Provider News: 2020
Year-End Claim Payment Cycles
December 22, 2020
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…
COVID-19 Vaccine Administration Information
December 21, 2020
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…
The Winter Issue of Provider Check Up is Now Available!
December 10, 2020
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/conditio…
Expansion of CHIP Program Offering
November 23, 2020
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…
eviCore Portal Enhancements
November 20, 2020
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…
Spirometry Testing in Primary Care
October 20, 2020
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 …
HealthRules Payor—New Claims Platform Implementation for Medicare
October 8, 2020
We continue our transition to our new claims processing platform called HealthRules Payor (HRP). We moved our entire KidzPartners (CHIP) product on October 1, 2019 and our Health Partners (Medicaid) product on May 1, 2020 and are now ready to migrate…
The Fall Issue of Provider Check Up is Now Available!
September 22, 2020
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 …
NCQA Announces Changes and Adjustments
August 19, 2020
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.…
Improving Provider P4P Measures Webinar: Medication Adherence for Members with Chronic Conditions
July 13, 2020
As part of our ongoing efforts to assist you in improving your patients’ health outcomes, member satisfaction and maximizing your performance in our Provider Quality Care Plus (QCP) program, HPP invites you and your team to join us for our new qualit…
The Spring Issue of Provider Check Up is Now Available!
July 1, 2020
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…
Tri-Tech Health Announcement
June 23, 2020
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…
Provider Check-In
June 3, 2020
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 …
2020 Rewards Now Available for Health Partners, KidzPartners Members
May 29, 2020
HPP is excited to announce that HPP Rewards, our popular incentive program for Health Partners (Medicaid) and KidzPartners (CHIP) members, is continuing in 2020. All Medicaid and CHIP members will receive reward points for completing specific health …
InterQual Criteria
May 29, 2020
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…
HealthRules Payor—New Claims Platform Implementation for Medicaid
April 22, 2020
We continue our transition to our new claims processing platform called HealthRules Payor (HRP). We moved our entire KidzPartners (CHIP) product on October 1, 2019 and are now ready to migrate our Health Partners (Medicaid) product on May 8, 2020. H…
HPP Changing Telehealth Services Requirements in Response to COVID-19
March 16, 2020
As the response to COVID-19 continues to evolve, Health Partners Plans (HPP) wants to assure our members continue to have access to the care they need. We understand the direction from state and federal agencies continues to change and we want and ne…
Health Partners (Medicaid) CG&A Change
February 25, 2020
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…