Maine
Provider Communications

October 2022 Provider Newsletter – Maine

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Notices of material changes/amendments to contract - October 2022

Notices of material changes/amendments to contract may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements. In this issue, please reference the following articles:
  • Precertification list changes effective January 1, 2023
  • Clinical Criteria updates for specialty pharmacy
  • Specialty pharmacy updates - October 2022
  • Reimbursement policy update: Multiple and Bilateral Surgery Processing – Professional
Administrative

Monkeypox and smallpox vaccines: Product code on claims

Administrative

Precertification list changes effective January 1, 2023

Notice of material change/amendment to contract
Administrative

National Accounts 2023 Pre-certification list

Administrative

CAA: Review your online provider directory information

Administrative

Prior authorization required for hip and knee services for State of Maine Health Plan members effective July 1, 2022

Administrative

Provider Learning Hub is here

Digital Tools

IngenioRx will become CarelonRx on January 1, 2023

Pharmacy

Clinical Criteria updates for specialty pharmacy

Notice of material change/amendment to contract
Pharmacy

Specialty pharmacy updates - October 2022

Notice of material change/amendment to contract
Pharmacy

Pharmacy information available on provider website

Pharmacy

Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility

Reimbursement Policies

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Notice of material change/amendment to contract
Reimbursement Policies

Availity Essentials provider chat - a fast, easy way to get your UM questions answered for Federal Employee members

Federal Employee Plan (FEP)

Monkeypox and smallpox vaccines: Product code on claims

Medicare

Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQ

Medicare

Reimbursement Policy Retraction: Sexually Transmitted Infections Testing - Professional

Medicare

Courtesy notification of specialty pharmacy medical step therapy updates

Medicare

Keep up with Medicare news

  • Medicare Part B Precert Expansion Alymsys
  • Medicare Part B Precert Expansion Amvuttra Xipere
  • Consultation Codes
Medicare
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