Tag: #unitedhealthcare

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Posted in Uncategorized

Announcement: Pharmacy Benefit Coverage Update – Effective May 1, 2020 & July 1, 2020 – UnitedHealthcare Commercial Plans

Posted on by KR2Medical Billing

The original pharmacy formulary for UHC Commercial Pharmacy Benefits Plans was scheduled to take place on May 1,2020.

However, due to the current circumstances UHC revised their Pharmacy Benefits update and pushed it to become effective on July 1,2020.

According to UHC statement the change was done: “…to allow additional time for you and your patient to discuss alternative therapies when appropriate…”

This change applies to the following medications:

1. Diabetes-Insulin: Basaglar KwikPen, Levemir, Levemir FlexTouch and Tr

a. Lantus, Lantus SoloSTAR, Toujeo Max SoloSTAR and Toujeo SoloSTAR are currently excluded but will be added to the coverage on July 1,2020

2. Diabetes- Non-Insulin: Janumet, Janumet XR and Januvia

3. Neuromuscular Disorders: Firdapse

Step Therapy for Zomig will be required effective July 1,2020

Asthma- Arnuity Ellipta, Flovent Disus, Flovent HFA and Pulmicort Flexhaler will be covered at this time until further notice. However, these medications are still on tier 3 for UHC commercial Plans pharmacy benefit plans.

Since there are multiple prescription drug lists exist, please feel free to refer to patient-specific information received through e-prescribing or UHC PreCheck MyScript tool on Link.

Posted in In The Know Series, Insurance, Training

The Empire Plan (NYSHIP)- Office Visit co-pay changes for 2020

Posted on by KR2Medical Billing

This past year there were a number of employee groups that are under The Empire Plan NYSHIP and had some changes in their benefits, including office visit co-pays.

With the new year (2020) around the corner The Empire Plan NYSHIP has released a list of more employee groups that will be affected by the office visit co-pay changes.

Please refer to the following list:

1. The office visit $20 co-pay will still apply to the following employee groups:
– APSU
-Council 82
-PEF

2. Student Employee Health Plan will still continue to have a $10 Office Visit co-pay

3. Effective 01/01/2020 the following employee groups will have a $25 office visit co-pay:
– PIA( NYS Police Investigative Unit)
-Unified Court System-COBANC

4. Effective 01/01/2020- Excelsior Plan members will have the office visit co-pay of $35.

Posted in Insurance, My services, Training, Updates

Anthem BCBS acquires Beacon Health Options

Posted on by KR2Medical Billing

As of March 01/2020- Anthem BCBS finalized its acquisition of an independent behavioral health organization, Beacon Health Options.

Beacon Health Options serves over 36 million people across the country.

Things to consider:

  1. Members- can still use the phone number on the back of the cards and their health plan’s website to access self-services.
  2. Providers- continue using the provider service contact information on the back of the member’s card or online self-service portals or websites

According to the announcement the Beacon Health and Anthem provider networks, contracts and fees will remain separate at this time.

For full announcement please visit: https://providernews.empireblue.com/article/anthem-acquires-beacon-health-options

As well Anthem announcement to the investors: https://ir.antheminc.com/news-releases/news-release-details/anthem-inc-completes-acquisition-beacon-health-options?field_nir_news_date_value%5bmin%5d=