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Latest News

Expiration of NYS DFS Insurance Circular Letter No. 17 Provisions

Audience: Hospitals, Inpatient Mental Health Facilities, Skilled Nursing Facilities and Home Health Care Providers

New York State Department of Financial Services (NYS DFS) has not extended the requirements of its December 23, 2020 Insurance Circular Letter No. 17 (2020), which expired February 21, 2021. We recognize that some services may have been scheduled before February 21,...

Coverage Exclusion of Non-FDA Approved Medications for Commercial, Exchange, Essential Plan, and Child Health Plus Members

Audience: Providers of impacted patients

We have identified several medications on our formularies that are non-FDA approved products. As a result, beginning April 1, 2021, we will remove these medications from the respective formularies and exclude coverage for the following medications: Hydrocortisone...

Transition of Voluntary Foster Care Agencies and Foster Care Children into Medicaid Managed Care

Audience: Primary Care Physicians, Nurse Practitioners, Psychologists, Psychiatrists, Occupational Therapists, Licensed Clinical Social Workers, Licensed Mental Health Counselors, Licensed Marriage and Family Therapists, Hospitals, Inpatient/Outpatient Mental Health and Substance Use Facilities and Federally Qualified Health Centers

We would like to provide you with information related to New York state’s efforts to transform and expand the health care system to improve service access and provide earlier intervention for children in Foster Care (FC) with complex medical and behavioral health needs. ...

Telemedicine and Telehealth Administrative Policy 22 Part II Effective May 24, 2021

Audience: All Providers

Univera Healthcare is implementing the following administrative policy effective May 24, 2021, to define the coverage and billing guidelines for Telemedicine and Telehealth Part II billed by providers contracted to provide this service. You can access the individual...

March Behavioral Health Provider Training

Audience: All Providers

Univera Healthcare will host the following educational training sessions via webinar format in the month of March. All providers are welcome!  You can access registration information from the Staff Training area on our website, Provider.UniveraHealthcare.com. ...

February Medical Policy Update

Audience: All Providers

In our constant effort to provide you with information in the fastest, most efficient way possible, Univera Healthcare medical policies are now available by clicking here. Please find attached your regular monthly update containing the following: A summary of new...

Certain Continuous Glucose Monitoring Systems Available at Retail Pharmacy

Audience: Providers of impacted patients

Continuous Glucose Monitoring Systems (CGMS) are a medical benefit that previously required a Durable Medical Equipment (DME) provider for processing.  We are notifying you that we have made recent changes that now allow certain CGMS products to process at a retail...

COVID-19 Vaccine Effort – Volunteer Information

Audience: Physicians, Hospitals and Facilities

Supporting our communities is a big part of who we are as a company, and donating our time is one way we can help lessen the impact of COVID-19. We have encouraged those who’d like to help with vaccination efforts to sign up through New York State’s Volunteer Program...

February Behavioral Health Provider Training

Audience: All Providers

Univera Healthcare will host the following education and training sessions in February 2021. All providers are welcome. Access registration information from the Staff Training area at Provider.UniveraHealthcare.com. Please direct questions to...

Patient Access to Health Information via Third-Party App

Audience: All Providers

As of January 1, 2021, most health insurance plans are required to provide their members with access to their health information through a patient access application programming interface (API).   This new requirement allows members the option of downloading...

Utilization Management Program-Preauthorization Update Effective May 1, 2021 for All Lines of Business that Require Preauthorization

Audience: All Providers

We would like to share updates with you regarding preauthorization under our Utilization Management (UM) Program.  The UM Program gives Univera Healthcare and its health care provider partners the opportunity to monitor medical episodes of care to prevent...

February Behavioral Health Training Opportunities

Audience: Behavioral Health and Primary Care Practitioners

Univera Healthcare will host the following education and training sessions in February. All providers are welcome.  Access registration information from the Staff Training area. Please direct questions to Nafisah.Clay@UniveraHealthcare.com Training...

New Dental Record Requirements Grid Available Online

Audience: Participating Dental Care Providers

We are excited to share with you that we have a new grid available on our website to help you determine when we require dental records to consider or approve a claim for payment. The Procedure Codes that Require Dental Record Submission grid includes information on the...

COVID-19 Treatment with Monoclonal Antibodies

Audience: Physicians, Hospitals, Infusion Centers, Skilled Nursing Facilities and Home Health Care Providers

The U.S. Food and Drug Administration issued an emergency use authorization for investigational monoclonal antibody therapies bamlanivimab and casirivimab/imdevimab for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adult and pediatric patients. ...

Extension of NYS & Federal Time Frames Related to COVID-19 Telehealth Member Cost-Share

Audience: Physicians and other Health Care Practitioners

Univera Healthcare would like you to be aware of the following information: Member Cost-Share for Telehealth Services  For Medicare Advantage members, we will continue to cover both COVID-19 and non-COVID-19 related telehealth services with no member cost-share...

Showing 1– 15 of 121 Results