Posted on October 17, 2018
In our continued effort to go green, our Medicare Advantage members only received an Annual Notice of Change document, explaining the changes to their plan for the upcoming 2019 year. As of September 30, 2018, members had access to www.healthnewengland.org/members/eoc to view and download a copy of their Evidence of Coverage (EOC). They can also […]
Posted on October 17, 2018
As of October 1, Northwood, our durable medical equipment benefit manager, started managing a range of services and providers types for DMEPOS on behalf of Health New England. For more information on managed codes and how to reach Northwood, please go to healthnewengland.org/provider/resources and reference Durable Medical Equipment.
Posted on June 22, 2018
Health New England is experiencing EDI transaction connectivity issues. We appreciate your patience as we work diligently to rectify the situation.
Posted on May 9, 2018
To ensure our compliance with HIPAA, Health New England strengthened its eligibility access controls to make sure that only those individuals who have the right to this information have access to the information. Over the last few days, we received feedback from our network providers and we also further evaluated other options to satisfy these […]
Posted on May 9, 2018
Effective July 1, 2018, Health New England will partner with Northwood, Inc., to manage durable medical equipment, prosthetic, orthotic and medical supply (DMEPOS) for all members. Under this new relationship, Northwood will manage a full range of services in order to administer our DMEPOS benefit, including: • Prior authorization of DMEPOS • Claims processing and […]
Posted on May 9, 2018
As you know, the Centers for Medicare & Medicaid Services (CMS) replaced the Social Security number on their Medicare cards with a unique, ramdomly-assigned number called a Medicare Beneficiary Identifier (MBI) in an effort to combat identity theft, and safeguard taxpayers dollars. These new Medicare cards started mailing April 2018, and the plan is to […]
Posted on May 9, 2018
Health New England is continuing our efforts to educate our Medicare members the importance of scheduling their annual wellness visit. We are asking them to schedule their appointments using the “wellness visit” language so providers know when to submit claims under the Medicare HCPCS Codes G0402, G0438 and G0439. More information related to this program […]
Posted on May 9, 2018
As a reminder, the continuity of care period began March 1. For members and providers who need additional time to complete the transition process, Health New England is working with you to ensure uninterrupted care and continued coverage for members through May 31. For behavioral health, continuity of care remains at 90 days (May 31). Some important […]
Posted on May 9, 2018
Health New England’s 2018 formularies are available on healthnewengland.org. We encourage Providers to utilize the online formularies, which are accessible to all users without a login or password. The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and […]
Posted on May 9, 2018
To access Health New England’s Clinical Policies, go to 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: • Formula and Enteral Nutrition • Female Reduction Mammoplasty and Breast Reconstruction • High Frequency Chest All Oscillation Devices • Long-Term […]