Updates

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Using CPT code 99499 enables providers to submit all documented encounter diagnosis codes.
Low resolution screenshot of the Prohibition on Billing Qualified Medicare Beneficiaries document
All Medicare providers and suppliers, including pharmacies, must not bill Medicare beneficiaries in the Qualified Medicare Beneficiary (QMB) eligibility group for Medicare Part A or Part B cost-sharing. This includes Medicare Part A and Part B deductibles, coinsurance, and copayments.
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Welcome to the cultural competency in health care annual compliance training.
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The Centers for Medicare & Medicaid Services (CMS) mandates all contracted providers receive basic Special Needs Plans (SNP) Model of Care training.
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Between February and May, you may receive requests from us for patient medical records on behalf of our health plan partners. Health plans review these medical records for specific information to determine if the record satisfies the Eye Exam for Patients with Diabetes (EED) measure criteria for HEDIS® submission.
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ECPs who want to participate in our Medicaid networks and submit claims for providing services to Medicaid members must enroll both themselves and their offices in their state’s Medicaid Program.

View the Provider Manuals on the Portal
Provider manuals can be found in the portal under Resources – Reference Tools.

Check Out the Quarter 4 2024 Provider Newsletter

With the latest newsletter, you can learn about the the improvements that we make to the portal in addition to various policy updates.

New Provider Policy Updates

To see the latest updates, visit our newsletters page and click on “October 2021 Provider Policy Updates.”

Provider Satisfaction Survey

Thank you in advance for taking the time to share your very important input with us. We value your participation and feedback to improve our provider relations.

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