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

1 AUGUST UPDATES Medicare Advantage

2 UNITED HEALTHCARE - Release notice: July 30 th, 2015 - 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 - https://register.instamed.com/uhc - Medical Policy Updates - Routine review of Skilled Care

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

4 CARE IMPROVEMENT - Also offers EFTs & ERAs - On-site visits - Summer training: August 18 th 1:00EST https://uhc.webex.com/uhc/k2/j.php?MTID=t8e09052acad58543d6a3c 527ddd8983a August 27 th 1:00EST https://uhc.webex.com/uhc/k2/j.php?MTID=taf795918fdf75d7b551b09b b66714d90

5 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 - https://www.humana.com/provider/medical-providers/education/provider-self-service/interactive/ https://www.humana.com/provider/medical-providers/education/provider-self-service/interactive/ - Provider Compliance update: Deadline Dec. 1 st, 2015 - Centers for Medicare & Medicaid Services (CMS) mandates that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements - 800.626.2741

6 THANK YOU - Email: Leanne_layne@yahoo.com


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