Health Plan Representatives

The Representative List has been updated

Which Health Plans Are Exempt from Prompt Pay Laws

Improve Your Appeal Efforts

“Know the Law When Managing Claim Denials for Better Appeals” 

Medical denials and appeals can be an expensive and time-consuming. Sharpen your skills with this article from MGMA.

Self-Pay Medicare Beneficiary

Protect Your Patient…  Protect Your Practice…  Protect Yourself
When a Medicare Beneficiary wants to pay out of pocket?

Stay informed about COVID-19

Patients look to you to help them make the most informed health care decisions. We know your patients have a lot of questions about the COVID-19 vaccines – from their safety and effectiveness to where they can get a vaccination and more.

We’ve pulled together resources to help guide your patient conversations, direct them to vaccination locations in their area and reinforce the importance of continuing to wear masks.

Use the Vaccine Resource Locator

UnitedHealthcare has developed a ZIP-code tool to help members find FDA-authorized vaccine resources near them. The resources include information on who can get a vaccine, where vaccines are being given, how to schedule an appointment to get a vaccine and how to sign up for alerts.

Answer questions about the vaccine

Your patients are likely asking many questions about the COVID-19 vaccines. They look to you to help them make sense of what they’re hearing in the news and what they should consider in deciding whether or when to get vaccinated. We’ve gathered resources from the American Medical Association (AMA) and the Centers for Disease Control and Prevention (CDC) – the organizations you trust most to provide reliable information – in one spot for easy reference. You’ll find sample scripts to use with patients as well as news articles with information to help answer patient questions about the COVID-19 vaccines.

Encourage mask wearing

Even with COVID-19 vaccinations, it’s important that everyone continue to wear masks, social distance and wash hands frequently. We’ve partnered with the American Medical Association to help promote their “Mask Up” campaign and provide flyers and other materials that you can use in your office and on social media to remind patients about the importance of masking up. These resources may be particularly helpful for health care professionals located in states without mask mandates.

 Check out Mask UP

Confused About On-line Meetings

A historic number of employees are rapidly transitioning to remote work. Web-ex meetings have never been more vital for staying connected. Click to see what Cisco list as Top Tips for staying connected.

Public Health Emergency Likely to Last Through 2021

TMA experts say the extension allows the Centers for Medicare & Medicaid Services (CMS) to maintain several COVID-19-related Medicare waivers and flexibilities, including paying the same rate for telemedicine visits as for in-person visits, and allowing use of audio-only

2021 E&M Changes:

Avoiding pitfalls with the right technology-enabled strategy

Extensive revisions aim to prioritize patient care information, resource-based reimbursement, and lessening the need for audits.

As part of its goal to reduce administrative burdens on physicians, the Centers for Medicare and Medicaid Services (CMS) has introduced a final rule for Evaluation and Management (E&M) coding changes that go into effect in January 2021. Extensive revisions to the guidelines aim to minimize the amount of time physicians spend on documenting visits—prioritizing the documentation of information pertinent to patient care, creating resource-based reimbursement, and achieving less need for audits.

Medicare Payments for January Withheld!

UHC Out Of Network

Oh, the dog doesn’t have anything to do with anything. Just wanted to bring a smile to your face.