Provider News
Our network provider news delivers health plan updates, plus tips for services and claims.
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05/08/25
In-network referrals, simplified.
Notification to the US Family Health Plan of in-network specialty referrals is no longer required. Send these referrals direct to in-network specialist and copy your patient. Learn more about referral requirements.
05/08/25
Submitting Claims for USFHP Patients
Detailed claims submission tips for US Family Health Plan providers, including requirements for subscriber and newborn patients. Helps ensure accurate processing and timely reimbursement. Last revised March 2025.
05/08/25
Martin's Point Policies: Where to Find Them
US Family Health Plan & Generations Advantage: Martin’s Point providers must adhere to Benefit, Medical, and Payment Policies for accurate claims processing and compliance. Learn how these policies affect reimbursement and claims submission.
05/08/25
Provider Directory Accuracy Matters
US Family Health Plan & Generations Advantage: CMS and TRICARE require providers to maintain accurate directory information. Learn how to update your practice and provider details using Provider DataPoint.
05/08/25
Medicare Star Ratings
Generations Advantage: Discover how the 2025 Medicare Star Ratings impact patient care and provider incentives. Learn how to help maintain high ratings and ensure continued access to quality healthcare services.
05/08/25
NCQA Health Plan Rating
US Family Health Plan: Martin’s Point US Family Health Plan earned a 4-star NCQA rating for quality performance in 2024, including a 5-star rating for Patient Experience. Learn more about the measures and where to find ratings.
05/08/25
2025 Formulary Updates & Rx Prior Authorization
US Family Health Plan & Generations Advantage: Access the latest 2025 formulary updates for Generations Advantage and US Family Health Plan members.
05/08/25
Risk Adjustment Coding and Documentation
Generations Advantage: Learn how to improve Medicare Advantage risk adjustment documentation and coding accuracy. Follow best practices to ensure compliance with CMS guidelines and support proper reimbursement.
05/08/25
Clinical Practice Guidelines
US Family Health Plan & Generations Advantage: Learn how to improve Medicare Advantage risk adjustment documentation and coding accuracy. Follow best practices to ensure compliance with CMS guidelines and support proper reimbursement.
05/08/25
Medicare Statin Use in Persons with Diabetes (SUPD) Quality Measure
Generations Advantage: Ensure compliance with Medicare Part D's SUPD measure. Learn how accurate documentation and exclusions help maintain quality scores.
05/08/25
Community Health Worker Program Update
US Family Health Plan & Generations Advantage: Martin’s Point CHW program provides essential preventive care education and community resources to improve member health.
05/08/25
Metabolic Monitoring Children
Generations Advantage: Supporting children’s behavioral health through ADHD follow-up care, therapy before medication, and monitoring of antipsychotic use.
05/08/25
Seeking Member Feedback on Their Care
US Family Health Plan & Generations Advantage: Martin’s Point uses CAHPS® surveys to gather member feedback on care quality, customer service, and coordination—guiding improvements for services and providers.
05/08/25
988 Suicide Crisis Lifeline
US Family Health Plan & Generations Advantage: The 988 Suicide and Crisis Lifeline provides 24/7 confidential support for individuals in crisis, including direct connections to the Veterans Crisis Lifeline. Learn how this essential service can help those in need.
09/25/24
The Point | Issue 2 | 2024
In this edition:
• Referral & ProAuth for USFHP
• CAHPS: Improving Your Health Care Experience
• Martin’s Point Service Standards
• Explore deeper insights inside!
03/21/24
The Point | Issue 1 | 2024
In this edition:
• Want Timely Claim Payments and More New Patients?
• Continuity of Care—New CMS 90-Day Rule
• Understanding Behavioral Health Quality Measures
• Dive in for more insights!