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Mutual News Q1 2019 Newsletter
Medical Mutual of Ohio·OH·Mutual News Newsletter
Effective date
May 15, 2019
We identified it
Jun 20, 2026
Summary
Medical Mutual is implementing major claims processing changes with Optum partnership for pre-payment reviews (May 15) and new institutional claims editing system using NCCI edits and other federal guidelines (June 1). Additionally, all prior authorization requests must be submitted through NaviNet electronic system starting June 1 - no more fax or phone submissions accepted.
Action Required
By May 20, 2019: Register for NaviNet at NaviNet.SecureForce.com (takes 5-7 days to process). By June 1, 2019: Stop submitting prior authorization requests by fax or phone - use only NaviNet for all medical services except medical drugs, radiology, chiropractic, and therapies. Access Optum Claim Edit Portal through Provider.MedMutual.com ePortal to test institutional claims before submission. Update staff on new Medical Mutual ID cards issued January 1, 2019.