August 2023
Click here to view the .PDF version of the August 2023 Midlands Choice Provider E-Newsletter.
May 2023
Click here to view the .PDF version of the May 2023 Midlands Choice Provider E-Newsletter.
February 2023
Click here to view the .PDF version of the February 2023 Midlands Choice Provider E-Newsletter.
December 2022
Click here to view the .PDF version of the December 2022 Midlands Choice Provider E-Newsletter.
August 2022
Click here to view the .PDF version of the August 2022 Midlands Choice Provider E-Newsletter.
May 2022
Click here to view the .PDF version of the May 2022 Midlands Choice Provider E-Newsletter.
February 2022
Click here to view the .PDF version of the February 2022 Midlands Choice Provider E-Newsletter.
December 2021
Click here to view the .PDF version of the December 2021 Midlands Choice Provider E-Newsletter.
August 2021
Click here to view the .PDF version of the August 2021 Midlands Choice Provider E-Newsletter.
June 2021
Click here to view the .PDF version of the June 2021 Midlands Choice Provider E-Newsletter.
February 2021
Click here to view the .PDF version of the February 2021 Midlands Choice Provider E-Newsletter.
November 2020
Click here to view the .PDF version of the November 2020 Midlands Choice Provider E-Newsletter.
August 2020
Click here to view the .PDF version of the August 2020 Midlands Choice Provider E-Newsletter.
May 2020
Click here to view the .PDF version of the May 2020 Midlands Choice Provider E-Newsletter.
February 2020
Click here to view the .PDF version of the February 2020 Midlands Choice Provider E-Newsletter.
December 2019
Click here to view the .PDF version of the December 2019 Midlands Choice Provider E-Newsletter.
August 2019
Click here to view the .PDF version of the August 2019 Midlands Choice Provider E-Newsletter.
May 2019
Click here to view the .PDF version of the May 2019 Midlands Choice Provider E-Newsletter.
February 2019
Click here to view the .PDF version of the February 2019 Midlands Choice Provider E-Newsletter.
November 2018
Click here to view the .PDF version of the November 2018 Midlands Choice Provider E-Newsletter.
August 2018
Click here to view the .PDF version of the August, 2018 Midlands Choice Provider E-Newsletter.
May 2018
Click here to view the .PDF version of the May, 2018 Midlands Choice Provider E-Newsletter.
February 2018
Click here to view the .PDF version of the February, 2018 Midlands Choice Provider E-Newsletter.
December 2017
Click here to view the .PDF version of the December, 2017 Midlands Choice Provider E-Newsletter.
August 2017
Submit Claims to Correct Address
Not all claims for medical services incurred by patients who access the Midlands Choice network are to be sent to Midlands Choice. If the patient has coverage through payers such as Cigna, Medica, HealthPartners, QualChoice and others, the claim should be submitted directly to the payer.
Password Reset Required
Registered users of MidlandsChoice.com secured tools have recently been required to change their password upon login. Going forward, passwords will be required to be reset every 60 days.
Winnebago Tribe of Nebraska
The group Winnebago Tribe of Nebraska is moving from Web-TPA to Auxiant effective September 1, 2017.
Groups Moving From CNIC to UMR
Six employer groups are moving from CNIC Health Solutions to UMR.
York General Hospital
Effective July 1, 2017, the employees of York General Health Care Services (previously known as York General Hospital) became covered through Cypress Benefit Administrators. Coverage was previously through Regional Care Inc.
City of Charles City
The employer group City of Charles City has transitioned coverage from North Iowa Community Healthcare to Auxiant effective July 1, 2017.
Uniparts Olsen
Uniparts Olsen employees in Iowa began to be insured through Quad City Community Healthcare c/o Auxiant effective June 1, 2017.
Cigna July 2017 Provider Newsletter
The July 2017 issue of Cigna's provider newsletter, Network News, has been published and is available for viewing.
Health Partners July 2017 Provider Newsletter
The July 2017 edition of HealthPartners provider newsletter, Fast Facts, has been published and is available for viewing.
Medica August 2017 Provider Newsletter
The August 2017 edition of Medica's monthly newsletter, Medica Connections, has been published and is available for viewing.
Medica July 2017 Provider Newsletter
The July 2017 edition of Medica's monthly newsletter, Medica Connections, has been published and is available for viewing.
