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Showing 1– 15 of 109 Results

Latest News

CareAdvance Provider®Tool Expanding to Commercial Business on April 20

Audience: All providers, facilities

Our new electronic preauthorization tool, CareAdvance Provider, will be used to request authorizations for our members with commercial coverage as of April 20, 2020. This includes: traditional indemnity, HMO, PPO, EPO and point-of-service products.  Important...

Discontinuation of Paper Notification of Claim Billing Errors Effective April 4

Audience: Professional providers

Effective April 4, 2020, Univera Healthcare will discontinue its practice of sending a paper notification when certain billing errors occur. This change is part of our overall effort to reduce the amount of paper sent to provider practices.  We first...

Behavioral Health Provider Training

Audience:

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

Ongoing Updates Regarding COVID-19

Audience: All Providers

Univera Healthcare is working diligently to keep you informed of the latest developments regarding Novel Coronavirus (COVID-19) and important information you will need as you deliver care to our members. The fastest and most efficient means for disseminating this...

Medical Utilization Management Program Updates Effective April 6, 2020

Audience: All providers

We would like to share an overview with you regarding our standard medical Utilization Management (UM) Program updates effective for requests beginning April 6, 2020 . These updates will be posted on March 27, 2020 For services already existing on our...

Advanced Opioid Management Program Updates

Audience: Participating Providers

The Advanced Opioid Management Program has successfully reduced the risk of opioid abuse and misuse in the community since implementation on July 1, 2018. This program, in combination with provider vigilance of opioid prescribing has: Reduced the average day...

Coronavirus (COVID-19) Update

Audience: Providers and Facilities

Univera Healthcare is closely monitoring Novel Coronavirus (COVID-19). Our top priority is the health and well-being of the members that we serve. Because the COVID-19 situation is rapidly evolving, the U.S. Centers for Disease Control and Prevention website remains the...

2020 HIPPS Codes Required on Medicare Advantage Home Health Claims Effective May 1

Audience: Certified Home Care Agencies

We advise you that claims received on or after May 1, 2020 with 2020 dates of service, will require valid 2020 Health Insurance Prospective Payment System (HIPPS) codes. Use of 2020 HIPPS codes will not have any impact on reimbursement. Your current reimbursement rate...

Durable Medical Equipment (DME) Online Resources

Audience: DME Providers

Our website contains several resources that we recommend you use prior to issuing durable medical equipment to our members and submitting claims. DME Rental / Purchase Grid A DME rental vs. purchase grid is available to assist you...

Medical Utilization Management Program Updates Effective June 1, 2020

Audience: Providers and Facilities

NOTE: Preauthorization added to codes for Univera Healthcare MyHealthSM, MyHealth PlusSM, Child Health Plus and the Essential Plan. Additional details are included below.    We would like to share an overview with you regarding our standard medical...

Requesting Additional Units Using CareAdvance Provider® Tool

Audience: Durable Medical Equipment Providers

We would like to provide clarification regarding the new process for requesting additional units for Durable Medical Equipment through our new CareAdvance Provider online authorization tool. If you have an authorization that was entered originally using our Clear...

CareAdvance® Provider Preauthorization Tool Expansion to Medicare and Commercial Lines of Business

Audience: All Providers

We announced previously that our new electronic preauthorization system, CareAdvance Provider, would be introduced in phases beginning with the Safety Net line of business on February 3, 2020. We would now like to provide you with advance notice regarding the transition...

Correct Coding in CareAdvance Provider® Preauthorization Tool

Audience: Physical Therapy, Occupational Therapy and Home Care providers

We remind you that the same coding rules that applied in the Clear CoverageTM authorization tool also apply when requesting authorization in our new CareAdvance Provider tool. Please help us to process your authorization request correctly and efficiently by applying the...

Requesting Additional Visits for Essential Plan Members

Audience: All Providers

We would like to provide clarification regarding the new process for requesting additional visits for our Essential Plan members due to our transition to the new CareAdvance Provider® authorization tool. If you have an authorization that was entered originally using...

CareAdvance Provider® Preauthorization Tool Reminder and Tips

Audience: All Providers

We remind you that our new CareAdvance Provider online authorization tool should now be used when requesting preauthorization for our Safety Net members. This includes Medicaid Managed Care (Univera Healthcare MyHealth TM and Univera Healthcare MyHealth Plus TM ), Child...

Showing 1– 15 of 109 Results