August 6, 2010 News Flash
- 2010 Medicare Physician Fee Schedule
April 2010 Hot Topics
- Tobacco cessation programs
- Pharmacy and therapeutics updates
- CPAP/AutoPAP/BiPAP/Oral Appliances for Obstructive Sleep Apnea (OSA) policy
- Gundersen Lutheran Health Plan utilization management criteria
- Notification of changes to billing patterns
- Spinal orthoses: TLSO and LSO
- Hand-finger orthoses (L3923)-Use of CG modifier
- CMS documentation signature requirements for medical records
January/February 2010 Hot Topics
- CMS revisions to consultation services payment policy JA6740
- Complaint resolution by providers (Policy 11.218)
- Access to speciality care and outreach referrals - HMO products (Policy 11.200)
November/December 2009 Hot Topics
- Risk adjustment audit
- 2010 Senior Preferred changes
- Notice of Denial of Medical Coverage for Hospital Observation Level of Care
- Policy updates
- GLHP Criteria for DME
September/October 2009 Hot Topics
- Risk Adjustment Audit
- Claim submission for H1N1 vaccine and administration
- Surgical treatment of Obstructive Sleep Apnea
- Part D drugs in an outpatient setting
- Communication among network providers
July/August 2009 Hot Topics
- Member Rights
- Surgical treatment of Hyperhidrosis
- Gundersen Lutheran Health Plan policies & criteria for DME items/service
- 2009 Criteria-Most requested DME reference sheet
August 24, 2009 News Flash
- Senior Preferred Part B therapies exceeding 30 visits
- Prior authorization procedure for Senior Preferred Part B therapies exceeding 30 visits
May/June 2009 Hot Topics
- Gundersen Lutheran Health Plan unveils new Web site
- Referral authorization and prior authorization forms
April 2009 Hot Topics
- Ineligible services
- Discrimination against members prohibited
March 2009 Hot Topics
- CMS documentation signature requirements for medical records
- Elastic garments
- Annual facility operations forms
February 2009 Hot Topics
- Complaint resolution by providers
- Access to specialty care and outreach referrals
February 17, 2009 News Flash
- Vagus nerve stimulation (VNS) device
January 2009 Hot Topics
- Marketing
- New provider to the network
December 2008 Hot Topics
- Durable medical equipment (DME)
- Pre-certification and prior authorization
- Diabetic supply changes - effective January 1, 2009
November 2008 Hot Topics
- NCQA accreditation
- Notification of complaints or concerns
- Reporting to state and federal authorities
October 2008 Hot Topics
- Elimination of 2009 flu shot drawing
- 2009 annual notice of change (ANOC)
- Specialty providers
October 23, 2008 News Flash
- Senior Preferred 2009 vision benefit enhancements
September 2008 Hot Topics
- Provider Directory
- Practitioner credentialing and notification of practitioner/provider changes
August 2008 Hot Topics
- BadgerCare Plus effective 9/1/08
- Cass Street Pharmacy
- NCQA accreditation
July 2008 Hot Topics
- 2008 Medicare physician fee schedule update
- Services no longer requiring prior authorization
- Senior Preferred Part D-Formulary updates
July 3, 2008 News Flash
- 2008 Medicare Physician Fee Schedule: July Update Status
July 21, 2008 News Flash
- Notification requirements for skilled nursing and swing bed facilities
June 2008 Hot Topics
- Mailing address
- BadgerCare Plus approval
- Services no longer requiring prior authorization
May 2008 Hot Topics
- Mailing address
- Gundersen Lutheran Health Plan medicaid addendums
- Services no longer fequiring prior authorization (PA)
- Health plans taking steps to make out-of-pocket cost information more transparent
- Notice of Medicare Non-Coverage (NOMNC)
April 2008 Hot Topics
- Provider network management contacts
- Combined prior authorization grid for Commercial and Senior Preferred
- Member rights and responsibilities