Medica June 2017 Provider Newsletter
The June 2017 edition of Medica's monthly newsletter, Medica Connections, has been published and is available for viewing.
May 2017
Employee Benefit Systems Group Numbers
Employee Benefit Systems is issuing updated member ID cards to the employees of Henry County Health Center and S & J Tube Corporation.
Submitting Medica Claims via Zirmed
Providers who use the clearinghouse Zirmed to submit EDI claims for Medica members should use payer ID Z95382.
Midlands Choice Holiday Office Closings
The Midlands Choice office with be closed in observance of summer holidays.
Secured Website Audit Process
All registered users of the secured tools on the MidlandsChoice.com website are subject to a yearly audit.
Assurant Health Accessibility
Beginning April 1, 2017, the Assurant Health customer service department will no longer be accessible by phone. Questions must be submitted in writing.
Medica May 2017 Provider Newsletter
The May 2017 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica April 2017 Provider Newsletter
The April 2017 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica March 2017 Provider Newsletter
The March 2017 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
HealthPartners May 2017 Provider Newsletter
The May 2017 edition of HealthPartners provider newsletter, Fast Facts, has been published and is available for viewing.
HealthPartners March 2017 Provider Newsletter
The March 2017 edition of HealthPartners provider newsletter, Fast Facts, has been published and is available for viewing.
Cigna April 2017 Provider Newsletter
The April 2017 edition of Cigna's provider newsletter, Network News, has been published and is available for viewing.
February 2017
Resubmitting Corrected Claims
A claim cannot be processed as a "corrected" claim unless it is resubmitted with an indicator to alert the Midlands Choice claim processing system that the claim is a replacement claim.
Medica December 2016 Provider Newsletter
The December 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica Preventive Medicine and Screening Policy
Effective January 1, 2017, Medica is implementing a Preventive Medicine and Screening policy which addresses reimbursement of preventive medicine services when performed with other evaluation and management (E/M), screening and miscellaneous services.
Illinois Casualty Company
Illinois Casualty Company will be insured through Quad City Community Healthcare c/o Auxiant, a new payer with Midlands Choice, effective January 1, 2017.
Advance Physical Therapy
Employees of Advance Physical Therapy will be insured through HealthLink c/o Current Health Solutions effective January 1, 2017.
HealthPartners January 2017 Provider Newsletter
The January 2017 edition of HealthPartner's provider newsletter, Fast Facts, has been published and is available for viewing.
Medica January 2017 Provider Newsletter
The January 2017 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Quincy Medical Group
Employees of Quincy Medical Group are insured through HealthLink c/o CoreSource Inc. effective January 1, 2017.
Medica February 2017 Provider Newsletter
The February 2017 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Cigna January 2017 Provider Newsletter
The January 2017 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Provider's Rights during the Credentialing Process
Current and prospective Midlands Choice providers going through the initial or renewal application process have rights granted as an applicant through national credentialing standards.
Office Site and Medical Records
Midlands Choice maintains standards for both office site and medical records that Midlands Choice network providers are expected to meet.
Midlands Choice Call Center Hours
The Midlands Choice customer service call center will be closed for a half an hour each day during the lunch hour. Our new service hours will be 8:00 am to 4:30 pm with a break from 12:00 pm to 12:30 pm.
HealthPartners February 2017 Special Edition Newsletter
HealthPartners has published a special edition of their provider newsletter, Fast Facts, that provides information about the HealthPartners UnityPoint health plan.
HealthPartners and Midlands Choice Partner in Iowa and Nebraska
Effective 1/1/2017 Midlands Choice will be the network option for all HealthPartners members who receive care in Iowa and Nebraska. This previously was administered through Cigna.
November 2016
HealthPartners and Midlands Choice Partner in Iowa and Nebraska
Effective 1/1/2017 Midlands Choice will be the network option for all HealthPartners members who receive care in Iowa and Nebraska. This previously was administered through Cigna.
Midlands Choice Holiday Office Closings
The Midlands Choice office will be closed to observe upcoming holidays.
Submitting Claims for Medica Insure Members
When submitting claims for patient's who are insured through Medica Insure, please remember to use the claim submission information found on the member identification card.
