ProviderMatters

Payment Policy (June 2024)

Posted on June 4, 2024

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.

Vaccines & Immunizations Effective 5/1/2024
  • Added Industry Standard Language
  • Added additional language to Non-State Supplied Vaccines under Commercial
  • Conditional Formatting
Inpatient Services  Effective 5/1/2024
  • Updated language under Purpose and Definitions
  • Added MS-DRG & APR-DRG language
  • Conditional Formatting
Skilled Nursing Facility Effective 5/1/2024
  • Updated the first paragraph under All Medicare Advantage Plans under the Indications for Coverage
  • Removed Definitions section
  • Removed outdated coverage requirements and added MDS score requirements under Medicaid
  • Conditional Formatting
Treatment Room Effective 5/1/2024
  • Update to Billing Instruction/Payment section to include Emergency Room within the language
  • Conditional Formatting
Counseling and/or Risk Factor Reduction Intervention Services Effective 5/1/2024
  • Reviewed with no changes
  • Conditional Formatting

 

If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. You may also send an email to providerrelations@hne.com.

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