June 3, 2013
Reminders about Wellness Coverage
Chlamydia screening is covered for all members without cost-sharing.
Cholesterol and lipid screening (80061, 82465, 83718 and 83721) is covered without cost-sharing for:
Men 35 years and older - Once every 5 years
Men 20-35 years- Once every 5 years with diagnosis code V17.3–V17.4X, V81.0-V81.2
Women 45 years and older - Once every 5 years
Women 20-45 years Once every 5 years with diagnosis code V17.3–V17.4X, V81.0-V81.2
Services performed outside these parameters, as well as other coded services, are covered according to the limits of the member’s medical benefits.
The wellness brochure, which lists services and procedure codes covered under the wellness benefit, is posted on the Forms and Resources page of Your Health Alliance. You can also contact your provider relations specialist for a copy.
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April 25, 2013
Effective May 1, 2013, we will partner with naviHealth (formerly SeniorMetrix) for post-acute care services for our Medicare Advantage ONLY. We're excited at the new opportunities this partnership will bring to our members. naviHealth offers a comprehensive suite of functional assessment and clinical decision-support solutions to support evidence-based care.
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April 25, 2013
New Partnership with CVS Caremark Specialty Pharmacy
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April 1, 2013
Meet With a Coding Specialist
The Medicare Advantage Coding Consultant has been making rounds to high-volume participating provider offices sharing member-specific examples of coding and Medicare quality measure needs. She is willing to meet with you to discuss any coding or quality questions you may have, or to provide member-specific examples from your panel of members. If interested, contact Dawn Peterson, CPC 217-722-0869 or via e-mail [email protected].
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