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
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)
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)
Russell J. Munson, M.D., Chief Medical Officer at HealthyCT, contributed an article to the November 2015 publication of Medical Home News (page 3). Read the publication here.
To read the Provider Update from October 2015, click here.
HealthyCT is ready to comply with ICD-10
Please read for more information about the May issue of Participating Provider News and the June Better Health Conference.
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