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Provider News: 2018

The Winter 2018 Provider Newsletter is Now Available

The Winter 2018 edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available on our website. Learn more about Community HealthChoices, provider education and training opportunities available in 2019, HEDIS chart rev…

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Winter Holidays — Modified Hours of Operation

Please be aware that in observance of the Christmas and New Year holidays, some Health Partners Plans call centers and departments will have modified hours of operation. See below for details. Provider Services Helpline Monday, December 24 - Closed …

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Prior Authorizations for Behavioral Health Transports

Effective immediately, behavioral health transports will not require prior authorization. HPP will pay claims for behavioral health transports without a prior authorization. As a reminder, all Health Partners (Medicaid) ambulance providers must have …

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Opioid Awareness

As a healthcare partner to the community of Philadelphia--where the opioid crisis has affected thousands of families—we are committed to tackling the city’s opioid epidemic along with your help. But there’s a lot of work to be done. In 2016, Philadel…

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Thanksgiving Holiday Hours of Operation / Billing Cycle

In observance of the Thanksgiving holiday, Health Partners Plans will be modifying our claim payment cycle and hours of operation. Claim Payment Cycle Change As a result of the upcoming Thanksgiving holiday, next week’s payment cycle will be reduced,…

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Please take our HPP Provider Communication Survey

Please take a few minutes of your time to complete our online survey intended to solicit your thoughts and ideas about how Health Partners Plans (HPP) can best communicate with your office. As an incentive for completing the survey, each completed re…

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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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Top 5 Tips for Improving Front-Office Customer Service

Some of your Health Partners Plans (HPP) patients may receive a post-visit, telephone survey that asks about their recent experience with your office. We’re measuring patient satisfaction, which encompasses more than the patient-doctor relationship, …

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The April 2018 Provider Newsletter is Now Available

View the April edition of the Health Partners Plans provider newsletter, Providers in Focus. Learn more about what we’re doing to increase member and provider satisfaction, a new Diabetes Prevention Program for Health Partners (Medicaid) members, sp…

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The February 2018 Provider Newsletter is Now Available

The February edition of the Health Partners Plans provider newsletter, Providers in Focus, is now available. In this issue, we provide information about our dental health programs (including our Healthy First Birthday Smile Program and our High-Risk…

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Top 5 Tips for Boosting Member Satisfaction Scores

Starting in March, patients in your practice will receive the CAHPS survey—the Consumer Assessment of Healthcare Providers and Systems survey used to evaluate patient satisfaction. “Getting care quickly” is an important component of the survey, and a…

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Specialist Referral Requirement (Medicare)

We’ve heard your questions regarding the specialist referral requirement, which was effective January 1, 2018, for most Health Partners Medicare members. We’ve updated our list of Frequently Asked Questions (FAQs) on this topic.  As always, a comple…

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