National General Benefits Solutions
National General Benefits Solutions administers the self-funded groups formerly administered by Assurant Health.
Lincoln Electric System
Coverage for the group Lincoln Electric System will be moving from PreferredOne Administrative Services to Auxiant effective January 1, 2017.
Cigna October 2016 Provider Newsletter
The October 2016 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Medica November 2016 Provider Newsletter
The November 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica October 2016 Provider Newsletter
The October 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica September 2016 Provider Newsletter
The September 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
August 2016
Register for Secure Access to MidlandsChoicecom
Since Midlands Choice revamped the MidlandsChoice.com website in July 2015, more than 2650 users have registered for secure access to the site.
Group Information on Claims
Midlands Choice often receives claims with group and payer information that is no longer accurate or for groups that no longer have a relationship with Midlands Choice.
QualChoice Lab Policy Update
Beginning January 1, 2017, QualChoice will no longer reimburse providers who bill for send out lab using modifier 90, per CMS guidelines.
Medica August 2016 Provider Newsletter
The August 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Cigna July 2016 Provider Newsletter
The July 2016 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Federated Insurance
Federated Insurance has begun transitioning employer groups from the Midlands Choice network to the UHC Choice Plus network starting July 1, 2016.
City of Charles City
City of Charles City employees in Iowa began to be insured through North Iowa Community Healthcare c/o Auxiant effective July 1, 2016.
Medica July 2016 Provider Newsletter
The July 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica June 2016 Provider Newsletter
The June 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
May 2016
Secure Website Audits Underway
Midlands Choice conducts annual audits to ensure that authorized individuals who currently have access to the secure data on MidlandsChoice.com should continue to have access.
Communicate Demographic Updates
All demographic changes for group practices or specific providers must be communicated to Midlands Choice or your contracting entity.
Cigna April 2016 Provider Newsletter
The April 2016 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Medica May 2016 Newsletter
The May 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica QHP Requirements
The Medica Administrative Manual contains specific Qualified Health Plan (QHP) requirements, including the QHP requirements for Indian Health Care Providers.
Medica April 2016 Newsletter
The April 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Buchanan County
Buchanan County employees in Iowa will be insured through Cedar Valley Community Healthcare c/o Auxiant, a new payer with Midlands Choice, effective April 1, 2016.
Medica March 2016 Newsletter
The March 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
February 2016
A Complete Application is Key to Timely Credentialing
The Midlands Choice credentialing department has shared guidelines to help ensure that credentialing applications are processed in a timely manner.
Provider's Rights During the Credentialing Process
Current and prospective Midlands Choice providers going through the initial or renewal application process have rights granted as an applicant through national credentialing standards.
Office Site and Medical Records
Midlands Choice maintains standards for both office site and medical records that Midlands Choice network providers are expected to meet.
Cigna's DRG Clinical Review Program
Cigna's Diagnosis Related Group (DRG) Clinical Review program evaluates claims data from hospitals that are reimbursed using a DRG payment methodology.
Cigna Changes Coverage for Juxtapid and Kynamro
Starting January 15, 2016, customers with Cigna pharmacy coverage will need to try Repatha.
Cigna Ambulance Services Reimbursement Policy
Effective April 11, 2016, Cigna will update their Ambulance Services Reimbursement Policy (R18) and only reimburse non-emergency ambulance transportation when a hospital is the origin or destination of the service.
Cigna January 2016 Provider Newsletter
The January 2016 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Medica January 2016 Provider Newsletter
The January 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
Medica February 2016 Provider Newsletter
The February 2016 edition of Medica's provider newsletter, Medica Connections, has been published and is available for viewing.
National General Benefits Solutions
National General Benefits Solutions is a new payer with Midlands Choice.
UnityPoint Health Employer Group
The employer group UnityPoint Health became insured through HealthPartners c/o Cigna effective January 1, 2016.
November 2015
Register for an Account on the New MidlandsChoice.com Website
By registering for a secure account on the recently updated MidlandsChoice.com, users can discover the status of claims, get a copy of the repricing face sheet, find out how to contact payers, look up information for employer groups and more - 24 hours a day, 7 days a week.
Nebraska Furniture Mart
The employer group Nebraska Furniture Mart will be insured through Cigna effective January 1, 2016.
