Medicare fax number change and peer-to-peer update

We are committed to strengthening our relationships with our valued care provider partners and would like to give an update on efforts to focus on requests for our Medicare members.

Dedicated fax line for inpatient

Effective July 17, 2023, there will be a new dedicated fax line for Medicare inpatient clinicals and requests for long-term acute care (LTAC), acute rehabilitation (AIR), and skilled nursing facilities (SNF). The new fax number is 866-811-0197.

Dedicated fax line for the health plan outpatient precertification only

Integrated Home Care Services (IHCS) will continue to be our dedicated vendor for all in-home durable medical equipment (DME)/home health care (HHC). Call 844-215-4264 or fax 844-215-4265.

Effective July 17, 2023, DME/HHC not covered by IHCS that require prior authorization should be faxed to the health plan’s new fax numbers:

• Health plan outpatient precertification — 866-811-0143
• Health plan DME and home health precertification — 866-811-0148

Peer-to-peer conversations

A new prompt will be added for the Medicare peer-to-peer voicemail if the care provider chooses to request a peer-to-peer reconsideration effective July 17, 2023. You will be prompted to choose the new option for Medicare. All messages will be returned within one business day.

The following providers can participate in a peer-to-peer conversation:

• Attending, treating, and/or ordering physician

• A covering physician for the attending, treating, and/or ordering physician
• Physician’s nurse practitioner or physician assistant
• Medical director, physician advisor, or chief medical officer employed by the facility

Note: Peer-to-peer calls cannot be scheduled with a vendor or physician advisor that is employed by a third party.

Provide the following information when leaving a voicemail:

• Member’s name
• Member’s ID#
• Date of birth or event reference #
• Requesting provider and provider’s scheduler’s name and contact information
• Time and date the requesting provider is available for a peer-to-peer call

If you have questions regarding these changes, contact your local Provider Relations representative or call our Provider Services team at 877-915-0551, option 1.