through quality, innovative technology, member and provider satisfaction
Vision:
To be the premier service organization in government healthcare
To be the #1 health organization based on quality, innovative technology and service to our Meridian Family
Meridian is the only multi-state plan in the nation to receive an overall rating of 4 out of 5 for all three Medicaid HMO products – Meridian Health Plan of Michigan, Meridian Health Plan of Illinois and Meridian Health Plan of Iowa*
*According to NCQA’s Medicaid Health Insurance Plan Ratings 2015–2016

3. New Logo

4. Meridian Programs

5. Prior Authorization Updates
Provider Portal Submission- Preferred Method
Universal Online Form
Authorization form can be found on our website at
Provider Tools

6. Prior Authorization Updates
Universal Online Form
Complete all required sections
Include clinical documentation
Print form and fax to

7. Change of Address – Meridian Appeals
Meridian Care and Meridian Complete:
Meridian Health Plan
ATTN: Appeals Department
P.O. Box 44260
Detroit, MI 48226
Meridian Health and Meridian Choice
P.O. Box 44287
Detroit, MI 48244

8. HEDIS Bonus Program Updates effective 10/1/2016 Comprehensive Diabetes
HbA1c Control updated from <7% to <8%
Chlamydia Screening
$35 if service is billed by assigned PCP
$25 if service is found through medical record review or billed by provider other than assigned PCP
Prenatal and Postpartum Care
Updated to a quarterly bonus
Split between PCP and Servicing Provider

9. HEDIS Bonus Program Updates effective 10/1/2016 Added Removed
Colorectal Cancer Screening - $20
Removed
Follow-Up After Hospitalization
Smoking Cessation
Cervical Cancer Screening
Prenatal and Postpartum Care

10. HEDIS Bonus Program Updates effective 10/1/2016 Added Removed
Colorectal Cancer Screening - $20
Removed
Follow-Up After Hospitalization
Smoking Cessation

11. HEDIS Bonus Program New Program Effective 1/1/2017
Cervical Cancer Screening $25
Prenatal and Postpartum Care $100-$200
payment to be split between PCP and in-network servicing provider
Chlamydia Screening $25
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
$15 for completion of Child BMI Percentile (ages 3-17), Counseling for Nutrition, and Counseling for Physical Activity (must complete all)
Well Child Visits 3-6 $25
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
will be paid to servicing provider $25 for each component
Comprehensive Diabetes Care $25-$100

12. QUESTIONS?