Claim Submission Deadline for CoOportunity Health
Pursuant to the Liquidation Order of the Iowa District Court, all claims for healthcare services provided to CoOportunity Health insureds must be submitted by December 15, 2015.
Nebraska Beef, LTD
Employees of Nebraska Beef LTD began accessing coverage through Meritain Health effective November 1, 2015.
Cigna October 2015 Provider Newsletter
The October 2015 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Medica Insure Update
Medica, a new payer with Midlands Choice, will begin marketing to potential members in Nebraska and Iowa beginning November 1, 2015. Medica will be offering individual and family business plans both on and off the Nebraska and Iowa Health Insurance Marketplace under the product name "Medica Insure".
MidlandsChoice.com Browser Support
The MidlandsChoice.com website will not be fully supported when accessed through Internet Explorer versions 7, 8 or 9 beginning on January 12, 2016.
September 2015
ICD-10 Claim Submission Guidelines
Midlands Choice will be compliant in accepting, processing, and transmitting ICD-10 code sets beginning on October 1, 2015.
Metropolitan Community College
A new group with Midlands Choice, Metropolitan Community College, is effective August 15, 2015 through payer AIG Educational Markets.
CoOportunity Health Claims Submittal Deadline
All claims for healthcare services provided to CoOportunity Health members should be submitted by December 15, 2015.
Cigna July 2015 Provider Newsletter
The July 2015 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Register for Access to Secured Tools
Due to the recent updates to MidlandsChoice.com, all past and current users of the website’s secured features must re-register for a secure user account.
May 2015
February 2015
November 2014
August 2014
May 2014
February 2014
1500 v. 02-12 Claim Form
Any paper claims for professional services that Midlands Choice receives submitted on the CMS 1500 (08-05) form after March 31, 2014 will be sent back to the provider requiring that the claim be resubmitted on the 1500 (02-12) form.
Office Site and Medical Records Standards
Midlands Choice maintains standards for both office site and medical records that Midlands Choice network providers are expected to meet.
Provider's Rights during the Credentialing Process
Current and prospective Midlands Choice providers going through the initial or renewal application process have rights granted as an applicant through national credentialing standards.
Revstone Castings Fairfield
Claims for members of Revstone Castings Fairfield must be received no later than March 31, 2014 to be considered for reimbursement.
Cigna's Daily Maximum Limit for Injectable Claims
Cigna will begin requesting additional documentation for injectable claims in certain instances starting on February 17, 2014.
Cigna Launches New Code Editing Software
On February 17, 2014, Cigna began using ClaimsXten, a rules-based software application that evaluates claims for adherence to industry-standard coding practices.
CoOportunity Health February 2014 Provider Alert
The February 2014 CoOportunity Health Provider Alert publication is available for viewing.
CoOportunity Health Unique ID Numbers
CoOportunity Health issues a unique member ID number for each family member, regardless of age.
Aetna Network Change
Effective April 1, 2014 Aetna will no longer be using the Midlands Choice network and contracted pricing.
Cigna's January 2014 Provider Newsletter
The January 2014 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Aetna's 2014 Precertification List
Aetna's 2014 precertification list for participating providers has been published.
Bernie Lowe & Associates 411 Plan
Effective January 1, 2014, Midlands Choice established a new payer relationship with Bernie Lowe & Associates, Inc. to use the Midlands Choice network in the administration of benefits for municipalities located in Iowa covered by the Iowa 411 law.
Aetna's December 2013 Provider Newsletter
The December 2013 issue of Aetna's provider newsletter, Aetna OfficeLink Updates, has been published and is available for viewing.
November 2013
Aetna's September 2013 Provider Newsletter
The September 2013 issue of Aetna's provider newsletter, Aetna OfficeLink Updates, has been published and is available for viewing.
First Administrators, Inc.
The payer First Administrators, Inc. has notified Midlands Choice that they are terminating their relationship with us effective December 31, 2013.
Payer ICD-10 Readiness Survey Results
Midlands Choice recently sent a survey to payers to poll their ICD-10 implementation readiness.
Learn More about CoOportunity Health
More information about CoOportunity Health can be found by visiting their website, www.coOportunityhealth.com/provider.
