Posted on June 30, 2023
In the coming months, you will notice some changes occurring with how Health New England manages the care for sleep apnea. Beginning August 1, 2023, you will no longer need to obtain a prior authorization for home sleep apnea testing. Those codes consist of: G0398 G0399 G0400 95806 95801 95800 Additional information will be […]
Posted on June 30, 2023
Attention Providers and Practice Managers: Accurate provider directories are critical to helping our members make educated decisions about their plan choices. Health New England offers an online directory for all products, and hard copies of each directory are available upon request. In an effort to support the Centers for Medicare & Medicaid Services (CMS), MassHealth, […]
Posted on June 30, 2023
Quality of care for our members is a priority. This is why we require ACR accreditation when performing high cost imaging services. When the accreditation evaluation is complete or when you renew, a certificate is awarded to you. As a reminder, this certificate is as important to Health New England and our Care Management Solutions […]
Posted on May 2, 2023
Health New England periodically reviews their online site to ensure the resources provided are accurate and up-to-date. With that stated, the following adjustments were made on https://healthnewengland.org/Providers/Resources. Care Management Solutions (eviCore): We added a grid to help clarify the prior authorization time span from approval to rendering the services. Durable Medical Equipment (DME): We added […]
Posted on May 2, 2023
As communicated in January 2023, Health New England shared with our network that we will cover abortions and abortion-related services in accordance with the Division of Insurance. http://hnetalk.com/provider/division-of-insurance-notifications-1-23/ With the recent Bulletin 2023-10 – Executive Order No. 609 – Protecting Access to Medication Abortion Services in the Commonwealth, released April 14, 2023, Health New England […]
Posted on May 2, 2023
Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org/Providers/Resources. Once on the Resources page, click on Behavioral Health/Medical Policies to learn more. *Please note, new/revised policies may not appear until closer to the effective date. Below is a list of codes reviewed and determined to fall within our Non-Covered, Experimental […]
Posted on March 29, 2023
Health New England is committed to reviewing our internal procedures and defining coverage and billing guidelines with applicable laws and industry standards to ensure our policies are appropriate. To access payment policies, please visit healthnewengland.org/Providers/Resources. The following policy was reviewed and updated: Evaluation and Management Professional Services – The policy was updated to align with […]
Posted on March 29, 2023
Health New England reviews our provider manual regularly and notifies you when there are updates. Most recently, we updated the Reimbursement and Claim Submission section, as well as the HNE BeHealthy Addendum. Go to https://healthnewengland.org/provider-manual to learn more. In the Billing and Reimbursement section, http://healthnewengland.org/providers/provider-manual/billing-reimbursement, under Reimbursement and Claims Submission, we added clarification on the […]
Posted on March 29, 2023
Attention Providers and Practice Managers: Accurate provider directories are critical to helping our members make educated decisions about their plan choices. Health New England offers an online directory for all products, and hard copies of each directory are available upon request. In an effort to support the Centers for Medicare & Medicaid Services (CMS), MassHealth, […]
Posted on March 29, 2023
Health New England’s formularies are located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool.