New Molina Prior Authorization Matrix!

Please find attached the current Prior Authorization Matrix for Molina to be utilized for Affinia Health Network. The Prior Authorization Matrix only applies to AHN members if you participate in Affinia’s Molina contract. If offices participate with Molina through a direct … Continued

Mercy Health Physician Partners Innovative Primary Care

A team-based approach designed to transform the primary care experience Current health care trends reveal an increasing number of primary care physicians and teams experiencing burnout, making it harder for patients to access quality health care. Rising health care costs, … Continued

Medication Therapy Management (MTM)

Do you take prescription medications and have Priority Health Insurance? You may qualify to meet with a pharmacist for a Medication Therapy Management appointment! What is Medication Therapy Management (MTM)? MTM is a term describing medical care provided by a … Continued

New Prior Authorization Requirements through eviCore

Molina Healthcare of Michigan (Molina) has contracted with eviCore healthcare (eviCore), an independent specialty medical benefits management company, to provide outpatient utilization management services. The new program is designed to streamline the authorization process through on-line and/or phone requests. eviCore … Continued

Meridian Health Monthly Provider Update

Dear Providers, Based on your feedback, Meridian is making improvements to help make your job easier. We understand communication is key, so we’re implementing a monthly notification process to share updates around quality, operations and more. Additional information will be … Continued

Meridian Medical Policy Review

Effective August 1, 2019, Meridian is implementing updates to Meridian Medical Policy B. 05 Readmission Review. This policy outlines Meridian’s processes of reviewing, adjudicating, and adjusting claims payments for inpatient admissions that are deemed to be potentially preventable readmissions.

Major Depressive Disorder

The Diagnostic and Statistical Manual of Mental Disorders (fifth edition) defines major depression as an individual experiencing five or more symptoms during the same two-week period, with at least one of the symptoms being either depressed mood or loss of … Continued