McKesson ClaimCheck® software update. We currently use McKesson ClaimCheck® code auditing software to ensure correct coding and payment for our providers. By the end of 2013, this software will be updated resulting in enhanced scrutiny for submitted claims. To help our providers with this transition, we are giving them access to McKesson’s Clear Claim Connection™, a tool that will allow providers to verify correct coding prior to submitting a claim. More information on this change can be found in our Provider Notice or in the Clear Claim Connection™ Overview. For questions, please call Provider Relations at 888-895-4998.
USFHP Referral Process Streamlined. Effective December 1, 2013, we will streamline the process for the Johns Hopkins US Family Health Plan (USFHP) specialty office visits. Starting December 1, 2013, USFHP specialists will no longer need to submit a paper referral form with your claim. Again, this change only affects office visit referrals. Pre-authorization requirements remain unchanged. Primary care providers will continue to provide referrals or script detailing the specialist services needed to the USFHP plan members and specialist (no paperwork needs to be submitted to the health plan). Please continue to include the referring provider’s NPI number on the referrals. To see the notice that was mailed November 1, click here.
Watch the HEDIS® Coding Seminar. If you couldn't make our recent HEDIS® coding seminar, or just want a refresher on the content, you can access a video of the seminar here.
You could be saving your patients money on their meds. We have information to help you do so. Click here to learn more about cost-effective prescribing.
Want to Learn More?
Call the Provider Relations Department at 888-895-4998 or 410-762-5385 Monday through Friday, from 8:00 a.m. to 5:00 p.m. Review our Department Network Grid.