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Implementation of the 2018 InterQual Criteria

As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria as a guideline for making medical necessity determinations. Effective November 15, 2018, we will implement the 2018 InterQual criteria in these modules: Acute Adult Criteria Ac…

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Home Health Prescribing by Non-Physicians

As a reminder, the Pennsylvania Department of Human Services (DHS) requires all home health services provided under the state’s Medicaid Program/HealthChoices — including certain durable medical equipment (DME), appliances and medical supply items — …

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Improve Health Outcomes with Preventive Screenings

Many patients are unsure of the benefits of preventive screenings. Engage with patients about which screenings and preventive health measures are right for them. Some of these screenings may be part of your practice’s Quality Care Plus (QCP) program,…

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Provider Manual Update Notification

Please be aware that we have made a series of updates to our HPP Provider Manual, effective July 1, 2018. Below is a short summary of these updates. Chapter 10: Employee Screening Standards Based on input from the Department of Human Services (D…

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The June 2018 Provider Newsletter is Now Available

View the June edition of the Health Partners Plans provider newsletter, Providers in Focus. Learn more about specialist referral requirements in the HP Connect provider portal, substance use disorder and pregnancy, changes to Medicare opioid guideli…

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