Managed Care Minute

June 2022 Volume 30

Bright Health Group Continues to Drive Focus on Consumer Retail Markets with Fully Aligned Model

For the 2023 Plan Year, Bright HealthCare will no longer offer Individual and Family Plan products in Illinois, New Mexico, Oklahoma, South Carolina, Utah, and Virginia. Bright Health Group, Inc.

Changes coming to Florida Medicaid

The current Medicaid managed care contracts expire on December 31, 2024. Only those health plans that win the competitive bid will be able to service the regions. Stay tuned as Managed Care Consultants will pay close attention to who will procure contracts in the renewal process.

Electronic payments

Effective June 1, 2022, UnitedHealthcare is no longer sending paper checks for claim payments.

Kepro BFCC-QIO Appeals

Did you know whether Medicare is paying as primary or secondary your member is still entitled to an appeal according to CMS?

Stayed tuned for MCCFL hosted webinars

June

Common Billing Errors hosted by: Nita Bolton
SCA's vs. LOA's hosted by: Rhonda Robinson

July

Triple Check hosted by: Mary Hirsch

Things changing in 2022

Devoted will restart to withhold a 2% sequestration for dates of service of July 1, 2022
Simply Medicaid Clear Health Alliance moving to Availity for expedited. Provider Bulletin
Cigna HealthSprings is moving to Evicore for post-acute authorizations.
Click here to register click on "upcoming"

MCCFL will be at a few conferences this year - Come say hi!

HomeCare Con 7/19 - 7/22
FHCA 8/1 - 8/4
Texas Healthcare Association 9/12 - 9/14