Informed

FLASH: Health Alliance Flash: Medicare Advantage Members Get Easier Access to Diabetes Monitors

March 15, 2019

As of January 1, 2019, our Medicare Advantage members no longer need preauthorization to get FreeStyle Libre glucose monitors. They can now get these monitors at in-network pharmacies that sell this product, along with the current durable medical equipment (DME) companies. The member’s out-of-pocket cost is the DME cost-sharing amount.

Please let your patients know of this change that gives them easier access to this important medical equipment.

If you have any questions, please don’t hesitate to contact your provider relations specialist.

 

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FLASH: Health Alliance Flash: Colorectal Cancer Awareness Month

March 4, 2019

March is Colorectal Cancer Awareness Month, so it’s a good time to check that your patients are up to date on screenings. The U.S. Preventive Services Task Force recommends regular screenings for people ages 50–75 years old.

Colorectal Stats

  • 1 in 22 men and 1 in 24 women will be diagnosed with colorectal cancer in their lifetime.
  • 60% of colorectal cancer deaths could be prevented with screening. 
  • 1 in 3 people are not up to date with colorectal cancer screenings.

Sources: Cancer.org and FightColorectalCancer.org

There are several screening options with different timelines.

  • Cologuard (every 3 years)—can be done at home, with no special prep or changes made to diet (New with HEDIS 2017)
  • Colonoscopy (every 10 years)—visual exam of the colon with a small scope
  • Fecal occult blood testing (once a year)—can be done at home. Exam of a stool sample, looking for traces of blood
  • Sigmoidoscopy (every five years)—visual exam of the lower one-third of the colon

Please talk to your patients about the importance of colorectal screenings and which method is best for their situation.

 

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FLASH: Provider Directory Updates through LexisNexis

February 26, 2019

As you know, it is vital your patients have access to accurate, up-to-date information in the provider directory. To ensure this accuracy, the Illinois Department of Human Services, the Illinois Department of Insurance, and the Centers for Medicare & Medicaid Services all require that providers review and update their information quarterly or whenever there is a significant change.

To help you meet this requirement, we have partnered with the search firm LexisNexis Risk Solutions and American Medical Association Business Solutions. They will be reaching out on a quarterly basis by one or more of their three communication channels (phone, fax, and Verify Health Care Portal) to verify that your provider information is accurate.

As a reminder, here is the directory information that must be reviewed and updated:

  • Ability to accept new patients
  • Street address
  • Phone number
  • Office hours
  • Hospital privileges
  • Any other information that affects availability to the patient


Members must be able to call the phone number listed in our provider directory and make an appointment with that specific provider at that location.

If you have any questions or have trouble with your updates, please contact your provider relations specialist or call our Provider Services team at 1-800-851-3379, option 3.

Thank you for your cooperation in this important initiative.

 

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