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Update your information in our Provider Directories (04/16/2012)
Please help us maintain accurate Provider Directories by completing the recently revised Provider Information Update Form when:
- A provider leaves or joins your clinic or practice
- You have a change to your organization's address, phone number, tax identification or National Provider Identifier number
The form can easily be submitted online or printed and faxed.
Thank you for your assistance in helping us keep critical information about your practice up-to-date.
Asuris TruAdvantage members receive annual wellness visit and preventive services materials (04/16/2012)
Beginning April 16, members will receive a letter and informational materials encouraging them to schedule and educating them about annual wellness visits or other preventive services available. See sample materials (PDF).
Regence Life and Health name change. (04/04/2012)
Effective April 1, Regence Life and Health Insurance Company is now LifeMap Assurance Company™ (LifeMap). Members will receive new member cards reflecting the new name. Please visit the LifeMap website at www.LifeMapCo.com for more information.
Sign-up to receive future communications from LifeMap.
New benefits added for Medicare (03/30/2012)
The Centers for Medicare & Medicaid Services (CMS) has recently issued several national coverage determinations (NCDs) that affect members with Medicare coverage:
The benefits added by these NCDs are available to Asuris TruAdvantage members.
Dental Professionals section to be removed (3/30/2012)
On April 16, the Dental Professionals link displayed in the site navigation will be removed. All dental-specific information previously in this section has been incorporated into the general information for each topic throughout the site
You will find dental information in the following sections:
Delayed claim payments (updated on 03/09/2012)
We recently identified a claims pricing issue caused by a defect in the Trizetto upgrade install that affected claims received between February 5 and March 6, 2012. We will review all claims processed during this time period and will notify you regarding any needed adjustments.
All claims received after March 6, are processing correctly and, once completed, will be part of your regular payment schedule.
Outpatient diagnostic imaging services MUST have an order number from AIM (Updated to further clarify the program information on 03/02/2012)
Asuris’s Radiology Quality Improvement Initiative (RQI) requires that an order number be obtained from American Imaging Management (AIM®) prior to the following advanced diagnostic imaging services for our group, Individual (commercial) and Asuris TruAdvantage members:
- Nuclear cardiology
- Magnetic resonance imaging (MRI)
- Magnetic resonance angiography (MRA)
- Positron emission tomography (PET) studies
- Computerized tomography angiography (CTA)
- Outpatient elective computerized tomography (CT)
Failure to comply with the Asuris RQI program will financially impact servicing provider practices and delay patient care. If an order number is not obtained, the service will be considered a provider write-off and cannot be billed to the member.
Obtaining an order number is a quick and easy process
AIM offers two methods for submitting imaging order requests, allowing provider offices quick access to complete imaging order requests in less than five minutes.
- Online: ProviderPortal is available 24 hours a day, seven days a week. Online tools assist with managing RQI processes such as checking the status of open requests, cancelling requests and changing servicing providers.
- Phone: Contact AIM’s call center at 1 (877) 291-0509 to submit order number requests.
Asuris contracted servicing providers:
It is critical that radiology providers and free-standing imaging centers confirm that an order number has been obtained prior to performing the procedure. If an order number is not obtained, the procedure WILL NOT BE COVERED AND THE CHARGES WILL BECOME A PROVIDER WRITE-OFF.
Servicing providers can confirm order numbers by calling AIM or checking their ProviderPortal. If an order number has not been obtained, the servicing provider should request that the ordering provider contact AIM to obtain one.
Learn more.
We will soon require providers to access the Provider Center to verify information regarding member eligibility, benefits and claims information. (Updated 03/15/2012)
We will soon require dentists, physicians, other health care professionals and facilities to access the Provider Center to verify information regarding eligibility, benefits and simple claims status.
Most providers have found it’s faster to obtain this information online rather than waiting on hold for a Customer Service specialist. Using this free, online tool can save you up to five minutes per inquiry, and the information is available for most members Monday through Saturday 24 hours a day and on Sunday (except from 8 a.m. to noon for maintenance).
Customer Service will continue to be available to answer complex inquiries or questions you have about the information you are unable to view online.
Medical multi-year accumulators now available
The Provider Center now displays medical multi-year accumulators that are applicable to each member’s product.
The following information is displayed:
- Benefit maximums
- How much of the benefit the member has remaining
- How much of the benefit the member has used to date
To see this information for your patients, simply navigate to the Medical Benefits, Multi-year Accumulators tab. From the drop-down menu, select the service. Then select ’Submit’. The multi-year accumulator information will be displayed.
View our User's Guide (PDF) for step-by-step instructions on verifying member information on the Provider Center.
Cenestin® moves to non-preferred medication status (03/01/2012)
Effective April 1, Cenestin will be a non-preferred medication for all Asuris members, and will be subject to the non-preferred copayment. Our preferred alternatives to Cenestin are estradiol, estropipate and Enjuvia®. As always, we encourage members and providers to discuss preferred options to decide which medication is right for the member.
We make changes to the Preferred Medication List (PML) based on scientific evidence and a medication’s value compared to other medications. Learn more about our PML.
Asuris partners with Altegra to assist Medicare “dual eligible” members (03/01/2012)
We have contracted with Altegra Health™ (Altegra) to reach out to our Medicare Advantage members who may be eligible to receive federal or state assistance to pay all or part of their Medicare Part B premium.
Certain Asuris members may qualify for federal programs that provide Medicare beneficiaries with some type of financial relief. One of these programs, the Medicare Savings Program (MSP) helps pay for some or the entire Part B premium -- $99.90 in 2012. Another federal program, Extra Help, pays for some or all of a Medicare beneficiary’s Part D premium, reduces Medicare beneficiaries’ prescription drug copayment to as little as $1.10 per prescription, and provides protection through the coverage gap. In some cases, members may also be eligible for a State Medical Assistance Program.
This partnership is part of our ongoing efforts to deliver the highest service and value to our Medicare members. Altegra will assist our members by:
- Explaining the application process
- Answering any questions they might have
- Helping them complete any necessary forms
Altegra will implement the first phase of this program March 1 with calls to select members, followed by a mailing to Asuris TruAdvantage members who are eligible and likely to enroll in the program. These mailings will begin the week of March 12.
Physician Satisfaction Survey (02/13/2012)
We appreciate all of the physicians who completed our annual Physician Satisfaction Survey in 2011.
Results indicate:
- 89% of physicians would likely continue to contract with Asuris
- 82% of physicians felt Asuris’s performance was better than other health plans
Our areas of strength include:
Suggested areas for improvement include:
- Member education – Visit myAsuris.com to view the online tools and information available to our members
- Opportunities to provide input about Asuris medical policies – Join our reviewer team
Clarification on Asuris TruAdvantage vision claims submission (02/9/2012)
We have updated information about the recent change to the routine vision benefits on Asuris TruAdvantage, including the relevant International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM) codes to help you determine whether a claim is routine or not. Learn more.
For past announcements, please view the What's New archive.
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