09/05/2018

Newsletters of Interest

A Few Articles You Won’t Want to Miss:

• Submit your precertification clinical information online
• Clinical payment and coding policy changes
• Our office manual keeps you informed
• Don’t let your network status change — complete your FDR attestation today
• Changes to commercial drug lists begin on January 1, 2019

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

A Few Articles You Won’t Want to Miss:

• Check to see if you have a new professional provider consultant
• Important information about the new audit process
• How to request peer‑to‑peer review of inpatient admissions
• Effective Oct. 1, Prolia and Xgeva are subject to a site‑of‑care requirement for BCN HMO members
• Clinical editing billing tips
• How to submit a replacement or void claim

And Much More…SEPTEMBER/OCTOBER 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:

• Use Web Tools to Request Preauthorizations for Radiology Services
• Reminder: Prepare Now for Portal Closure
• 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
  • Link Self-Service Updates and Enhancements
  • Updates for Specialty Medications for UnitedHealthcare Commercial, Community Plan and Medicare Advantage Members
  • Drug Changes for Injectable Chemotherapy and Colony Stimulating Growth Factors Require New Authorization
  • Pharmacy Update: Notice of Changes to Prior Authorization Requirements and Coverage Criteria for UnitedHealthcare Commercial and Oxford

• UnitedHealthcare Commercial
  • UnitedHealthcare Genetic and Molecular Testing Prior Authorization/Notification Updates

• UnitedHealthcare Reimbursement Policies
  • Coordinated Commercial Reimbursement Policy Announcement

• UnitedHealthcare Community Plan
  • Outpatient Injectable Cancer Therapy Authorization Program for UnitedHealthcare Community Plan Process Change

And Much More…SEPTEMBER Monthly Issue Available HERE

Oncology Related Articles You Won’t Want to Miss:

Medical Benefit Drug Policy Updates

New:

• Onpattro™ (Patisiran) – Effective Sep. 1, 2018

Revised:

• Crysvita® (Burosumab-Twza) – Effective Sep. 1, 2018
• Somatostatin Analogs – Effective Sep. 1, 2018
• White Blood Cell Colony Stimulating Factors – Effective Sep. 1, 2018
• Xolair® (Omalizumab) – Effective Sep. 1, 2018

Utilization Review Guideline (URG) Updates

Revised:

• Specialty Medication Administration – Site of Care Review Guidelines – Effective Oct. 1, 2018

SEPTEMBER Monthly Issue Available HERE