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Providers News: 2017

DHS Requirement Regarding CHIP Enrollment

We want to remind providers that effective January 1, 2018, the Pennsylvania Department of Human Services (DHS) will be implementing a provision of the Affordable Care Act (ACA)1 that will require all providers who order, refer, prescribe or render i…

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The November 2017 Provider Newsletter is Available

The November edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available. In this issue, we provide more information on the new Medicare referral requirement for specialists and upcoming webinars where you can learn…

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Specialist Referral Requirement (Medicare)

Effective January 1, 2018, Health Partners Plans will require specialist referrals for most Health Partners Medicare members. To help prepare for this new requirement, review our list of Frequently Asked Questions, “FAQs,” related to this new require…

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Prior Authorizations for Opioid Prescriptions

The Pennsylvania Department of Human Services (DHS) mandates that all Medicaid managed care organizations (MCOs) in Pennsylvania implement prior authorization requirements for opioid prescriptions. These include prior authorization requirements for M…

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Implementation of the 2017 InterQual Criteria

As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria* as a guideline for making medical necessity determinations. This week we successfully resolved a technical issue that had delayed the implementation of the 2017 criteria past …

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The September 2017 Provider Newsletter is Now Available!

The September edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available on our Provider Newsletters web page. In this September edition, we provide information regarding DHS enrollment requirement for ordering, r…

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ONAFs Now Online

To help you transition to the online submission process for ONAFs, we’re offering a one-time incentive for ONAFs submitted via the Optum cloud (obcare.optum.com) between September 1, 2017, and December 31, 2017. Learn more below or by referring to a …

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Top Five Ways to Prepare for Back-to-School Season

We value the vital role you play in helping to improve the health outcomes of our members. This time of year we want to help your office get "back-to-school" ready. Read more for some tips to help the kids in your care have a healthy year‒from immuni…

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The July 2017 Provider Newsletter is Now Available

The July edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available on our website here. In This Issue: CAHPS and HOS Spotlight: HPP Resources to Improve Patient Care Clinical Review Process: Implementation of…

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Quality Management Program Resources Available Online

Health Partners Plans (HPP) has a Quality Management (QM) program in place to ensure that our members receive safe, effective, timely and patient-centered clinical care. Throughout the year, we monitor the delivery of health care for our members and …

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FDA Warning Regarding Inaccurate Lead Tests

Please be aware that the U.S. Food and Drug Administration (FDA) issued a safety communication on Wednesday, May 17 that warns about the use of Magellan Diagnostics’ LeadCare® analyzers (LeadCare, LeadCare II, LeadCare Ultra and LeadCare Plus) with v…

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The May 2017 Provider Newsletter is Now Available

The May edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available on our website. In This Issue: Provider Survey Now Available: Improving the Way We Communicate Medicare Provider Compliance Attestation Key H…

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Maximum Authorization Periods Extended

We are happy to announce that, effective immediately, Health Partners Plans (HPP) will be extending the length of the maximum authorization period — when deemed medically necessary — for select ancillary services and DME purchases and rentals. In or…

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