Posted on February 8, 2011
Dear Provider: Recently, we sent you a notice that described our new modifier 25 payment policy. Based on your feedback, we would like to provide additional details about the policy. The modifier 25 policy applies primarily to Primary Care Physicians (PCPs) and Pediatricians. It involves a limited set of codes when these codes are billed […]
Posted on January 28, 2011
Please click on this link to view a recent notice that went out regarding udpates to our online formulary. Provider letter for 201010_1 (2)
Posted on January 12, 2011
IN-PLAN PROVIDERS: If you have not registered for HNEDirect please do so at: https://www.hnedirect.com/login/index.aspx and click on “Need to Register”. Once you are logged in to HNEDirect, you can locate the EOP option under the “Reports” tab. You can search the EOP by the trace number on your check. OUT-OF-PLAN PROVIDERS: Out-of-Plan Providers do not […]
Posted on December 14, 2010
MedSolutions has taken over the Radiology Management Program previously handled by N.I.A. as of 12/1/10. Below is their contact information: Call Center: 888-693-3211 (8 a.m. to 9 p.m. EST Mon-Fri) Online Web Portal: www.medsolutionsonline.com
Posted on December 10, 2010
Attached please see memo regarding recent changes to the Acute Inpatient Hospital Coverage Limit. 20 day acute hospital MCO QA (120810) (2)
Posted on December 10, 2010
Below please find the most current update for the 2010-2011 MHQP Preventive Care Guidelines MHQP Pedi (Rev 09-10)-11-29 Pediatric/Routine Preventive Care Recommendations MHQP Adult (Rev 09-10) copy12-3 Adult Routine Preventive Care Recommendations MHQP_DeskGuides_adult-pedi-10-11 MHQP Desk Guides mm5901-Immunization Recommended Adult Immunization Schedule DPH Child and Adol Imm Schedule 2010 Recommended Immunization Schedule for Persons Aged 0 […]
Posted on December 6, 2010
(Not applicable to Medicare Advantage or Be Healthy plans) Attached is the Member Notice of Changes that went out to our Commercial population regarding upcoming Formulary changes. This is information your offices should find helpful. ff-0111-rxonly
Posted on November 12, 2010
*This post does NOT apply to Medicare Advantage beneficiaries* Please click on the link below to view the Statin Program letter that is being mailed out to approximately 1500 HNE members that are currently filling the following medications: Altoprev Crestor 5mg, 10mg, 20mg Lescol 20mg, 40mg Lescol XL 80mg Lipitor 10mg, 20mg, 40mg Pravachol 40mg […]
Posted on November 12, 2010
Complete Diagnosis Submission Improves Quality and Care Have you ever shot eight out of ten free throws in a row and had no one to witness your accomplishment? Ever make that incredible putt and no one in your group was paying attention? That’s what happens when a physician completes a thorough evaluation but doesn’t document […]
Posted on November 9, 2010
Click on the link below to find out more information on our HNE Medicare Advantage-Home Assessment Program. Medicare Advantage-Home Assessment Program