Specific fax numbers for Pharmacy Prior Authorizations and Medicare Part D

We have a designated fax line for incoming Pharmacy Prior Authorizations. We also have a specific Medicare Part D fax line for enhanced receipt and tracking. Please use these numbers to help efficiently process authorizations.

This information is available in the Contact Us section.

3/8/2010

Walgreens free blood glucose testing event

The clinic is available to anyone age 18 or older. All 24-hour Walgreen stores will hold the event on February 5. Anyone not living near a 24-hour Walgreens may call 1 (800) 925-4733 or visit Walgreens for a variety of locations nearest to them. Read more details about the event (PDF).

2/3/2010

Tracer claims no longer accepted

As a reminder, we are no longer accepting tracer claims. These are claims that are resubmitted due to nonpayment. They are also known as rebills, second submissions or duplicate billings.

Please use Asuris Online Services for Providers for basic claim status (if the claim has been received, is in process or has been completed). This process also applies to tracer claims.

If you are unable to find the information you’re looking for online, please contact Customer Service.

1/5/2010

Consultation codes no longer reimbursed by Centers for Medicare & Medicaid Services (CMS)

CMS no longer reimburses for most consultation codes. Effective January 1, the only consultation codes still eligible for reimbursement are follow-up inpatient telehealth consultation, HCPCS G0406 - G0408. The savings realized by CMS due to this determination will be redistributed among existing evaluation and management (E&M) services. CMS also adjusted its reimbursement for the surgical global period to reflect the higher value of office visits during the global period.

Asuris adheres to CMS determinations; therefore, we have made the same adjustments to our reimbursement methodology for Asuris TruAdvantage and other Medicare members. We will continue to pay a percentage of CMS allowances as currently established. No other Asuris lines of business are affected by this change.

12/29/2009

Is your listing in our Provider Directory correct?

Please help us maintain the accuracy of our Provider Directories by using the Provider Information Update Form or contacting provider services when you have any of the following changes to your practice:

• A physician or other health care professional joins your clinic
• A provider leaves your clinic
• Your clinic/practice is no longer in business
• Change of address, phone number, tax ID or NPI number

11/11/2009

Coordination of Benefits (COB) is changing

Effective with dates of services on or after September 1, Asuris has changed the way COB claims are processed. We are making the change to comply with a new rule issued by the Office of the Insurance Commissioner (OIC). We will no longer estimate secondary plan payments if the primary Plan’s payment amount is unknown. This new rule applies to all employer groups and Individual plans. However, Employee Retirement Income Security Act (ERISA) self-funded groups and Medicare plans are exempt.

For more information, visit the Office of the Insurance Commissioner Web site or contact your provider consultant.

09/02/2009

Asuris Online Services for Providers Outage Notification

There will be a system upgrade this weekend which will result in limited access to some information. This will only impact patients on our medical products - Asuris Embark^®, Vantage^®, Motivate^SM and HSA Healthplan 2.0^SM; and our dental products - Aspire^SM, Enhance^SM and Achieve^SM.

The outage is scheduled to begin at 4 p.m. PDT, on Friday, September 4 and continue through Monday, September 7 ending at 9:00a.m PDT. We apologize in advance for any inconvenience this may cause you.

09/01/2009

Medicare alert to update account information in 48 hours is a scam

The Centers for Medicare & Medicaid Services (CMS) has notified us of a scam where perpetrators are sending faxes to physician offices posing as Medicare carriers or Medicare Administrative Contractors (MAC). The fax instructs staff to respond to a questionnaire to update account information within 48 hours in order to prevent Medicare payment gaps. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity.

If you receive a request for information that seems suspicious, please check with your contractor before submitting any information. Medicare providers should only send information to a Medicare contractor using the Provider Call Center Toll-Free Numbers Directory found in the download section of the CMS Web site.

Asuris Launches Consumer Engagement Campaign

With health care reform at the center of debate in D.C. and no clear answers on how to achieve a working system, or reign in runaway health care costs, Asuris continues in our efforts to educate and engage consumers in becoming more active participants in the health care system.

To help in this long-term endeavor, early this week Asuris launched a newly revamped, interactive www.WhatsTheRealCost.org Web site.

This site is part of our ongoing campaign to educate consumers about the real costs of health care, how the choices they make each day impact those costs, and that without addressing costs, we cannot achieve meaningful transformation of the health care system.

This campaign is geared toward all consumers, as the more interactive site will appeal to a variety of demographics. We encourage you to visit www.WhatsTheRealCost.org and experience the various elements of this Web site designed to help people understand the problems facing our health care system, and to inspire them to take action toward meaningful health care reform.

If you have questions about www.WhatsTheRealCost.org please contact your provider consultant.

07/17/2009