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Latest News

Musculoskeletal Preauthorization Procedure for Essential Plan Members Effective August 1

Audience: Physicians, Hospitals

We advise you that effective August 1, 2020, preauthorization requests for musculoskeletal procedures pertaining to Essential Plan members must be submitted directly to the Health Plan. Musculoskeletal-related requests for Commercial and Medicare Advantage business should...

Requesting Additional Visits in CareAdvance Provider® Tool

Audience: Physical, Occupational and Speech Therapists

<p>Please remember when requesting additional visits for an existing authorization in CareAdvance Provider, you must complete the following steps:</p> <ul>     <li>     <p>Locate and open the authorization...

COVID-19 Diagnostic & Antibody Testing Administrative Policy & Information for all Lines of Business

Audience: Physicians, Hospitals, Facilities and Laboratories

In our communication to you dated May 21, 2020, we shared Health Plan coverage guidelines and member cost-share information related to COVID-19 diagnostic/viral and antibody testing for our commercial members. The information and guidance we shared in our May 21, 2020...

Electronic Submission Tools

Audience: All providers

To make it easier and more efficient to conduct business with our Health Plan, we are enabling more real-time automation to reduce your administrative burden. As part of our continuing effort to improve our service, we are offering the following electronic submission...

COVID-19 In-Network Outpatient Behavioral Health Services for Essential Workers

Audience: Behavioral Health Providers and Facilities

On May 2, 2020, the New York State Department of Financial Services issued an emergency regulation and circular letter that waives member cost-share for outpatient mental health services provided to essential workers during the COVID-19 state of emergency. Under this new...

COVID-19 Diagnostic and Antibody Testing Information

Audience: Participating Physicians, Hospitals, Facilities and Laboratories

For its commercial members, the Health Plan provides coverage with no member cost-share for COVID-19 diagnostic/viral testing as well as antibody testing that is determined to be medically appropriate for the diagnosis and treatment of an individual by an attending...

Entering Rental Requests in CareAdvance Provider® Tool

Audience: Durable Medical Equipment Providers

We remind you that when requesting authorization for a durable medical equipment (DME) rental in CareAdvance Provider, you must include Modifier RR with the HCPCS code. Important note: If the DME item is listed on the National DME Purchase Grid as a rental, the service...

COVID-19Telehealth Billing Information for NYS OMH Licensed & Designated Facilities

Audience: NYS OMH Licensed & Designated Facilities

The following information is meant to assist you in providing care and easier access to our members during the COVID-19 State of Emergency. We hope that this information helps to address telehealth questions unique to your facility. Telehealth visits are covered for all...

Memorial Day Pay Cycle Information

Audience: All providers

We are providing you with advance notice of a change to our pay cycle schedule due to the Memorial Day holiday. These schedule changes will not affect your payment amount. Paper checks will mail on Tuesday, May 26. Please allow for delivery time via the U.S. Postal...

COVID-19 Commercial & Medicare Update for CPT Codes 99441-99443; Expansion of E/M Codes Allowed for Safety Net Programs

Audience: Participating Physicians

Phone Only E/M Rate Update for CPT® Codes 99441-99443 for Commercial and Medicare The Centers for Medicare & Medicaid Services recently updated its reimbursement rates for telephone evaluation and management CPT codes 99441-99443 during the COVID-19 state of...

COVID-19 Supplement to NYS DFS Insurance Circular Letter #8 Related to Hospitals

Audience: Participating Hospitals

The following information is meant to assist you in providing outpatient services to our members during the COVID-19 state of emergency. We want to ensure that our members have access to needed health care from the safety of their homes. Telehealth visits are covered for...

Behavioral Health June Training Schedule

Audience: Primary Care and behavioral health providers

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

Reminder – CareAdvance Provider® Tool Expanding to Medicare Advantage Business on May 18, 2020

Audience: All Providers

We remind you that our new electronic preauthorization tool, CareAdvance Provider, will be used to request authorizations for our members with Medicare Advantage coverage as of May 18, 2020. Important note: The Clear CoverageTM tool will no longer be active for Medicare...

COVID-19 Preventive Health Visit Information for Physicians

Audience: Participating Physicians

The health and well-being of our members remain our highest priority.  We want to ensure that our members have access to preventive care during the COVID-19 state of emergency, and we also want to eliminate barriers to providing this care.  Because a key...

Dental Claim Fields 53 and 54 Reminder

Audience: Participating Dental Providers

Univera Healthcare would like to remind you that field 53 (dental provider signature) and field 54 (NPI) are required for a claim to process successfully. Please note that a claim submitted with “Signature on file” for field 53 will be returned as a billing error. ...

Showing 46– 60 of 117 Results