UnitedHealthcare to discontinue use of fax numbers for medical prior authorization requests UnitedHealthcare announced in its September 2018 Network Bulletin that it will begin retiring fax numbers utilized for medical prior authorization requests beginning January 1, 2019. Providers will be directed to utilize the Prior Authorization and Notification tool on Link, the UHC website currently utilized to check eligibility and benefits, manage claims and update provider demographic information. The following fax numbers will be retiring as of January 1, 2019: (877) 269-1045 (866) 362-6101 (866) 892-4582 (866) 589-4848 ... September 12, 2018 Managed Care Commercial Payors, Practice Management 0 0 Comment Read More »
L.A. Care issues recoupment letters for services dating back to 2012 The California Medical Association (CMA) has learned that L.A. Care Health Plan, the publicly operated Medi-Cal health plan serving more than 2 million Los Angeles County residents, issued letters to physicians in late July requesting the refund of claim overpayments dating back to 2012. The letters, dated July 28 and received by practices through mid-August, cited that the overpayments were a result of processing errors, including the following: L.A. Care incorrectly processed Medi-Medi claims as the primary payor instead of secondary to Medicare. ... September 12, 2018 Medi-Cal Payor Issues and Reimbursement, Practice Management, Public Payors 0 0 Comment Read More »
Health Net Federal Services continues to address TRICARE transition issues As previously reported, Health Net Federal Services (HNFS) has experienced implementation issues since taking over as the new Defense Heath Agency (DHA) managed care contractor for the TRICARE West Region on January 1. In recent discussions with the California Medical Association (CMA), HNFS said it continues to address the breakdowns in process and resulting consequences that have impacted TRICARE providers in the areas of provider contracting and credentialing, beneficiary reassignment and provider directory inaccuracies. Updates are as follows: Contracting and Credentialing Because of staffing and operational issues, physicians may have experienced ... September 12, 2018 Managed Care Commercial Payors, Payor Contracting, Payor Issues and Reimbursement, Practice Management 0 0 Comment Read More »
CA pharmacy board launched drug take-back database The California Board of Pharmacy has launched an online drug take-back tool to help consumers looking for a place to safely dispose of unwanted or expired prescription drugs. The searchable online database includes pharmacies statewide offering drug take-back services authorized by the California State Board of Pharmacy. The drug take-back search tool is available at pharmacy.ca.gov. Users can enter a pharmacy name, city or zip code to easily find a nearby location for disposing of unused medications. Pharmacies operating take-back programs registered with the Board of Pharmacy may offer two types ... September 12, 2018 General Drug Prescribing/Dispensing 0 0 Comment Read More »
CMA and AMA oppose CMS proposal to collapse E/M codes More than 150 health care organizations, including the California Medical Association (CMA) and the American Medical Association (AMA), sent a joint letter to the Centers for Medicare and Medicaid Services (CMS), opposing the agency’s proposal to collapse evaluation and management (E/M) code and payment levels. The proposal was included in the draft 2019 Medicare Physician Fee Schedule and MACRA Quality Payment Program rule released earlier this summer. CMA and AMA appreciate CMS’s genuine desire to reduce documentation burdens on physicians to allow them to focus on patients over paperwork. Several ... September 12, 2018 General, Medicare Advocacy, Payor Issues and Reimbursement, Public Payors 0 0 Comment Read More »
