{"id":4873,"date":"2019-09-27T15:59:30","date_gmt":"2019-09-27T15:59:30","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=4873"},"modified":"2019-09-27T15:59:30","modified_gmt":"2019-09-27T15:59:30","slug":"cologuard-update-cpt-81528","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/cologuard-update-cpt-81528\/","title":{"rendered":"Cologuard\u00ae Update (CPT 81528)"},"content":{"rendered":"<p><strong>Effective 1\/1\/20, one of our self-funded employer groups, <em>Baystate Health<\/em>, will be covering 100% of the cost of the Cologuard test for their employees and NO prior authorization is needed. <\/strong><\/p>\n<p>As a provider, you will need to see your patient\u2019s member ID card to know if a prior authorization is needed prior to ordering the test.<\/p>\n<ul>\n<li>Baystate Health employees will have the following group numbers; and the claim can be submitted to Health New England without involving eviCore for approval.<\/li>\n<li>S03004 &#8211; BH Silver HMO<\/li>\n<li>S03032 &#8211; BH Gold PHCS PPO<\/li>\n<li>S03033 &#8211; BH Advantage PPO<\/li>\n<li>S03053 &#8211; BH HSA Medical PPO<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>As a reminder, all other Commercial and BeHealthy Partnership members require a proir authorization through eviCore before ordering the test.<\/p>\n<p><strong><br \/>\nEffective 1\/1\/20, our Medicare Advantage members will also require a prior authorization through eviCore before ordering the test.\u00a0\u00a0 <\/strong><\/p>\n<p><strong><em><br \/>\n<\/em><\/strong>For more information, please call Provider Relations at (800) 842-4464, ext. 5000, or send an email to <a href=\"mailto:providerrelations@hne.com\" target=\"_blank\" rel=\"noopener\"><strong>providerrelations@hne.com<\/strong><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Effective 1\/1\/20, one of our self-funded employer groups, Baystate Health, will be covering 100% of the cost of the Cologuard test for their employees and NO prior authorization is needed. As a provider, you will need to see your patient\u2019s member ID card to know if a prior authorization is needed prior to ordering the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4875,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-4873","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2019\/09\/ThinkstockPhotos-151016267-e1569599947573.jpg?fit=800%2C533","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1gB","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/4873","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=4873"}],"version-history":[{"count":1,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/4873\/revisions"}],"predecessor-version":[{"id":4876,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/4873\/revisions\/4876"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/4875"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=4873"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=4873"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=4873"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}