Insurance Carrier Updates: November 2024

Nov 22, 2024 | The Back Channel

Horizon – NJ Health

Horizon NJ Health providers, make sure you’re enrolled in ERAs.

Beginning November 15, all unregistered ERA users will have their remittance preference changed to print Explanation of Payments (EOP). There is still time to enroll in ERAs, which are timelier and more convenient than printed EOPs. Use the button below to begin the online registration process.

Electronic Remittance Advice (835) Enrollment Form

Aetna

Authorization Transaction Tips

Need help with using Aetna’s Authorization transaction?

Review their guide for some helpful tips! You can also view the Aetna learning calendar to register for an upcoming educational webinar online.

Authorization Tips (PDF)

UHC

Prior Authorization Requirement

As we all know by now, UHC’s instituted a prior authorization requirement for certain Medicare Advantage plans. Please review the link button below for additional clarification and exclusions.

Please be advised:

  • Treatment can begin the same day as the member’s evaluation if you wish to do so, as authorizations, when issued, will cover dates retroactive to the date of the evaluation.
  • You can submit an authorization up to 10 business days (14 calendar days) after the date of service, and authorizations, when issued, will be retroactive to the date of the evaluation.

Prior Authorization Resources

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