Medicare Advantage - Provider News

Medicare Advantage Plan Changes for 2024 | 11/6/2023

We’ve made a few changes we’d like to share

Symphony Prior Authorization Tool Upgrade | 11/6/2023

New improvements to your prior authorization entry experience

MA code and policy updates for November 2023 | 11/6/2023

The Medicare Advantage policies and code list have been updated

Medicare Advantage Code and Policy updates for September 2023 | 9/7/2023

The Medicare Advantage policies and code list have been updated

Medicare Advantage Transitions to Symphony | 9/7/2023

Use Symphony to enter your prior authorization and referral requests

Medicare Advantage Referral and Prior Authorization Tool Changes September 1 | 8/3/2023

Symphony will streamline your workflows by improving online prior authorization and referral submissions

Code and Policy Updates | 8/3/2023

The Medicare Advantage policies and code list have been updated

Code and Policy Updates for Medicare Advantage | 7/6/2023

The Medicare Advantage policies and code list have been updated

Medicare Advantage HCC Model Change in 2024 | 6/1/2023

Changes to Hierarchical condition category (HCC) model V28 can impact your documentation and coding practices

Updates for MA Policies and Codes | 6/1/2023

The Medicare Advantage policies and code list have been updated

New Medicare Advantage Prior Authorization and Referral Tool | 6/1/2023

Symphony to launch September 1, 2023

Reduction Pharmacy Rebate Program | 5/4/2023

Reduces coinsurance for certain part B medical drugs

Discontinuation of Local Rules | 5/4/2023

We no longer use local rules criteria for Medicare Advantage inpatient authorizations

Policy and Code Updates for Medicare Advantage | 4/6/2023

The Medicare Advantage policies and code list have been updated

Encourage Medicare Advantage Patients to Get Screened for Colorectal Cancer | 3/2/2023

Tips for what information to include in medical records, codes for patient claims, and tips for talking with patients

Understanding Star Ratings - How are CMS star ratings determined? | 3/2/2023

Understanding Star Ratings - How are CMS star ratings determined?

Updates for Medicare Advantage Policies and Codes | 3/2/2023

The Medicare Advantage policies and code list have been updated

Medicare Advantage Members’ Annual Wellness Exams | 2/2/2023

These visits play an important role in helping your patients maintain or improve their health through disease prevention and detection

Gain Insights from CAHPS Research on Improving the Patient Experience | 2/2/2023

Learn how annual CMS research improves the patient experience and health outcomes

Understanding Star Ratings - What is the Medicare star ratings program? | 2/2/2023

An introduction to the Centers for Medicare & Medicaid Services star ratings program

Medicare Advantage Policy Updates | 2/2/2023

Check out the latest Medicare Advantage policy and code list updates

Medicare Advantage Dental Resources and Reminders | 2/2/2023

Get the latest tips to make caring for your Medicare Advantage patients easier

Kroger Pharmacies are In-network for our Medicare Advantage Plans | 2/2/2023

All in-network pharmacies for our MA plans on the Medicare Advantage Pharmacy resource page

Updates for Medicare Advantage Policies and Code List | 1/5/2023

Learn about updates for Medicare Advantage policies and code lists

Pharmacy Changes for 2023 Medicare Prescription Drug Plans | 1/5/2023

The Inflation Reduction Act impacts pharmacy benefits for 2023 plans

Two Medicare-Related Surveys Being Conducted | 12/1/2022

Surveys from Administration for Community Living (ACL) and Centers for Medicare & Medicaid Services (CMS) are underway - they are not phone scams

Updates for Medicare Advantage Policies | 12/1/2022

Learn about updates for Medicare Advantage (MA) policies and code list

High Demand for Novo Nordisk’s Ozempic and Wegovy Creates Shortage | 12/1/2022

Wegovy shortage could lead to greater off-label use of Ozempic for weight loss

Statin Guideline Update from United States Preventive Services Task Force | 11/3/2022

Statin use for prevention of cardiovascular disease in adults

Medicare Advantage Prior Authorizations | 10/6/2022

Learn who to contact for help and how to escalate MA prior authorizations

New Medicare Advantage Prior Authorization and Referral Tool | 9/1/2022

New Symphony tool is coming soon

Updates to MA Medical Policies | 9/1/2022

Learn about newest updates for Medicare Advantage polices

New Medical Policies for Medicare Advantage | 8/4/2022

Learn about the newest updates for Medicare Advantage (MA) policies

New Prior Authorization and Referral Tool for Medicare Advantage Plans | 7/7/2022

Find out more about Premera’s move to Symphony

Medicare Advantage Medical Policy Updates | 7/7/2022

Learn about the newest updates for Medicare Advantage (MA) policies

Updates for Medicare Advantage Medical Policies | 6/2/2022

Learn about the newest updates for Medicare Advantage (MA) polices

Medicare Advantage - Medical Policies | 5/5/2022

Learn about newest updates for Medicare Advantage polices

Medicare Advantage Medical Policies April Update | 4/1/2022

Learn about the newest updates for Medicare Advantage polices

Enter Your Medicare Advantage Referral Requests with Our Online Tool | 2/24/2022

Don’t forget your referral start and end date need to match

Medicare Advantage Medical Policies Update | 2/24/2022

Learn about newest updates for Medicare Advantage (MA) policies

NYC Medicare Advantage Plus Plan Update | 2/24/2022

If you are contracted with Premera’s Medicare Advantage network, you are already an in-network provider participating in this plan

Understanding Star Ratings | 2/3/2022

Find out more about the Centers for Medicare & Medicaid Services star ratings program

Medicare Advantage Medical Policies | 1/6/2022

Learn about newest updates for MA policies.

