September 2012 - Greater Baltimore Medical Center
September 2012 - Volume 51 An important message from UnitedHealthcare to health care professionals and facilities Inaugural National Medicare Education Week – September 15 - 22, 2012 National Medicare Education Week, which runs Sept. 15 – Sept. 22, is dedicated to helping baby boomers, Medicare beneficiaries, their families and caregivers learn more about our nation’s largest health insurance program, serving 49 million Americans.* Taking the time to learn about Medicare during National Medicare Education Week will help your patients better prepare to make informed, confident health care decisions during the Medicare Open Enrollment Period which runs Oct. 15 - Dec. 7, 2012. A variety of informational resources are available including: • NMEW.com. • MedicareMadeClear.com. • Medicare Made Clear Facebook page. • National Medicare Education Week app or tab, on the Medicare Made Clear Facebook page. • Call 877-630-8721 to request a UnitedHealthcare Medicare Made Clear guide. • Visit Medicare.gov or call 800-MEDICARE (TTY users 877-486-2048), available 24 hours a day, seven days a week, for more information. • Visit your local State Health Insurance Assistance Program (SHIP) office for assistance in understanding and choosing a health plan. * Source: Centers for Medicare & Medicaid Service Coming in the November 1, 2012 Issue • Clinical Criteria Used by UnitedHealthcare • Evaluation of New Medical Treatment for Possible Coverage in Benefit Plans. • Global Days Policy Reminder • OrthoNet High Cost Surgical Claims Review Program Note: Pharmaceutical benefit management information is included in every issue. Prompt Responses to Medicare Part D Prescription Appeals Inquiries Ensure Continuity of Care When you or your patient files an appeal with UnitedHealthcare, we will contact your office to request certain key information needed as part of the appeal process. By federal law, UnitedHealthcare must render an appeal decision within 72 hours for an expedited request and seven calendar days for a standard request. Your assistance in responding to these requests promptly helps ensure continuity of the member’s treatment plan. For more information call 877.842.3210 or visit UnitedHealthcareOnline.com UnitedHealthcare respects the expertise of the physicians, health care professionals and their staff who participate in our network. Our goal is to support you and your patients in making the most informed decisions regarding the choice of quality and cost-effective care, and to support practice staff with a simple and predictable administrative experience. The Network Bulletin was developed to share important updates regarding UnitedHealthcare procedure and policy changes, as well as other useful administrative and clinical information.* *Where information in this bulletin conflicts with applicable state and/or federal law, UnitedHealthcare follows such applicable federal and/or state law.