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Page 1: AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral

AUGUST UPDATES

Medicare Advantage

Page 2: AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral

UNITED HEALTHCARE- Release notice: July 30th, 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

Page 3: AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral

CARE IMPROVEMENT - Reminder: the ability to upload documents

via website

Page 4: AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral

CARE IMPROVEMENT- Also offers EFTs & ERAs

- On-site visits

- Summer training: August 18th 1:00ESThttps://uhc.webex.com/uhc/k2/j.php?MTID=t8e09052acad58543d6a3c527ddd8983a

August 27th 1:00ESThttps://uhc.webex.com/uhc/k2/j.php?MTID=taf795918fdf75d7b551b09bb66714d90

https://uhc.webex.com/uhc/k2/j.php?MTID=t8e09052acad58543d6a3c527ddd8983a
https://uhc.webex.com/uhc/k2/j.php?MTID=t8e09052acad58543d6a3c527ddd8983a
https://uhc.webex.com/uhc/k2/j.php?MTID=taf795918fdf75d7b551b09bb66714d90
https://uhc.webex.com/uhc/k2/j.php?MTID=taf795918fdf75d7b551b09bb66714d90
Page 5: AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral

HUMANA- Aetna acquired Humana

- Offers interactive Webinars:

- Thurs, Aug 13th at 11:00EST: CLAIMS

- Thurs, Aug 20th at 11:00EST: ELIGIBILITY

- Thurs, Aug 27th at 2:00EST: MEDICAL RECORDS

- Thurs, Sept 1st at 11:00EST: REFERRALS- https://www.humana.com/provider/medical-providers/education/provider-self-service/interactive/

- Provider Compliance update: Deadline Dec. 1st, 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

https://www.humana.com/provider/medical-providers/education/provider-self-service/interactive/
https://www.humana.com/provider/medical-providers/education/provider-self-service/interactive/
Page 6: AUGUST UPDATES Medicare Advantage. UNITED HEALTHCARE - Release notice: July 30 th, 2015 - The member’s primary physician must submit and electronic referral

THANK YOU- Email: [email protected]


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