Premera Medicare Advantage 2022 Plan Resources | 12/16/2021

Learn where to find Medicare Advantage online tools, forms, policies, and the prior authorization list.

Dental Benefit Changes for Medicare Advantage 2022 Plans | 12/16/2021

Dental Benefit Changes for Medicare Advantage 2022 Plans

New Medical Policies - Medicare Advantage | 12/2/2021

Learn about newest updates for MA polices

COVID-19 Vaccine Billing Changes for 2022 Medicare Advantage Plans | 12/2/2021

The Centers for Medicare & Medicaid Services released new information regarding billing for COVID-19 vaccines

Benefit changes for 2022 Premera Medicare Advantage Plans | 10/7/2021

Enhanced pharmacy, dental, acupuncture, naturopathic, and chiropractic services

Remind Patients to Get a Mammogram | 9/16/2021

Eligible Medicare Advantage members can get a mammogram every two years

Updated Medicare Advantage Medical Policies | 8/19/2021

Learn about the newest updates for Medicare Advantage policies

Cognitive Assessment for Medicare Advantage Members | 8/5/2021

Visits for a cognitive assessment are important for our Medicare Advantage members

HEDIS Measure: Osteoporosis Management for Women | 7/1/2021

Help patients manage osteoporosis to reduce fracture risk

Health Plans Now Required to Provide Access to Patient Clinical Records | 7/1/2021

New requirements give members timely access to their health data to better manage their own care

Health Outcomes Survey Begins in August | 7/1/2021

Discuss fall risk, urinary incontinence, and physical activity with your Medicare patients

New Medical Policies | 7/1/2021

Learn about newest updates for MA polices

Reduce the Risk of Diabetes and Atherosclerotic Cardiovascular Disease Complications | 6/3/2021

Consider prescribing statins for your patients diagnosed with atherosclerotic cardiovascular disease and diabetes

New Medicare Advantage Appeal Form | 6/3/2021

A new form available for submitting your appeals and reconsiderations

New Medical Policies for Medicare Advantage | 6/3/2021

Learn about the newest updates for Medicare Advantage polices

Medicare Advantage Medical Policies | 5/6/2021

Medicare Advantage medical policy and PA code list updates are now available

Expedited Prior Authorization Requests | 4/1/2021

These requests should only be used when waiting for a standard review might jeopardize health of the patient.

Medical Records Requests for Annual HEDIS® Review | 2/4/2021

CIOX Health will contact provider offices for records starting in February.

Updates for Medicare Advantage Medical Policies | 1/21/2021

View MA medical policy updates and updated prior authorization code list.

The COVID-19 Vaccine Is Here | 1/7/2021

Make sure you’re enrolled with CMS so that the vaccine can be swiftly distributed.

New Medicare Advantage Medical Policies | 1/7/2021

Learn about the latest MA policy updates.

Plan Now for 2021 Preventive Visits | 12/3/2020

Premera is incentivizing Medicare Advantage patients to schedule visits in 2021.

New Medicare Advantage Medical Policies | 12/3/2020

Learn about newest updates for MA policies.

Pharmacy Benefits for 2021 Medicare Advantage Plans | 11/19/2020

Make sure your patients know about these benefits.

Medicare Advantage Medical Policy Updates | 11/19/2020

Learn about newest updates for Medicare Advantage policies.

Virtual Care Documentation Best Practice | 11/5/2020

Are you documenting all the elements of a telehealth visit?

Use Overpayment Form When Returning Checks to Premera | 10/29/2020

If you need to send us a check, please include a completed Medicare Advantage request form.

Updates for Medicare Advantage Policies | 10/15/2020

Medical policy updates and an updated prior authorization code list are available.

Premera Is Growing Our Medicare Advantage Options | 10/15/2020

We’re offering plans in two new counties.

Annual Wellness Visits Are an Opportunity for Telehealth Visits | 10/1/2020

Don’t let COVID-19 keep Medicare Advantage patients from having annual wellness visits.

HEDIS 2020 Medicare Advantage Star Measure Changes | 9/17/2020

The National Committee for Quality Assurance (NCQA) released proposed HEDIS® specification changes for the 2020 measurement year.

Breast Cancer Screening | 9/17/2020

Remind your eligible Medicare Advantage members to get mammograms every two years.

Member Open Gap Care Phone Outreach | 9/3/2020

We’re reaching out to help close care gaps.

New Medical Policy and Prior Authorization Code Updates | 8/20/2020

Learn about the new updates for Medicare Advantage.

Member Wellness Check Calls | 8/6/2020

Premera is contacting Medicare Advantage members about telehealth and other available resources.

Premera Offering Members In-Home Test Kits | 8/6/2020

Members may receive FOBT, HbA1c, and/or microalbumin urine test kits based on their individual open care gaps.

New Medicare Advantage Medical Policy Update | 7/16/2020

Check out the latest Medicare Advantage policies and prior auth list.

HEDIS Measure: Medication Reconciliation Post-Discharge | 7/2/2020

Get 3 helpful hints for patient medication reconciliation.