An order of rehabilitation was issued 11/1/16 by the Superior Court of the State of Connecticut naming Commissioner Wade HealthyCT’s rehabilitator. This is the next progression in the orderly run-off of HealthyCT with the primary goal of protecting the policyholders. The Commissioner’s oversight as Rehabilitator makes certain that the covered claims of HealthyCT members will continue to be paid under the terms of the policies and for the duration of those policies. For individual policyholders, coverage remains in effect through December 31, 2016. For employers who renewed their year-long group plans on or before July 1, 2016, coverage for their workers can remain in effect until the end of their policy year, which could be until June 30, 2017. Customers must continue to pay their monthly premium to sustain that coverage and can continue to see their providers and fill their prescriptions with no interruption in service. Pursuant to the Rehabilitation Order, HealthyCT will pay provider claims for all covered services rendered to a HealthyCT member. Providers are prohibited from balance billing members. Under the terms of the Rehabilitation Order all contracted providers are enjoined from terminating their contractual relationship with HealthyCT without the Rehabilitator’s and Court’s consent. Whether you … Read More
Summer 2016 – What the Order of Supervision Means to Your Practice, BRCA Testing, “Surprise Bills,” Provider Manual Updates and more. (Read More)
Spring 2016 – Provider Survey, Disease Management Programs for Members, Check Out Your Provider Manual, Utilization Review Decisions. (Read More)
Radiology Prior Authorization Services On December 1, 2015, HealthyCT partnered with eviCore healthcare to manage prior authorization for radiology services. The list of services requiring a prior authorization has not changed. Authorization is required for: CT/CTA MRI/MRA PET Nuclear Medicine (Click Here to Continue Reading this Important Update)
JOIN US FOR AN UPCOMING WEBINAR: LEARN HOW TO FIND COMMUNITY RESOURCES FOR YOUR PATIENTS 211 CONNECTICUT March 9, 2016 12:00 PM– 1:00 PM Please register for the webinar at this link: https://attendee.gotowebinar.com/register/8448771964885982466 Attend this informative webinar to learn more about the 211 system, available for you and your patients 24 hours a day, 7 days a week, both online and over the phone. Representatives from the United Way will explain how to access the system and how it can benefit your patients. The 211 Connecticut system is a resource to connect with essential health and human services, including: Youth behavioral health crisis intervention Services for children with suspected development delays The food stamp program Medical expense assistance Medical appointment transportation services Prescription assistance programs Nutritional support services such as community food banks We hope you can join us! For questions, please email Sandra Coppola at firstname.lastname@example.org.
CHECK OUT THE NEW PARTICIPATING PROVIDER NEWS! You can read the Winter 2016 issue of Participating Provider News here. This issue features these topics: A Big Leap Forward During 2015 New and Revised Payment Guidelines Important Clinical Updates What Our Quality Improvement Program Means to You Formulary Prior Authorization Requirements Expediting Claims with Unlisted and Unspecified Codes Introducing Teladoc Medical Records Collection Process Preventive Services Update Accumulator Lookup Tool Now Available Using Data to Improve the Quality of Care Claim Submission Timeframes Pharmacy Benefits Manager Transition Where to Send Claims Review Your Provider Directory Listing Recredentialing Process Reminder
The Importance of Proper Coding Coding is critical to obtaining proper reimbursement, maintaining patient records and ensuring a valid record of patient care history. An accurate claim is dependent upon factors such as staying up-to-date on annual coding changes, following standard coding guidelines and keeping detailed patient records. (Read More)
We invite you to participate in a Orthopedic Advisory Group Meeting As a physician or practice manager, you can let us know how we’re doing, what we can do better and how we can help you and your patients. Don’t miss this opportunity, your input is valued! Tuesday, March 22, 2016 – 5:30 PM Connecticut State Medical Society Offices 127 Washington Ave. East Building 3rd Floor North Haven, CT Dinner will be provided The focus of this meeting will be to discuss the bundling of orthopedic services, including your experiences, discharge issues, management of patient choice, etc. Space is limited – to register, click here to fill out the form.