Cigna's October 2013 Provider Newsletter
The October 2013 issue of Cigna's provider newsletter, Cigna Network News, is available for viewing.
Aetna's Precertification List
Aetna's most recent precertification list for participating providers has been published.
Updated 1500 Claim Form
The National Uniform Claim Committee (NUCC) has announced the approval of the updated 1500 Claim Form that accommodates reporting needs for ICD-10.
Aetna Multiple Procedure Reduction Policy
Effective for dates of service on or after October 1, 2013, Aetna will update their multiple procedure reduction policy, including the reduction percentages for certain therapy procedures.
August 2013
May 2013
February 2013
November 2012
Midlands Choice Partners with Health Alliance
Midlands Choice has formed a relationship with Health Alliance, a large provider‐sponsored health insurer located in Urbana, Illinois.
NPI for Aetna Claims Inquiries and Precertification
The individual provider NPI number should be used for all claims inquiries and precertification requests and inquiries through Aetna.
Wellness Screening for Cigna Members
Starting in December 2012, a new wellness screening program will be available for Cigna patients.
Verifying Benefits through Cigna
There are three different ways to verify Cigna members' eligibility and benefits to learn what services are covered and to avoid claim rejections.
Cigna Precertification Changes
Cigna has updated their precertification list to reflect HCPCS codes released by The Centers for Medicare & Medicaid Services (CMS) on October 1, 2012.
Cigna Clinical, Reimbursement and Administrative Policies
Cigna has planned medical policy updates scheduled to go into effect October 22.
Newly Designed CignaforHCP.com Website
Cigna has redesigned the Cigna for Health Care Professionals website.
Midlands Choice Provider Matching Logic
During October 2012, Midlands Choice will implement updates to the logic that is used to match providers to the correct reimbursement terms in order to improve the accuracy of repricing claims.
Aetna Clinical Payment, Coding and Policy Changes
Aetna has made several clinical payment, coding and policy changes, some of which are effective December 1, 2012.
Changes to Aetna's National Precertification List
Additions, modification and deletions are being made to Aetna's National Precertification List, some of which go into effect on January 1, 2013.
Meritain Members to have Access to Additional Aetna Product
Beginning in January 2013, Meritain members will have access to the Aetna Choice POS II product.
Batch Precert Notification via Aetna EDI Connect
Aetna's direct connect website, EDI Connect, now allows providers to submit batch precertification notifications electronically.
August 2012
Aetna Precertification Updates
Aetna's most current precertification list can be found on Aetna's website. Some additions to the list include medications and medical injectables.
Cigna to Require Precertification for Radiation Therapy
Beginning August 1, 2012, Cigna will require precertification for codes listed on the Radiation Therapy Precertification List for participants covered under plans that are administered by Cigna and that require precertification.
NDC Requirement on Cigna Specialty Medication Claims
Beginning September 1, 2012, in addition to the Healthcare Common Procedure Coding System (HCPCS) code for specialty medications, Cigna will require the National Drug Code (NDC) on some claims.
EOP Upgrade for GWH-Cigna
Cigna has made changes to the appearance of the Explanation of Payment (EOP) for GWH-Cigna patients’ statements.
Cigna’s New Interactive Voice Response System
Cigna is upgrading their interactive voice response (IVR) automated telephone system. The new system will be launched starting in July 2012.
Cigna Precertification Updates
On August 6, 2012, Cigna is updating their list of CPT and HCPCS codes to include additional codes (including pharmacy codes) that will require precertification.
Aetna Clinical Payment, Coding and Policy Changes
Aetna has made several clinical payment, coding and policy changes, some of which are effective September 1, 2012.
Aetna to Require Precertification for Outpatient Infusion
Beginning July 1, 2012, Aetna will require precertification for outpatient infusion of several drug classes.
Aetna to Require Accreditation for In-Office Surgical Pathology
Effective January 1, 2013, Aetna will require practices offering in-office surgical pathology testing to be certified with Clinical Laboratory Improvement Amendments (CLIA) and one additional entity under CLIA.
Change in GWH-Cigna Claims Submission
Effective July 1, 2012, all Great-West Healthcare - Cigna (GWH-Cigna) claims with dates of service of July 1 and forward should be submitted directly to GWH-Cigna at the address shown on the member ID card.
May 2012