|Aetna Better Health of WV
|Resource for ABH prior authorization submission and status inquires.
|Aetna Better Health WV HEDIS Toolkit
|Downloadable reference guide for HEDIS measures
|HCC Coding Education
|Provides detailed information on understanding Hierarchical Condition Categories, a risk adjustment model that allows for a more accurate picture of patient health in a chronic disease state.
|Humana Provider Resources
|For providers: Valuable starting point for claims, preauthorizations, referrals, clinical support, pharmacy resources, dental resources.
Online portal (Population Health Compass) available with additional reporting features, gap closure attestation. Please contact your Practice Transformation Specialist to sign up for access to your facility.
|Provides fee schedules, provider manuals, enrollment forms and other helpful resources.
|The Health Plan
|For Providers: Serves as a launching point for information regarding training, patient care programs, claims support, case management referral, clinical support, prior authorizations and referrals.
|Starting point to access Unicare manuals, policies and guidelines (provider and claims), HEDIS reference, prior authorization and eligibility, payor resources available to patients.
|Resource for physicians, administrators, and healthcare professionals with information including policy/protocols, eligibility and benefits, claims, prior authorization, pharmacy information.
Online portal (Practice Assist) available with additional reporting features, gap closure attestation. Please contact your Practice Transformation Specialist to sign up for access to you facility.
|WV Bureau for Medical Services
2024 HCC Coding Lunch and Learn
United Healthcare STARs Pharmacy Measures FAQ Forum
This forum is designed as a time for provider groups to ask questions related to the medication adherence measures and/or the statin use measures. Each month the forum will be hosted by the east region clinical quality pharmacists and will begin with a short topic of the month followed by an open Q&A.
You may have questions on measure specifics, such as, inclusion or exclusion criteria, best practices for measure success, or questions related to strategy implementation. All questions related to the pharmacy adherence measures and the statin use measures are welcomed. Please note no PHI or PII will be discussed during the forums.
February 8, 2024
March 3, 2024
April 11, 2024
May 9, 2024
June 13, 2024
July 11, 2024
August 8, 2024
September 12, 2024
October 10, 2024
November 14, 2024
December 12, 2024