Posted on November 15, 2023
Upgrade to our Core Claims Platform Friday, November 17, through Sunday, November 19, 2023 As part of our continuing commitment to operational improvement, we will be undergoing an upgrade to our Core Claims platform the weekend of Friday, November 17, through Sunday, November 19. As part of this process, all 837 claims files received after […]
Posted on November 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. Cosmetic and Reconstructive Procedures: Coding guidance updated. CPT 15847 not covered for all lines of business. Knee Braces: Clarification HNE’s policy is retired as of 11/1. Please […]
Posted on November 1, 2023
Health New England reviews our benefit plans each year. The below outlines the upcoming changes our Members are seeing during open enrollment. Each plan year has an effective plan date of January 1, 2024. Medicare Advantage: Health New England is closing the Choice (HMO) plan effective 12/31/2023. In addition, below are some copay changes and […]
Posted on November 1, 2023
Back in 2021, with the release of the Division of Insurance Bulletin 2021-09, Health New England aligned our systems to look for the appropriate service codes and diagnosis related to PrEP (Pre-exposure prophylaxis) and respond as preventative care. Once again, with the release of the new ICD diagnosis code Z29.81, we have added it to […]
Posted on November 1, 2023
Health New England has shared, since 2017, our hopes of going paperless and providing all notices, including 60-day change notices electronically. Effective 12/1/2023, Health New England will no longer print and mail the ProviderMatters communications. On this date, you can locate the notices on our public site at http://hnetalk.com/provider/home. Using the search button, you can […]
Posted on November 1, 2023
Health New England is committed to reviewing our internal procedures and defining coverage and billing guidelines with applicable laws and industry standards to ensure our policies are appropriate. To access payment policies, visit healthnewengland.org/Providers/Resources. The following policies were reviewed and updated: Urgent, extended care & walk-in care – reviewed against authorization process Skilled nursing facility […]
Posted on September 29, 2023
Health New England is committed to reviewing our internal procedures and define coverage and billing guidelines with applicable laws and industry standards to ensure our policies are appropriate. To access payment policies, please visit healthnewengland.org/Providers/Resources. The following policies were reviewed and updated: Non-Reimbursed Revenue Code (PP008POL) – no change Modifier (PP040POL) – clarified authorization requirements […]
Posted on September 29, 2023
Health New England reviews our Provider Manual regularly and notifies you when there are updates. Most recently, we made the decision to remove the “Vaccine Policy” from our manual. We released a Vaccine and Immunization Payment Policy back in 2015. This resides with all of our other payment policies at https://healthnewengland.org/Providers/Resources. Since the information is […]
Posted on September 29, 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, […]
Posted on September 29, 2023
It is important for Health New England to hear from our Primary Care Providers and Behavioral Health Providers on the care of your patients as it relates to behavioral health. Your insights allow us to continue providing the best experience with patient care. We will email the survey to your office in the upcoming weeks. […]