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Updates to Administrative Policy-15 Part III: Evaluation & Management and Vaccine Administration Effective December 17, 2020
Audience: All PhysiciansUnivera Healthcare is updating Administrative Policy-15 to include a new Part III effective December 17, 2020, to define billing and reimbursement guidelines. You can access the individual policies by clicking here. Note: You must login with your username and password to...
Physical, Occupational, and Speech Therapy Preauthorization Process Change
Audience: Primary Care providers, and Physical, Occupational and Speech TherapistsWe would like you to be aware that effective January 1, 2021, Univera Healthcare will require preauthorization for all physical, occupational and speech services requested for our members who have Medicaid Managed Care (MyHealthSM) and Health and Recovery Plan (HARP)...
October Behavioral Health Training Opportunities
Audience: Primary Care and Behavioral Health ProvidersUnivera Healthcare will host the following education and training sessions in October. All providers are welcome. Access registration information from the Staff Training area. Please direct questions to Nafisah.Clay@UniveraHealthcare.com. Training...
Intensity Modulated Radiation Therapy for Prostate Cancer Update
Audience: Radiation OncologistsUnivera Healthcare works to ensure that the development of corporate medical policies occurs through an open, collaborative process. We encourage participating providers to become actively involved in medical policy development. Each month, draft policies are available...
Medicare Advantage Changes Effective January 1, 2021
Audience: All Providers and FacilitiesWe would like you to be aware of the following benefit and administrative changes effective January 1, 2021 for our members who have Medicare Advantage coverage. Members will be notified of these changes in September. The Annual Enrollment Period (AEP) extends from...
Reminder: Updates to New Administrative Policy Effective October 1, 2020
Audience: OptometristsOn June 22, 2020, Univera Healthcare notified you of the implementation of Administrative Policy 34 – Optometry Scope of Practice (“AP-34”) effective October 1, 2020, to define the billing and reimbursement guidelines for certain surgical codes for eye and ocular adnexa...
Requesting Additional Visits in CareAdvance Provider® Tool
Audience: Physical, Occupational, and Speech Therapists and home care providersPlease remember when requesting additional visits for an existing authorization in CareAdvance Provider, you must complete the following steps: Locate and open the authorization entry. Be sure you have the correct provider in focus in the top right corner using the...
New Procedure for Submitting Demographic Changes
Audience: All ProvidersKeeping your practice information up to date is very important. Not only do we share your practice information with patients in our provider directories, but having current information is also critical to our ability to conduct business with you. Effective...
Prohibition on Billing our Members for Personal Protective Equipment (PPE)
Audience: Medical and Dental Service ProvidersOn August 5, 2020, the New York State Department of Financial Services (“DFS”) issued Circular Letter No. 14 (2020) regarding charges for personal protective equipment (“PPE”) by health care and dental care providers. The Circular Letter addresses complaints received from...
Labor Day Pay Cycle Information
Audience: All providersWe are providing you with advance notice of a change to our pay cycle schedule due to the Labor Day holiday. These schedule changes will not affect your payment amount. Paper checks will mail on Tuesday, September 8. Please allow for delivery time via the U.S....
Extending Reimbursement, Cost-Share Waiver for COVID-19 & non-COVID-19 Telehealth Services
Audience: Providers, Hospitals and Certified Home Healthcare AgenciesPlease review the important updates below related to our extension of the member cost-share waiver and continued provider reimbursement for COVID-19 and non-COVID-19 telehealth services. We will continue to monitor the federal public health emergency and the New...
Behavioral Health September Training Opportunities
Audience: Primary Care and Behavioral Health practitionersUnivera Healthcare will host the following education and training sessions in September. All providers are welcome. Access registration information from the Staff Training area. Please direct questions to Nafisah.Clay@UniveraHealthcare.com. ...
Billing Clarification for HCPCS Codes G2023 and G2024- COVID-19 Specimen Collection
Audience: Skilled Nursing Facilities and Certified Home Health Care AgenciesIn our communication to certified home health care agencies dated April 22, 2020, we included Healthcare Common Procedure Coding System (HCPCS) codes G2023 and G2024 on a list of visit codes that could be used during the COVID-19 state of emergency. These codes should...
Updated Billing Requirements for Administrative Policy AP-26 COVID-19 Viral and Antibody Testing
Audience: Physicians, Nurse Practitioners, Labs & FacilitiesExcellus BlueCross BlueShield implemented Administrative Policy AP-26 COVID-19 Viral and Antibody Testing (effective March 13, 2020) to define the coverage, reimbursement and billing guidelines for this testing when it is determined to be medically appropriate for the...
Updated Administrative Policy 32—Billing and Reimbursement Guidelines for Increased Procedural Services Effective July 21, 2020
Audience: All ProvidersEffective July 21, 2020, Univera Healthcare is updating its administrative policy that defines billing and reimbursement guidelines for increased procedural services (i.e., modifier 22) billed on professional claims. You can access the individual policies. Note: You must...
