Change Healthcare Outage FAQ Update

IU Health Plans continues to navigate the impacts of the Change Healthcare outage and strives to provide the most up-to-date information to our provider partners. In adhering to this standard, we've updated our FAQ and encourage you to review it. Important updates include information on Medicare Advantage (MA) EFT/ERA distribution, MA ERA/835 registration, timely filing and interest payments on delayed MA EFT payments. Please check back regularly for future updates on our website home page banner and the provider resources page, section 4.

Updated Change Healthcare Outage FAQ

If you have any questions or concerns, please contact Provider Services, Mon. - Fri. from 7 am - 7 pm at the following numbers:

Commercial provider line: 866.895.5980
Medicare Advantage provider line: 866.218.1524

Change Healthcare Outage FAQ Update

IU Health Plans continues to navigate the impacts of the Change Healthcare outage and strives to provide the most up-to-date information to our provider partners. In adhering to this standard, we've updated our FAQ and encourage you to review it. Important updates include information on Medicare Advantage (MA) EFT/ERA distribution, MA ERA/835 registration, timely filing and interest payments on delayed MA EFT payments. Please check back regularly for future updates on our website home page banner and the provider resources page, section 4.

Updated Change Healthcare Outage FAQ

If you have any questions or concerns, please contact Provider Services, Mon. - Fri. from 7 am - 7 pm at the following numbers:

Commercial provider line: 866.895.5980
Medicare Advantage provider line: 866.218.1524

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Medication Therapy Management Program

IU Health Plans (HMO) (HMO-POS) offers a Medication Therapy Management (MTM) program at no extra charge to you. The program is not a benefit. It is a free service offered to those who are eligible and qualify for the program. Once enrolled in the program, there are no changes to your copays or other benefits.

The MTM Program helps you get the most benefit from your medications by:

Who qualifies for the MTM Program?

To qualify for the MTM program, you must meet the following criteria:

You may also qualify for a review with a pharmacist if you are using controlled substance medications and/or you are an At-Risk Beneficiary (ARB) under the plan’s Drug Monitoring Program (DMP).

If you qualify, you’ll receive a welcome letter mailed to your home. Medicare requires MTM programs to automatically enroll members who qualify throughout the calendar year but participation is voluntary, and you can choose not to participate at any time. The welcome letter provides instructions on how to opt out of the program.

Comprehensive Medication Review (CMR)

Those enrolled in the MTM program will be offered a comprehensive medication review (CMR).  A CMR is a one-on-one consultation between you and one of our clinical pharmacists.  The pharmacist will review all of your medications and medical conditions and answer any questions that you may have. The review will take place over the phone.

The pharmacist will offer ways to manage your conditions with the drugs you take. If any issues are identified, the pharmacist may work with your doctor to help get them resolved.  A CMR takes about 30 minutes and is usually offered once each year to qualifying members.

At the end of your consultation, you will receive a cover letter, a Recommended To-Do List, and a Personal Medication List within two weeks of speaking with the pharmacist. The Recommended To-Do List has steps you should take to help you get the best results from your medications. The Personal Medication List will help you keep track of your medications and describe how to use them the right way.

Click here for the Personal Medication List 2024.

Targeted Medication Review (TMR)

You may also have Targeted Medication Reviews (TMRs) performed for you. TMRs are identified on at least a quarterly basis (every three months) to address potential medication-related issues. When these issues are identified, the doctor prescribing the medication may be contacted about the potential issue and provided suggested interventions. As always, your prescribing doctor will decide whether or not to consider our suggestions. You may also receive information about a TMR directly, when needed.

Information Regarding Safe Disposal of Controlled Substance Medications

Part of keeping you healthy and safe is to provide you information on how to dispose of controlled substance medications when they are no longer needed. As part of the MTM program, this information will be mailed to your home. You can also access this information below.

Click here for information regarding the safe disposal of controlled substance medications

How can I get more information about the Medication Therapy Management Program? 

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Last updated 12.7.2023

Disclaimer

IU Health Plans is a Medicare Advantage organization with a Medicare contract. Continued enrollment depends on the contract between CMS and the Plan/Part D Sponsor remaining in effect, i.e. being renewed and not terminated. Other pharmacies/physicians/providers are available in our network. Product types include HMO and HMO-POS.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year.

Our hours of operation change throughout the year. We are available to take your call: Oct. 1 through March 31 from 8am to 8pm, seven days a week and April 1 through Sept. 30 from 8am to 8pm, Monday through Friday.