Happy New Year! We’re gearing up for another great year of partnership with each of you, and we appreciate your hard work and dedication to your patients and our members. As always, your provider relations specialist will be there for you throughout 2014 if you have any questions or concerns. They act as a liaison between us to help with open communication.
Effective 11/29/13, the “G” (inappropriate billing/coding) adjustment reason remits to OA16 (Claim/service lacks information or has submission/billing error). In the past, when a code was denied for “G” (inappropriate coding) you would see OA125 on the remittance. OA125 (billing/submission error) was deactivated. We are working to fix this, and it should be updated by 1/1/2014.
We’ve posted a guide for using our online preauthorization forms (for Medical and Durable Medical Supplies) on Your Health Alliance for providers and office personnel. Log in and choose the Forms and Resources page and look under Resources for a PDF of the online preauthorization instructions.
Help Your Patients Find the Info They Need Your patients might ask you where to call for information about the health insurance exchanges or to learn more about their coverage. Below is some Illinois contact information to help you direct them to the correct source. Members can also call the number on the back of their ID card if they have questions about their coverage. Our reps are happy to help.
Health Alliance Named Top Plan in Illinois and Iowa The National Committee for Quality Assurance (NCQA) Private Health Insurance Plan Rankings 2013-2014 and NCQA’s Medicare Health Insurance Plan Rankings 2013-2014 recognize Health Alliance Medical Plans as among the top in the nation and the highest in Illinois and Iowa for Private and Medicare plans.