Month: August 2025
Availity Portal Issues
It appears that Availity is having some issues.
If you have went in to Availity to complete an action, and it has your physician’s specialty wrong, this is an Availity issue. It seems to be across multiple insurances.
Please call Availity Customer Service (800) 282-4548.
POET is being told, it is not a credentialing or Healthplan issue.
CHS Terms HealthSpring Contract
POET has been informed that Woodland Heights Medical Center, a CHS hospital, has notified HealthSpring of its intent to terminate its contract. The contract in question is a national agreement held by CHS.
While a last-minute agreement remains a possibility, the termination is currently scheduled for August 28.
This termination will also include the Diagnostic Center of Woodland Heights.
We have requested to be kept informed of any updates or changes.
Health Plan Representatives Updated 8/4/2025
The Health Plan Representatives List has been updated. This is a good tool to print and have close by when you have an issue.
The biggest change for claims issues will be HealthSpring (HCSC) formerly Cigna MA. Here is how:
- Email ALL claims issues to [email protected]
2. HealthSpring has supplied the spreadsheet that MUST be used. A link is provided below, or you may call POET, we will be glad to email you an electronic copy.
Only the columns with Red Lettering, need to be filled out by the Physician’s office.
4. Always feel free to copy [email protected] if you would like POET to be in the loop.
5. If you have a time sensitive, special, or just an issue you would like to discuss with POET, please call (936) 637-7638.
Check Your Gold Card Eligibility
Last fall, UHC introduced the first national Gold Card program, reducing prior authorizations in favor of advance notification for provider groups consistently adhering to evidence-based care guidelines. They are happy to announce that in the 2nd year of the program, starting Oct. 1, 2025, additional provider groups will be eligible.
On Sept. 1, UHC will publish details on how to determine if your provider group has qualified for the program.
Check your Gold Card eligibility status starting Sept. 1
Provider groups can view their Gold Card program status in the UnitedHealthcare Provider Portal.
Renewing Oct. 1, 2025, the program simplifies the prior authorization process for qualifying providers and eligible services. Qualifying providers will need to submit advance notification, which confirms eligibility and network status, but no clinical information will be requested. We’ve updated the program protocol for the renewal period.
Visit our national Gold Card program page in September for detailed instructions on how to identify Gold Card status and access to an interactive guide that can help you navigate our resources.
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