Posted on May 9, 2018
Effective July 1, 2018, Health New England will partner with Northwood, Inc., to manage durable medical equipment, prosthetic, orthotic and medical supply (DMEPOS) for all members. Under this new relationship, Northwood will manage a full range of services in order to administer our DMEPOS benefit, including: • Prior authorization of DMEPOS • Claims processing and […]
Posted on May 9, 2018
As you know, the Centers for Medicare & Medicaid Services (CMS) replaced the Social Security number on their Medicare cards with a unique, ramdomly-assigned number called a Medicare Beneficiary Identifier (MBI) in an effort to combat identity theft, and safeguard taxpayers dollars. These new Medicare cards started mailing April 2018, and the plan is to […]
Posted on May 9, 2018
Health New England is continuing our efforts to educate our Medicare members the importance of scheduling their annual wellness visit. We are asking them to schedule their appointments using the “wellness visit” language so providers know when to submit claims under the Medicare HCPCS Codes G0402, G0438 and G0439. More information related to this program […]
Posted on May 9, 2018
As a reminder, the continuity of care period began March 1. For members and providers who need additional time to complete the transition process, Health New England is working with you to ensure uninterrupted care and continued coverage for members through May 31. For behavioral health, continuity of care remains at 90 days (May 31). Some important […]
Posted on May 9, 2018
Health New England’s 2018 formularies are available on healthnewengland.org. We encourage Providers to utilize the online formularies, which are accessible to all users without a login or password. The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and […]
Posted on May 9, 2018
To access Health New England’s Clinical Policies, go to our Provider Resources page at healthnewengland.org/Providers/Resources. On the Resources page, click on “Behavioral Health/Medical Policies.” Most recently, the following policies have been released and/or reviewed: • Formula and Enteral Nutrition • Female Reduction Mammoplasty and Breast Reconstruction • High Frequency Chest All Oscillation Devices • Long-Term […]
Posted on February 27, 2018
Please review the Health New England Provider Alert 51 “ACO Continuity of Behavioral Health Care” issued to the behavioral health provider network by the Massachusetts Behavioral Health Partnership (MBHP) on behalf of Health New England. The Health New England Be Healthy MCO will end on February 28, 2018, but MBHP will continue to manage behavioral […]
Posted on February 13, 2018
Health New England is committed to keeping all of our providers informed of plan changes and other updates related to our lines of business. We would like to inform you of an upcoming change in our Medicaid business. Earlier this year, we were informed by MassHealth that Health New England has not been awarded a new […]
Posted on January 24, 2018
Dear Providers – As a friendly reminder, Health New England requires prior authorization before prescribing short-acting opioids through OptumRx. This has been in effect since January 1, 2017. You can access the following medication request form to request authorization here. This form can be faxed directly to OptumRx at 1-800-550-9246.
Posted on December 7, 2017
The following chart defines the changes to the Be Healthy/Medicaid prescription drug coverage, effective 1/1/2018. These changes are included in members’ coverage notices.