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December 2014 Edition Articles


Changes to Medicare Advantage Addendum effective January 1, 2015 P, F, A
Compound medication policy update P
Highlighting HEDIS®: Follow-up care for children prescribed ADHD medication P
ICD-10: What’s Up Wednesday and external testing with providers will resume in 2015 P, F, A
Important information on prescribed narcotic therapy P
Mandatory specialty medication program will begin January 1, 2015 P
Medical and claim payment policy activity posted October 25 – November 20, 2014 P, F, A
Nasonex® to be removed from Select Drug Program® Formulary P
NaviNet® changes scheduled for December 2014 and early 2015 P, F, A
Our Quality Management Program promotes quality of care and service P, F, A
Prescription drug updates P, F, A
Presumptive and definitive drug testing P, F, A
Professional Injectable and Vaccine Fee Schedule updates effective
January 1, 2015 P, F, A
Referring members for laboratory services P
Reminder: Check member eligibility at every visit P, F, A
Reminder: New Preventive Plus benefit effective January 1, 2015 P, F, A
Reminder: Precertification requirement for non-emergent outpatient radiation therapy starts January 1, 2015 P, F
Reminder: Precertification requirements for DME providers go into effect January 1, 2015 A
Reminder: Upcoming changes to our precertification process for outpatient echocardiography services for Medicare Advantage HMO and PPO members P, F
Reminder: Upcoming changes to precertification requirements for medical benefit drugs P
Select Drug Program® Formulary updates P, F, A
Standards for medical record documentation P
Stay informed during our transition to a new platform P, F, A
Transitioning outstanding Accounts Receivable balances to new platform P, F
Upcoming policy on transcutaneous electrical nerve stimulators and associated supplies P, F, A
2014-2015 Clinical Practice Guideline Summary now available P
2014-2015 Member Wellness Guidelines now available P




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