Test Title

News Archive

GLO-PRV-News Archive Login Notice

Asset Search Filter and Browse

or
Showing 1– 15 of 129 Results

Latest News

New Electronic Preauthorization Tool Update

You were notified in September of our intention to provide you with a new electronic preauthorization system – CareAdvance Provider®, which will replace our current tool, Clear Coverage TM . We would now like to provide an update regarding the implementation time frame...

Read Article

Vatica Incentive Program Expanding

Dear Participating Physician or Physician Group, Univera Healthcare is pleased to announce that the Well365Plus Solution through an independent company called Vatica Health, Inc. (“Vatica Health”) will be expanded to include Affordable Care Act preventive visits for...

Read Article

Hospice Benefit Clarification

Once a member begins receiving hospice services, all care for their terminal illness will be coordinated by the hospice organization.  A review of our records indicates that hospice services for our members who have commercial or Medicaid Managed Care coverage may...

Read Article

MMC Ovulation Enhancing Drugs Prior Authorization Effective December 1

Medicaid Managed Care plan benefits now cover some ovulation-enhancing drugs for individuals ages 21 through 44 experiencing infertility. The following ovulation enhancing drugs will be covered and will be limited to three cycles of treatment per lifetime: ...

Read Article

InterQual® Criteria 2019 Update

Our Health Plan uses nationally recognized criteria, including InterQual, to determine appropriateness of care for our members.  We would like you to be aware that effective October 15, 2019, we will adopt the 2019 clinical revisions to InterQual criteria, which...

Read Article

Qualified Medicare Beneficiary Billing Update

Univera Healthcare reminds you that under federal law, any member cost sharing resulting from services provided to a Qualified Medicare Beneficiary (QMB) must be billed to Medicaid. QMB members, who are those eligible for both Medicare and Medicaid, cannot be billed for...

Read Article

Customer Care Department Closed for Training on October 14

On October 14, 2019, our Customer Care provider phone lines will be closed to allow for staff training and development. Our Medical Intake Customer Care line will remain open with minimal staff available for urgent preauthorization requests. You may reach Medical...

Read Article

Notification Reminder for Children’s Home and Community Based Services Carved into Medicaid Managed Care

Univera Healthcare (“Health Plan”) is requesting notification upon the initiation of Children’s Home and Community-Based Services (HCBS), in accordance with the New York State’s Children’s Waiver HCBS Plan of Care Workflow. For details, please refer to the New York...

Read Article

Chiropractic Network Management and Administrative Services Transition Effective January 1, 2020

Univera Healthcare is pleased to let you know that effective January 1, 2020, all chiropractic management and administrative services for our members will be handled by our Health Plan directly. Our business relationship with MEDSOLUTIONS, dba eviCore healthcare...

Read Article

Diabetic Retinopathy Documentation Reminder

Dear Eye Care Specialist: Univera Healthcare is collaborating with primary care providers (PCPs) across our service area to promote diabetic eye exams as a means for addressing the nation’s dramatic increase in diabetic retinopathy in recent years. We need your help. ...

Read Article

Medicare Advantage Dental Supplemental Benefits

Starting January 1, 2020, we will be offering Dental Optional Supplemental Benefits to our direct pay Medicare Advantage members. Please call Customer Care to verify the member’s eligibility. What’s New: There are no waiting periods for covered services. ...

Read Article

Medical Utilization Management Program Updates Effective January 1, 2020

We would like to share a general overview regarding our upcoming standard medical Utilization Management (UM) Program updates. The updates are effective for requests beginning January 1, 2020; however, we want to provide you with ample notification to enable you to...

Read Article

Clinical Editing Policy Update – Multiple Endoscopy

Our bulletin issued May 31, 2019 advised you that we would implement the Centers for Medicare and Medicaid Services multiple endoscopy policy effective for dates of service on or after September 2, 2019 for all lines of business. Implementation of this policy has been...

Read Article

Correct Billing Codes for Makena

We have recently received quite a few questions about Makena (Hydroxyprogesterone Caproate [HPC]) and correct billing procedures, and we are here to help! Please review the information below for some helpful billing guidelines for Hydroxyprogesterone Caproate (HPC). ...

Read Article

Reminder — Limited Medicaid Coverage of Infertility Drugs Effective October 1

We remind you that effective October 1, 2019, members enrolled in Medicaid Managed Care (MMC)  (Univera MyHealthTM) or the Health and Recovery Plan (Univera MyHealth PlusTM) will have coverage that includes medically necessary ovulation enhancing drugs and medical...

Read Article
Showing 1– 15 of 129 Results