Posted on March 12, 2020
Effective May 12, 2023 – Changes to Over-the-Counter COVID-19 Test Kit Coverage Health New England covered the costs of FDA-authorized, rapid, at-home COVID-19 tests and will continue to cover until the end of the public health emergency (PHE), which will end on May 11, 2023. Any reimbursement requests for test kits purchased before May 12, […]
Posted on January 24, 2018
Dear Providers – As a friendly reminder, Health New England requires prior authorization before prescribing short-acting opioids through OptumRx. This has been in effect since January 1, 2017. You can access the following medication request form to request authorization here. This form can be faxed directly to OptumRx at 1-800-550-9246.
Posted on December 7, 2017
Attention Practice Managers: Accurate provider/pharmacy directories are critical to helping our members make educated decisions about their plan choices. Health New England offers an online directory for all of our products. In addition, hard copies of each directory are available upon request. In an effort to support both CMS and NCQA requirements, we reach out […]
Posted on December 7, 2017
Because CPT code 90756 (Flucelvax ccIIV4) is not effective until 1/1/18, Health New England will require this flu shot to be billed with HCPCs code Q2039 for dates of service up to and including 12/31/17. For dates of service on or after 1/1/18, this flu shot should be billed with 90756. This applies to both […]
Posted on June 29, 2017
Did you know you can access Health New England’s Clinical Policies on our Provider Resources page at healthnewengland.org/Providers/Resources? On the Resources page, click on “Behavioral Health/Medical Policies.” Most recently, the following policies have been released and/or reviewed: Behavioral Health – Effective 09/01/2017 Applied Behavioral Analysis for Autism Spectrum Disorders Clinical Review Criteria related to Transcranial […]
Posted on May 30, 2017
Did you know you can access Health New England’s Clinical Policies on our Provider Resources page at healthnewengland.org/Providers/Resources? Once on the Resources page, click on “Behavioral Health/Medical Policies.” Most recently, the following policies have been released and/or reviewed: Behavioral Health – Effective 07/01/2017 Neuropsychological Testing – Updates to Prior Authorization Requirements for Medicare. Medical Guideline […]
Posted on May 30, 2017
Effective 08/01/2017, Health New England is announcing a refined version of our current Evaluation & Management Payment Policy. With our continued commitment to become more in line with the industry, our Payment Policy Committee worked to develop a new version of the Health New England Evaluation & Management Payment Policy. It is our goal to develop […]
Posted on December 5, 2016
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice. If you have any questions about the information in this notice, please contact Health New England Provider Relations at (800) 842-4464, extension 5000. A representative is available Monday through Friday […]
Posted on December 5, 2016
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice. If you have any questions about the information in this notice, please contact Health New England Provider Relations at (800) 842-4464, extension 5000. A representative is available Monday through Friday […]
Posted on July 13, 2016
In response to the continued impact of the opioid crisis, Health New England is providing substance use disorder evaluation coverage to our plan members. As part of recently enacted Massachusetts legislation (Chapter 52 of the Acts of 2016, An Act Relative to Substance Use, Treatment, Education and Prevention), Health New England is in compliance with […]