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Provider News: 2020

Year-End Claim Payment Cycles

Due to the Christmas and New Year holidays and our year-end closing process, Health Partners Plans will modify its year-end claim payment cycles. For those who receive electronic funds transfer (EFT), you can expect to receive payment on Thursday, De…

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COVID-19 Vaccine Administration Information

Please see the table below for the appropriate procedure codes to be used when billing Health Partners Plans (HPP) for the administration of COVID-19 vaccines administered to HPP members and the reimbursements applicable to those codes. HPP will foll…

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The Winter Issue of Provider Check Up is Now Available!

The Winter edition of the Health Partners Plans provider newsletter, Provider Check Up, is now available on our website. Learn more about provider services and support, member benefits, upcoming education and training opportunities, disease/condition…

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Expansion of CHIP Program Offering

We are excited to announce that Health Partners Plans (HPP) is expanding our Children’s Health Insurance Program (CHIP), KidzPartners, into your neighborhood. We have received approval from the Pennsylvania Departments of Health (DOH) and of Human Se…

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eviCore Portal Enhancements

You may have noticed a recent change in the eviCore portal that enhances the user experience. Health Partners Plans is working with eviCore to streamline the prior authorization process by using the new eviCore intelliPath technology with natural lan…

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Spirometry Testing in Primary Care

Chronic obstructive pulmonary disease (COPD) is a progressive, irreversible respiratory condition. According to the NIH, it is the third leading cause of the death in the United States. Spirometry testing is recommended by the Global Initiative for C…

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The Fall Issue of Provider Check Up is Now Available!

The Fall edition of the Health Partners Plans provider newsletter, Provider Check Up, is now available on our website. Learn more about provider services and support, member benefits, upcoming education and training opportunities, disease/condition r…

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NCQA Announces Changes and Adjustments

On July 1, 2020, the National Committee for Quality Assurance (NCQA) announced adjustments to 31 Healthcare Effectiveness Data and Information Set (HEDIS) measures to support the use of telehealth during and after the coronavirus (COVID-19) pandemic.…

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The Spring Issue of Provider Check Up is Now Available!

The Spring edition of the Health Partners Plans provider newsletter, Provider Check Up, is now available on our website. Learn more about provider services and support, member benefits, upcoming education and training opportunities, disease/conditio…

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Tri-Tech Health Announcement

Health Partners Plans is partnered with Tri-Tech Health, a Mobile Telehealth Wound Management Provider who provides wound care directly in the member's home under the guidance of a Board Certified Wound Care Clinician. You can refer patients who may…

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Provider Check-In

At HPP, we are saddened by the national events from the past week and what is happening locally from the past 72 hours. We are all experiencing an incredibly painful and disturbing time in our nation’s history. We are very concerned about how these …

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InterQual Criteria

Health Partners Plans values your participation and we're always working to provide clear, consistent utilization management guidance. As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria as a guideline for making medical necessi…

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Health Partners (Medicaid) CG&A Change

Effective February 28, 2020, when a Health Partners (Medicaid) member files a First Level Complaint or Grievance, they will be given at least 10 days written, advanced notice of the date, time and place of the review. This extended timeframe will giv…

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