Category: Medicare
UHC April Monthly Overview
For Texas:
Starting June 1, 2023, Optum will manage prior authorization and step therapy requests for prescription medications for Texas residents with pharmacy coverage.
Medicare vs Inflation
As part of a broader push for Medicare payment reform, the Texas Medical Association, along with the American Medical Association and 133 national specialty and state medical associations, recently called on Congress to index Medicare physician payments to inflation.
POET Says Farewell
As of March 31st, Leslie Anders is no longer with Cigna MA.
Please direct Cigna MA issues and questions to:
Jim Denman
(936) 635-0612
Please be patient, Jim will be filling both positions until Cigna finds a replacement.
Medicare Patient Additional Support
Have You Identified Patients That Need Additional Support?
Physicians may refer Cigna Medicare patients to Cigna’s multiple Care Management (Patient Support) programs. Simply by sending an email to the Care Management team at [email protected]
To request an eligibility assessment review for your patient or learn more, contact Cigna Medicare Advantage patient support programs:
- email: [email protected]
Include:
- Provider Name and Phone #
- Patient Name
- Patient Healthplan ID #
- Any additional information we may need relevant to medical, pharmaceutical, behavioral, or SDOH needs
Remember to use secured email when sending patient PHI or diagnostic information in order to protect patient information.
Prevent Improper Code Bundling
Physicians can take advantage of a new Medicare tool to sort through service codes that can be bundled together for claims payment – and AVOID improper billing.
The CMS recently released the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) lookup tool to promote accurate code-bundling and prevent improper payment of Medicare Part B and Medicaid claims when incorrect code combinations are reported.
Available via Texas’ Medicare contractor Novitas Solutions, the tool is further designed to help physicians identify when certain pairs of codes are subject to automated edits.
AND FOR EVEN MORE TOOLS
CLICK ON ANY OF THE BUTTONS BELOW
UHC Reconsideration and Appeals Going Digital
This change affects Commercial and MA health care professionals.
Cigna 1st Qtr 2023 Network News
PRINT THIS!
For Easy Access
Click the blue box for a printable download.
Is CIOX a Pain?
If you are having issues with CIOX, please let POET know.
UHC MA Plans
The below list is for Provider use only. Not to be distributed to Patients.
Information Provided by Melissa Boyd, UHC Network Account Manager
Recent Comments