Important Provider Updates from Health New England
Posted on May 31, 2016
Please read the following to learn more about the important updates, which may have an impact on your practice:
- Adolescent Well-Care Visit Incentive Program
- Medical and Behavioral Health Clinical Policy Updates
- Provider Directory Data Validation
Do you service Medicaid adolescents for Well-Care Visits?
Health New England is launching an incentive program for our Medicaid adolescent members and we need your help. This program is designed to increase HEDIS compliance rates for adolescent members, ages 11 to 21.
Adolescents who schedule and keep their Well-Care Visit appointments through the end of 2016 will receive a $10 gift card from Health New England. Our targeted go-live date is July 1, 2016.
We would love to partner with you and other primary care physicians in our community. We are excited to meet with you to go over the program and understand how we can work together to make it a success. To schedule a meeting or if you would like more information, please contact Provider Relations at (800) 842-4464, ext. 5000.
Clinical criteria updates for Medical and Behavioral Health
Health New England has recently reviewed our required clinical criteria related to Medical and Behavioral Health policies. All updates included in the criteria below are effective August 1, 2016.
For full copies of these criteria, please visit healthnewengland.org/provider/resources. They are listed under “Medical Policies:”
- Dermal Injections for the Treatment of Facial Lipodystrophy Syndrome
- High Frequency Chest Wall Oscillation (HFCWO) Devices
- Applied Behavioral Health Analysis (ABA) for Autism Spectrum Disorders (ASD)
Calling all practice managers! Provider/pharmacy directory information must be validated.
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 are reaching out to our In-Network Providers on a quarterly basis to validate information. We are asking for validation of the following, but not limited to address, phone number, office hours, availability to new patients, etc.
Please communicate any updates to Health New England in one of the following three ways:
- Visit our Forms library at healthnewengland.org/forms. Click on the “Providers” tab, then “Most Used” and choose the “Provider Information Change Form.” This form can also be accessed directly here.
- Email our Provider Enrollment team directly at penrollment@hne.com.
- Log into HNEDirect at hnedirect.com/login. Once you are logged in, click the last tab on the main page entitled “Change Provider Info.”If you have any questions regarding the information in this letter, please contact Provider Relations at (800) 842-4464, ext. 5000. A representative is available Monday – Friday, 8:00 a.m. – 5:00 p.m.
