Posted on January 8, 2019
As you may or may not know, Health New England has an automated review of claims against accepted industry rules and coding guidelines. The sources for coding rules and edits may include, but are not limited to, the following: CPT, ICD, CMS and Health New England Payment Policies. This automated update and review takes place […]
Posted on January 8, 2019
Health New England is committed to defining, reviewing and informing coverage and billing guidelines to be more in line with the industry. To access payment policies, please visit healthnewengland.org/Providers/Resources.
Posted on January 8, 2019
Attention Practice Managers: 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 reach out […]
Posted on January 8, 2019
With the new year upon us, this is when most updates take place. Please note that eviCore is updating its prior authorization list, and starting January 1, 2019, you will need to reference the Lab Grid as additional updates will take place. As always, if you have questions, please call your Provider Relations team at […]
Posted on January 8, 2019
Recent guidance on safe use of Opioid pain medication for Medicare Part D patients was released from the Centers for Medicare & Medicaid Services (CMS). Please see the enclosed policy. If there are specific questions, please feel free to reach out to our Pharmacy team at (413) 787-4004. Effective January 1, 2019.
Posted on December 5, 2018
Health New England is committed to defining, reviewing and informing coverage and billing guidelines to be more in line with the industry. To access payment policies, please visit healthnewengland.org/Providers/Resources.
Posted on December 5, 2018
As you may or may not know, Health New England has an automated review of claims against accepted industry rules and coding guidelines. The sources for coding rules and edits may include but are not limited to the following: CPT, ICD, CMS and Health New England Payment Policies. This automated update and review takes place […]
Posted on December 5, 2018
Reminder for Medicare Providers: As a reminder, Federal law prohibits Medicare providers from collecting Medicare Part A and Medicare Part B deductibles, coinsurance or copayments from those enrolled in the Qualified Medicare Beneficiaries (QMB) program, a dual eligible program that exempts individuals from Medicare cost-share liability. If you are a Medicare provider and have any […]
Posted on December 5, 2018
Attention Practice Managers: 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 reach out […]
Posted on December 5, 2018
Health New England has joined with other HCAS member health plans to use DirectAssure® to improve the quality and timeliness of health care provider directories. The DirectAssure® solution works within the current workflow of CAQH ProView®, an online database that allows you to input professional and practice information one time and then share it with […]