04/03/2018

Newsletters of Interest

A Few Articles You Won’t Want to Miss:

• Changes to our National Precertification List (NPL)
• Request precerts electronically — it’s fast, secure and simple
• Ordering genetic tests in the correct sequence will result in fewer denials
• Changes to commercial drug lists begin on July 1, 2018

And Much More….MARCH Mid-America Region Qtly Issue Available HERE

A Few Articles You Won’t Want to Miss:

• Blue Care Network won’t accept late claims, effective July 1
• Provider forums coming to a town near you
• Most BCN Advantage services do not require referrals
• Diagnosis and treatment of cancer
• Medical record guidelines policies require providers to maintain member records
• Medical policy updates
• Clinical editing billing tips
  • Transitional care management services
• Billing Q&A
  • Modifier 25

And Much More…MAY/JUNE Bi-Monthly Issue Available HERE

Current Issue Available HERE

Current Issue Available HERE   (once on the site, choose NEWS on the left side)

A Few Articles You Won’t Want to Miss:

• Complete Annual Compliance Training Requirements Online
• Humana Sets Date to Close Its Secure Provider Portal
• New and Revised Pharmacy and Medical Coverage Policies Available

And Much More…Latest Issue Available HERE

 A Few Articles You Won’t Want to Miss:

• Front & Center
  • Denosumab (HCPCS code J0897) Requires Prior AuthorizationLink Self-Service Updates and Enhancements
  • Link Self-Service Updates
  • Updates to Notification/Prior Authorization Requirements for Specialty Medical Injectable Drugs

• UnitedHealthcare Commercial
  • Risk Adjustment Data Validation (RADV) Audit Program

•  Doing Business Better
  • 2017 Quality Improvement Program Overview

And Much More…MAY Monthly Issue Available HERE

Oncology Related Articles You Won’t Want to Miss:

Medical Policy Updates

Updated:

• Molecular Oncology Testing for Cancer Diagnosis, Prognosis, and Treatment Decisions – Effective Jul. 1, 2018

Medical Benefit Drug Policy Updates

New:

• Crysvita® (Burosumab-Twza) – Effective May 1, 2018

Updated:

• Benlysta® (Belimumab) – Effective May 1, 2018
• Entyvio® (Vedolizumab) – Effective May 1, 2018
• Radicava™ (Edaravone) – Effective May 1, 2018
• Vaccines – Effective May 1, 2018

MAY Monthly Issue Available HERE