The Point Newsletter for Providers | All Newsletters
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WE HEARD YOU: We’ve simplified in-network referrals.
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
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Tips for Submitting Claims for US Family Health Plan 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
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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
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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
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Why Star Ratings Matter and Why We Need Your Support
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
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2024 NCQA Health Plan Ratings for US Family Health Plan
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
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2025 Formulary Updates and Rx Prior Authorizations
US Family Health Plan & Generations Advantage: Access the latest 2025 formulary updates for Generations Advantage and US Family Health Plan members.
05/08/25
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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
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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
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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