Posted on August 31, 2023
Effective November 1, 2023, Health New England’s filing limits will change unless otherwise noted in your contract. This change will affect the claim submission timeline for all providers doing business with Health New England, except under the Medicare product line. In addition, we will be adjusting some of our filing limits as it pertains to […]
Posted on August 31, 2023
Effective September 1, 2023, for high-cost imaging authorizations, Health New England and eviCore Healthcare have decided to return to the 60-day period from approval time of authorizations to rendering the services for all lines of business. For more information, please do not hesitate to call your Provider Relations Representative at (800) 842-4464, extension 5000, or […]
Posted on August 31, 2023
Health New England is committed to reviewing our Resource Center to ensure the accuracy of information. The following will be updated: “Magellan Site of Service” at healthnewengland.org/Providers/Resources will be updated to clarify the program is applicable to Fully Funded Commercial Members in both the HMO and PPO benefit plans. For more information, please do […]
Posted on August 31, 2023
As a courtesy, we are sharing the following: Effective October 1, 2023, Northwood, our durable medical equipment benefit manager (DBM), will now manage PAP authorizations for Health New England. Previously, Northwood’s DME provider network would work with eviCore on authorizations. Both Health New England and Northwood released notification of this transition to eviCore and the […]
Posted on August 1, 2023
Health New England partners with Northwood, Inc., our durable equipment benefit manager, for authorizations. This includes the management of durable medical equipment (DME), medical supplies, prosthetic and orthotic for all our members. It is important to know that timely and complete submission of clinical documentation to support medical necessity is key to receiving faster responses […]
Posted on August 1, 2023
Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org/Providers/Resources. Once on the Resources page, click on Behavioral Health/Medical Policies to learn more. For more information, please do not hesitate to call your Provider Relations Representative at (800) 842-4464, extension 5000, or send an email to providerrelations@hne.com. *Please note, new/revised policies […]
Posted on June 30, 2023
Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org/Providers/Resources. Once on the Resources page, click on Behavioral Health/Medical Policies to learn more. We reviewed the following policies with no substantial changes. We either moved the content into our new template or retired the policy. For more information, please do not […]
Posted on June 30, 2023
Health New England reviews our formulary and makes necessary changes. Health New England’s formularies are located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool. For more information, please do not hesitate to call your Provider Relations Representative at (800) 842-4464, extension 5000, or send an email to providerrelations@hne.com.
Posted on June 30, 2023
In the coming months, you will notice some changes occurring with how Health New England manages the care for sleep apnea. Beginning August 1, 2023, you will no longer need to obtain a prior authorization for home sleep apnea testing. Those codes consist of: G0398 G0399 G0400 95806 95801 95800 Additional information will be […]
Posted on June 30, 2023
Attention Providers and Practice Managers: Accurate provider directories are critical to helping our members make educated decisions about their plan choices. Health New England offers an online directory for all products, and hard copies of each directory are available upon request. In an effort to support the Centers for Medicare & Medicaid Services (CMS), MassHealth, […]