Attached is the link to the UHC Provider News for June 2020. Topics for this Month include:

*Extending Temporary Telehealth Expansion and Reimbursement Through 9/30/20 *Extending Telehealth Cost Share Waivers *Updated COVID-19 Testing Guidance * Updated Program Dates

Attached is the link to the Cigna Medicare Advantage PCP Newsletter for June 2020. Topics this month include:

·         Social Determinants of Health (SDOH)

·         2020 Medicare Advantage Prior Auth (PA) Requirements

·         CoverMyMeds.com

·         Valuable Insights:COVID-19 Resources

·         CAHPS Corner: COVID-19 Updates

AS of July 1, 2020 the Humana Medicare Advantage PPO agreement will be effective. Packets have been emailed and mailed by US Postal.

Please be sure to review and send in your response.

Changes in National Pre-certification List (NPL)

Changes to Commercial Drug list begin October 1, 2020

Accurate Claims Processing with Aetna’s 3rd Party Claim and Code Review Prog

Follow this link to find the Update in Aetna’s InK file.

Starting Monday, June 1,2020 UHC will make effective a new Commercial fee schedule.

Your packets are being emailed.

Please be sure to carefully review the packet. The change is not only the new fee schedule but effects which products you will required to accept.

UHC has rolled all products, MEDICAID, MEDICARE AND COMMERCIAL into one contract as of September 15, 2020 .

This means a physician will be required to see members with any of those products. UHC will no longer allow a physician to choose which products they will participate in.

Attached is the link to the Cigna Medicare Advantage PCP Newsletter for May 2020. Topics this month include:

• Healthy Equity Resource: CultureVision
• National Osteoporosis Month
• COVID-19 Update
• National Mental Health Month
• National Nurse’s Week
• CAHPS Corner

A Quick Guide to Each Payer’s Coronavirus Changes and Waivers

Throughout the COVID-19 pandemic, commercial and government payers have issued waivers and policy changes to help physicians care for as many patients as possible. 

But each plan has different effective and expiration dates for telemedicine, testing, and treatment changes. And most commercial plans can opt in or out of government-program adjustments such as waiving cost-share for treatment. 

If you’re trying to keep track of each payer’s policies, the Texas Medical Association has created a chart that shows when each change began – and is scheduled to end – for government and commercial plans. 

The chart includes information on Medicaid and Medicare as well as Texas Department of Insurance (TDI)-regulated commercial plans and ERISA (federally regulated) policies. It is based on details posted on each plan’s website and will be updated frequently. TMA recommends you contact each patient’s plan directly. 

The chart is one of several tools TMA has published to help you navigate the constantly changing payer landscape during the pandemic. 

TMA’s Practice Viability Toolkit details multiple ways to keep your practice’s finances healthy. It includes a section on each payer’s policies. 

The webinar, Payer Updates in the Time of COVID-19, offers guidance in sorting through the inconsistent patchwork of varying COVID-19 billing and coding policies. It is accredited for 0.5 AMA PRA Category 1 Credits™. 

You can find the payer chart, toolkit, webinar, and other resources and information on the practice viability section of the TMA COVID-19 Resource Center.

POET Update 8/19/2020: BCBS Expands Telemedicine through 12/31/2020.

Be sure to open this article ( click on title) to be able to access links.

Last Updated On

May 12, 2020

Payers Extend Prior Authorization Windows During COVID-19, follow this link.

A good article on communication with patients when re-opening… and other CoVID Issues.