Lighthouse Health Plan October Provider Newsletter

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October 2019

New Expanded Benefits

Lighthouse Health Plan is excited to announce the addition of dozens of new expanded benefits. These new benefits are reflected in the updated member handbook and this handy guide to expanded benefits .

To make sure your patients are aware of these benefits, we would love to have our community engagement team set up a table at your office. If you are interested, please contact Amanda Bawn at [email protected]

Pharmacy Update

Effective Immediately, AHCA has released an updated list of preferred drugs

View or download September 2019 AHCA Preferred Drug List Changes

Medicaid Open Enrollment

The Agency recently announced there will be an Open Enrollment period for all Medicaid recipients. In Medicaid Regions 1 and 2, the dates are Dec 1 through Jan 31.

If your patients want to change to Lighthouse, they would go online or call into the Medicaid Choice Counselor. Information on how to join Lighthouse is here.

Questions About Your Claims?

From our clams processing department, if your claims are getting denied, the reason may be below:

"Duplicate Bill" is the number one denial code. Make sure that you are not billing multiple times. If your claim is a corrected claim, please mark it appropriately so you do not receive a "Duplicate Bill" denial.
We are receiving many claims for members no longer with Lighthouse Health Plan or who no longer have Medicaid coverage. Please double check the members' coverage before billing your claim.
Please make sure the billing and rendering provider are active on the PML for your date of service.
Claims are being denied for requiring the EOB. If your member has primary insurance, please ensure you are billing the primary appropriately and submitting the EOB or EOB information with your claim.
Make sure that you obtain an authorization if one is required.

Meet Population Health Manager, Erica Olson

We are pleased to introduce you to Population Health Manager Erica Olson, BA-HCM, LPN. Olson has been with Lighthouse Health Plan since 2018 and works with the clinical team.

She earned her Bachelor of Business Administration/Healthcare Management from American Intercontinental University, Schaumburg, Illinois and her nursing degree from Black Hawk College of Nursing, Moline, Illinois.

Olson has more than 26 years of nursing and clinical leadership experience and more 15 years’ experience working in a role surrounding quality and patient outcomes.

She is passionate about working with her providers and practices on quality/risk adjustment and building lasting partnerships with her Region 2 providers.

“Taking care of the needs and improving the lives of our members is always something that I have been very compassionate about”.

Olson can be reached at: [email protected]

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