Coronavirus COVID-19 Update

Revised Benefit Coverage for MHP Members (4/8/2020)-click to expand

McLaren Health Plan continues to monitor the COVID-19 situation and has revised its benefit coverage as follows:

  • NEW – Copays, deductibles and coinsurance are waived for diagnoses related to COVID-19 for all McLaren Health Plan lines of business.*

    Other benefit reminders:

  • There is no cost-sharing for both in-network and out-of-network testing for COVID-19. This includes lab services and items and services related to when or how members receive the test. Services can take place at provider offices, urgent care centers, hospital emergency rooms or through telehealth visits.
  • There is no member cost-sharing for a telehealth visit nor any preauthorization requirements. Bill modifier -GT with the appropriate office call.
  • No authorization is required for any inpatient hospital stay at any in-network facility for any diagnosis.
  • No inpatient authorization is required for COVID-19 admission at in- or out-of-network facilities, including hospitals, SNFs, inpatient rehabs, LTACHs, transfers.
  • No authorization is required for COVID-19 testing at in- or out-of-network labs (CPT codes U0001, U0002, 87635)
  • No authorization is required for any outpatient COVID-19 related services, including DME, oxygen, therapy, etc.

These benefits apply to McLaren Health Plan Medicaid, Health Advantage, Community and Exchange members.

*May not apply to self-funded or high-deductible health plans.

Outpatient and Professional Services Authorization Update (3/10/2020)-click to expand

McLaren Health Plan is taking the following temporary steps to assist providers during the COVID-19 pandemic for dates of service March 10, 2020 to July 12, 2020. This list applies to the outpatient services listed below:

No prior authorization required for the following:

Medicaid, Health Advantage, Community, Exchange members: COVID-19 testing at in-network or out-of-network labs (CPT codes U0001, U0002, and 87635)

Medicaid Only: Out-of-Network Provider Office Visits

Medicaid Only: In-Network or Out-of-Network Home Health Care providers

Medicaid Only: Out-of-Network Therapy Providers (PT,OT,ST) Auth requirement has also been lifted                                                                                                               In-Network Therapy providers for any visits over the allowable 36 visits

 Medicaid Only: In-Network or Out-of-network providers for Enteral Nutrition B-codes

 Medicaid and Health Advantage Only: In-Network or Out-of-network providers of Insulin Pump Supplies and/or Continuous Glucose Monitor Supplies

 Medicaid and Health Advantage Only: No authorization required for In-Network or Out-of-network providers for Photochemotherapy

If you have any questions, please call our Customer Service department at 888-327-0671.

Hospital Authorization Update (3/10/2020)-click to expand

McLaren Health Plan is taking the following temporary steps for dates of service between March 10, 2020 to July 12, 2020, to assist our partners during the COVID-19 pandemic.


These temporary steps apply to:
McLaren Medicaid
McLaren Health Advantage
McLaren Community and
McLaren Exchange


• NO AUTHORIZATION IS REQUIRED for any inpatient hospital stay at any in-network facility for any diagnosis
• No inpatient authorization is required for any COVID-19 admission at in-network or out-of-network facilities. This includes hospitals, SNFs, inpatient rehab, LTACHs, transfers
• No authorization is required for COVID-19 testing at in-network or out-of-network labs (CPT codes U0001, U0002, 87635)
• No authorization is required for any outpatient COVID-19 related services including DME, oxygen, physical therapy, etc…
• Stays greater than 7 days in any facility, we ask that you please notify MHP using your usual UM process (faxing clinicals)
• If you have questions about identifying the member’s line of business, please use the provider portal to verify eligibility and line of business


Please call Customer Service at 1-888-327-0671 if you have questions.

 

March Provider Network Update-Telemedicine Visits-click to expand

 McLaren Health Plan (MHP) is closely monitoring and following all recommended guidelines surrounding the coronavirus (COVID-19) outbreak to ensure the health and safety of its members. This includes coverage for:

• COVID-19 testing for members requiring the test with no cost-sharing to the member (procedure codes U0001, U0002)

  - MHP will accept these codes effective immediately for dates of service on or after Feb. 4, 2020

• Encouraging the use of telemedicine for all screening visits to determine if COVID-19 testing is warranted (and for routine visits where applicable until further notice)

There are no preauthorization requirements for in-network providers who provide telemedicine services for MHP members. Bill modifier -GT with the appropriate office call to indicate a telemedicine service.

MHP has notified its members of the risks, symptoms and preventive measures about COVID-19 and have encouraged them to call their doctor first before going to the emergency room and to use telemedicine services when available. We’ve educated our employees, agents and employer groups and are taking all necessary precautions to ensure we are staying up to date with the latest information available from public health officials.

Please call our Customer Service team at 888-327-0671 (TTY: 711) if we can be of assistance or answer any questions. We’re here to help.