Posted on October 28, 2022
Health New England reviews our benefit plans each year. Below outlines the upcoming changes our Members are seeing during open enrollment. Each plan year has an effective plan date of January 1, 2023. Worcester County ConnectorCare Changes for 2023 Effective January 1, 2023, Health New England ConnectorCare plans will no longer be available in Worcester […]
Posted on October 28, 2022
As part of our goal to improve how quickly providers obtain information, Health New England offers a 24 hour/7 day a week service to obtain eligibility and claim status through an Interactive Voice Response (IVR) system. This automated phone system technology allows for incoming callers to access information by a voice response system of pre-recorded […]
Posted on October 28, 2022
In the June 2022 Provider Update, we informed our network of some changes to the language within the Commercial Fully Funded Explanation of Coverage (EOC) documents as it relates to what is not covered with Autism Spectrum Disorder. However, without the full description from the EOC, the update may have caused some questions and concerns. […]
Posted on October 28, 2022
EviCore Healthcare, LLC, a national leader in integrated, innovative intelligent care management solutions, collaborates with Health New England in the management of authorizations and reporting for all of our business lines. Through an online portal, our network has the ease of obtaining authorizations for services related to high-cost imaging, a sleep study program and genetic […]
Posted on October 28, 2022
On a regular basis, Health New England reviews our clinical criteria for our Behavioral Health and Medical policies, as well as the criteria for the drugs included in our formulary. This notification outlines changes to those policies recently reviewed. Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org/Providers/Resources. Once on […]
Posted on October 28, 2022
Health New England’s formularies are located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool. Medicaid: No formulary changes for 1/1/23. For additional questions, please call your Provider Relations Representative at (800) 842-4464, extension 5000, or send an email to providerrelations@hne.com.
Posted on October 14, 2022
We are happy to share with you this Special Edition October 2022 to update you on Inpatient Psychiatric Placement from the Emergency Department (ED), an observation unit, or non-psychiatric inpatient. Hospital Emergency Department/Behavioral Health Crisis Intervention Effective beginning with 11/1/2022 dates of service, and in accordance with the Department of Insurance Bulletin 2022-08, Health New […]
Posted on September 28, 2022
Health New England ensures our prescription drug coverage includes brand names and generic prescription medications. Most recently, we reviewed the following brand drugs. To learn more about the coverage, dosage and authorization requirements, reference Health New England’s formularies located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool. For additional […]
Posted on September 28, 2022
Health New England supports providers and members in taking an active role to prevent disease. During this time of year, vaccination against influenza is an important step in prevention. Below are the list of CPT codes to reference and for more information, please go to https://www.cdc.gov/flu/prevent/vaccinations.htm. For additional questions, please call your Provider Relations Representative […]
Posted on September 28, 2022
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, […]