MCCFL News Feed


October 2020 Newsletter

Care Coordinators NaviHealth manages post-acute care on a delegated, full-risk basis for health plans. It has a proprietary clinical model with data driven insights that are predictive of length of stay for certain diagnosis, therapy requirements and likelihood of hospital readmission. Recently purchased by United HealthCare Optum in May 2020, Optum hopes to merge their own clinical model with NaviHealth's model to provide more clinical capabilities with the value based care model. NaviHealth also works with health systems, ACOs and other providers in the BPCI (bundled payment care Improvement) with CMS. United Health Care plans to use NaviHealth's care coordinators for authorizations and care management in Florida in early 2021; stay tuned for more information.

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Managed Care Update #21 September 11, 2020

The CDC has made alternate directives with discharging back to group settings, it is important to be aware of these changes when dealing with the Managed Care Plans. CDC Discontinuation of Transmission-Based Precautions and Discharge Below are the individual plan directives; please be sure to follow directions from your corporate teams.

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Managed Care Update #20 September 4, 2020

The CDC has made alternate directives with discharging back to group settings, it is important to be aware of these changes when dealing with the Managed Care Plans. CDC Discontinuation of Transmission-Based Precautions and Discharge Below are the individual plan directives; please be sure to follow directions from your corporate teams.

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September 2020 Newsletter

We suggest as a best practice to re-validate all Medicare verification's on ALL skilled members on the 1st and 15th of the month to catch potential payer changes.

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Managed Care Update #19 August 28, 2020

Due to the current requirements for patients to have negative Covid test prior to discharge back to group settings, it is important to have this conversation with the health plan at the beginning of the stay to assist in appropriate coordination and timing of testing.

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Managed Care Update #18 August 7, 2020

MCCFL is working diligently on updates as related to the Covid-19 Crisis. We are gathering updates from the health plans as they are released to be able to provide you with the most recent information. Please note these updates and changes are very fluid and can change daily. It is best practice for out of network providers to check with the health plan for each referral to determine their current processes as they could vary based on type of product and benefits. On March 25th, 2020, President Trump declared that a major disaster exists in the State of Florida. Florida Disaster Declaration This additional declaration will most likely change the way the managed care organizations operate and how they will apply their rules regarding network operations. We are anticipating updates from the plans regarding this declaration. Medicare Advantage plans do have special requirements they must follow when such situations arise, please follow this link to review. CMS March 10, 2020 MCCFL is here to assist you and your staff with any managed care needs or questions that arise. Please do not hesitate to reach out to your Managed Care Liaison or any of our staff. We wish you and yours the best in these uncertain times.

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Managed Care Update #17 July 24, 2020

Due to the current requirements for patients to have negative Covid test prior to discharge back to group settings, it is important to have this conversation with the health plan at the beginning of the stay to assist in appropriate coordination and timing of testing.

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United Healthcare of Florida Medicaid Tranpsortation

United Healthcare of Florida, Inc. Transportation Vendor Transition to Logisticare Beginning August 1, 2020, non-emergency transportation services for United Healthcare of Florida, Inc. (United) will be provided by Logisticare. United is a Statewide Medicaid Managed Care (SMMC) plan operating in regions 3, 4, 6 and 11. All pre-scheduled and standing transportation trips for dates of service on or after August 1, 2020 will be automatically transferred to Logisticare. To make an appointment for a transportation trip for a United Medicaid member, contact the Logisticare Customer Service Team at 1-866-372-9891. For questions regarding this transition, contact United’s Customer Service Department at 1-888-716-8787.

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Managed Care Update #16 July 20, 2020

Due to the current requirements for patients to have negative Covid test prior to discharge back to group settings, it is important to have this conversation with the health plan at the beginning of the stay to assist in appropriate coordination and timing of testing.

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Managed Care Update #15 July 14, 2020

Due to the current requirements for patients to have negative Covid test prior to discharge back to group settings, it is important to have this conversation with the health plan at the beginning of the stay to assist in appropriate coordination and timing of testing.

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July 2020 Newsletter

We have made some recent access changes to the MCCFL Client Portal https://client.mccfl.us/public/. Effective immediately, we are implementing individual access to the portal instead of the single log in per facility. Please email your liaison or wstone@mccfl.us to initiate an individual log in. You will then receive an email from ‘support@mccfl.us’ with the subject ‘portal access’. The email will contain a link for you to create your own unique login credentials.

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Managed Care Update #14 July 03, 2020

Due to the current requirements for patients to have negative Covid test prior to discharge back to group settings, it is important to have this conversation with the health plan at the beginning of the stay to assist in appropriate coordination and timing of testing.

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Managed Care Update #13 June 26, 2020

MCCFL is receiving information from many of the insurance plans regarding prior authorization processes and other updates related to COVID-19. We will continue to provide this information via email communication, however, for the most recent information, we are recommending you visit the health plan's website or call their provider line. We will also be placing the communications from the health plans that can be accessed by visiting https://client.mccfl.us/public/ under the tools and resources tab in the Coronavirus folder. As best practice we still suggest you initiate authorization process, prior to admission. Please note that unless specified, out of network status still applies to some of their requirements, please read carefully.

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Managed Care Update #12 June 18, 2020

MCCFL is receiving information from many of the insurance plans regarding prior authorization processes and other updates related to COVID-19. We will continue to provide this information via email communication, however, for the most recent information, we are recommending you visit the health plan's website or call their provider line. We will also be placing the communications from the health plans that can be accessed by visiting https://client.mccfl.us/public/ under the tools and resources tab in the Coronavirus folder. As best practice we still suggest you initiate authorization process, prior to admission. Please note that unless specified, out of network status still applies to some of their requirements, please read carefully.

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Managed Care Update #11 May 29, 2020

MCCFL is receiving information from many of the insurance plans regarding prior authorization processes and other updates related to COVID-19. We will continue to provide this information via email communication, however, for the most recent information, we are recommending you visit the health plan's website or call their provider line. We will also be placing the communications from the health plans that can be accessed by visiting https://client.mccfl.us/public/ under the tools and resources tab in the Coronavirus folder. As best practice we still suggest you initiate authorization process, prior to admission. Please note that unless specified, out of network status still applies to some of their requirements, please read carefully.

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Managed Care Update #10 May 22, 2020

MCCFL is receiving information from many of the insurance plans regarding prior authorization processes and other updates related to COVID-19. We will continue to provide this information via email communication, however, for the most recent information, we are recommending you visit the health plan's website or call their provider line. We will also be placing the communications from the health plans that can be accessed by visiting https://client.mccfl.us/public/ under the tools and resources tab in the Coronavirus folder. As best practice we still suggest you initiate authorization process, prior to admission. Please note that unless specified, out of network status still applies to some of their requirements, please read carefully.

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Claims and Billing Special Bulletin May 2020

We have made some recent access changes to the MCCFL Client Portal https://client.mccfl.us/public/. Effective immediately, we are implementing individual access to the portal instead of the single log in per facility. Please email your liaison or wstone@mccfl.us to initiate an individual log in. You will then receive an email from ‘support@mccfl.us’ with the subject ‘portal access’. The email will contain a link for you to create your own unique login credentials.

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Managed Care Update #9 May 8, 2020

MCCFL is receiving information from many of the insurance plans regarding prior authorization processes and other updates related to COVID-19. We will continue to provide this information via email communication, however, for the most recent information, we are recommending you visit the health plan's website or call their provider line.

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March 2020 Newsletter

As you can already see, we here at Managed Care Consultants of Florida have some new and exciting things coming 2020. We have made some changes to our newsletter format.

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