Posted on July 31, 2017
Referring providers and laboratories may submit prior authorization requests or verify authorization status by contacting eviCore as follows: Online by visiting eviCore’s website at: www.evicore.com and logging into the Provider login after completing a free registration. The site is available 24 hours a day, 7 days a week and it is possible to obtain immediate authorization […]
Posted on July 31, 2017
Health New England is pleased to announce the launch of our Laboratory Management Program. We have partnered with eviCore healthcare to provide prior authorizations of certain outpatient Molecular and Genomic tests. Effective, October 1, 2017, ordering providers must contact eviCore to obtain prior authorization for the molecular and genomic tests. The performing laboratory may also […]
Posted on June 29, 2017
Health New England’s formularies can be accessed on healthnewengland.org using the “Find A Drug” tool at the top of the page. 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 Be Healthy/Medicaid. Each formulary includes the tier […]
Posted on June 29, 2017
Did you know you can access Health New England’s Clinical Policies on 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: Behavioral Health – Effective 09/01/2017 Applied Behavioral Analysis for Autism Spectrum Disorders Clinical Review Criteria related to Transcranial […]
Posted on May 30, 2017
The chart below defines the changes to the Be Healthy/Medicaid prescription drug coverage, effective 07/01/2017. These changes are included in the members’ coverage notice. Be Healthy/Medicaid Prescription Drug Coverage Step Therapy drug changes effective July 1, 2017: For Health New England (HNE) to cover the Step Therapy drugs listed here, you first must try the corresponding First […]
Posted on May 30, 2017
Health New England’s formularies can be accessed on healthnewengland.org using the “Find A Drug” tool at the top of the page. 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 Be Healthy/Medicaid. Each formulary includes the tier […]
Posted on May 30, 2017
Additional drugs have been added to the MagellanRx Management code list, which outlines all drugs requiring authorization through the Magellan program. The new codes consist of the following therapeutic classes: oncology, enzyme replacement, asthma and hemophilia. Please remember, all urgent requests for authorization can be requested through the MagellanRx customer service line. However, the preferred […]
Posted on May 30, 2017
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 May 30, 2017
Did you know you can access Health New England’s Clinical Policies on our Provider Resources page at healthnewengland.org/Providers/Resources? Once on the Resources page, click on “Behavioral Health/Medical Policies.” Most recently, the following policies have been released and/or reviewed: Behavioral Health – Effective 07/01/2017 Neuropsychological Testing – Updates to Prior Authorization Requirements for Medicare. Medical Guideline […]
Posted on May 30, 2017
Effective 08/01/2017, Health New England is announcing a refined version of our current Evaluation & Management Payment Policy. With our continued commitment to become more in line with the industry, our Payment Policy Committee worked to develop a new version of the Health New England Evaluation & Management Payment Policy. It is our goal to develop […]