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Provider Notices

** COVID-19 INFORMATION **

Ultimate Health Plans follows all CMS guidelines for providing benefits during disaster or public health emergency declarations. As such, please refer to the attached letter for additional information.

For Telehealth billing, Under CMS-1744-IFC, there has been a recent update regarding how these services should be billed. According to this update, physicians and practitioners who bill for Medicare telehealth services should report the POS code that would have been reported had the service been furnished in person. Additionally, modifier 95, should be applied to claim lines that describe services furnished via telehealth. For example, if the service would have been performed in an office setting, POS 11 would be billed along with the applicable office visit CPT (e.g. 99213) and the 95 modifier.

To view this policy and additional CMS updates related to COVID-19 waivers, please visit:
https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers

Other useful information from CMS is available on the links below:
List of Telehealth Services
COVID-19 Partner Toolkit

Laboratory Change

We have exciting updates about our Laboratory benefits. LabCorp will become Ultimate Health Plans’ exclusive national laboratory effective April 1st, 2020.

Participating providers offering in-office lab draws and any labs drawn at an Access draw station will be picked up and processed by LabCorp.

You can find all LabCorp locations by visiting www.labcorp.com.
Appointments can be scheduled by calling LabCorp at (800) 877-5227 (TTY: 711).

Provider Manual

Ultimate Health Plans’ “Provider Manual” was developed for use by contracted Providers and their staff. It is included by reference in the contractual agreement (the “Agreement”) between Ultimate Health Plans and the Provider, and it is intended to establish guidelines to facilitate compliance with Ultimate Health Plans’ established policies and procedures. This provider manual contains general information that should be utilized by Providers and their staff when caring for Ultimate Members.


Provider Newsletter

Important news, announcements and helpful information for our participating providers.


 

Advance Directives

Help Honor Your Patients’ Wishes.Our physicians and practitioners should discuss advance directives with their patients (as appropriate) and file a copy of any advance directive document (e.g., living will, durable power of attorney for health care, health care proxy or do not resuscitate (DNR) request) in a prominent place within the medical record. Each medical record that contains an advance directive should clearly indicate that said document is included.

This page was last modified: 4/3/2020 2:01:09 PM
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Ultimate Health Plans is an HMO plan with a Medicare contract. Enrollment in Ultimate Health Plans depends on contract renewal. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year. Ultimate Health Plans does not collect any member information through this website.

 

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