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Provider News: 2021

New PO Box for Paper Claims Submissions

Although Health Partners Plans (HPP) prefers that providers submit claims electronically using our Payer ID #80142, we recognize some providers may need to submit paper claims. Effective 1/1/2022, HPP will be changing our address for all paper claim …

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The Winter Issue of Provider Check Up is Available Now!

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…

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Update on InterQual Criteria

Health Partners Plans values your participation and is 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 necessity …

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Telehealth Policy Update (Health Partners Medicare)

Please be aware that HPP has created a telehealth policy (RB.021.A: Professional Telehealth Services Medicare) that impacts our Health Partners Medicare line of business. The updated policy can be found at our Policy Library. We are working on updat…

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Refer Your Adult Medicaid Patients to MANNA Today

Health Partners Plans (HPP) is dedicated to ensuring the health and wellness of our members. Since 2015, HPP has partnered with MANNA to provide medically tailored meals for our Health Partners (Medicaid) members with complex health care needs as wel…

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The Fall Issue of Provider Check Up is Available Now!

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 …

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Reminder: Request Prior Authorization for Synagis

Respiratory syncytial virus (RSV) cases usually begin to be reported in the fall and taper off in the spring. According to the American Academy of Pediatrics (AAP), it isn’t know if RSV cases will increase during the fall and into winter, and it is n…

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Upcoming Changes to HPP’s Claims Call Center

As you are aware, Health Partners Plans (HPP) migrated to a new claims platform starting in Fall 2019 and ending in Fall 2020. The transition went very well and HPP is already benefiting from efficiencies of a state-of-the-art claims platform. To al…

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Tobacco Cessation and NRT Resources

Health Partners Plans is dedicated to providing quality health care and continually improving the health outcomes of our members. As you may know, tobacco use is the leading cause of preventable death and disease in the U.S., accounting for more tha…

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COVID-19 Update: Authorization Process Changes

As we see the COVID-19 health crisis improving throughout Pennsylvania, Health Partners Plans (HPP) will be changing some of its practices to align with the Pennsylvania Department of Human Services (DHS) Medical Assistance Bulletin 99-21-03, which w…

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Check Out the Summer Issue of Provider Check Up

The Summer 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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HPP Launches COVID Vaccine Report

Health Partners Plans (HPP) is pleased to announce the creation of the “COVID Vaccine Report.” This report will be posted every Tuesday on NaviNet and can assist you in identifying your patients who have received their vaccination. Please take the t…

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Upcoming Webinars on Shift Care Staffing and Reporting

The Pennsylvania Department of Human Services (DHS) requires HPP to provide accurate reporting of missed shifts for all authorized shift care services. To meet the DHS regulatory requirement, HPP requires all agencies authorized for shift care servic…

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Prior Authorization Issue Identified

Health Partners Plans (HPP) recently implemented a new care management system, which includes the management of our prior authorization requests. Prior authorizations submitted through our provider portal are then fed into our new care management sys…

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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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Medicaid Check Cycle Delay

Thank you for being a Health Partners Plans participating provider. Due to an isolated technical issue, we are an expecting a 1-day delay in the Medicaid check cycle. We will keep you informed of any additional changes that may affect you during thi…

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Complete the Annual D-SNP Model of Care Training

If your practice has at least one Health Partners Medicare Special (D-SNP) member assigned to its panel, then at least one person on your staff who is involved in the care of our dual-eligible special needs plan (D-SNP) members must complete our annu…

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Participating Laboratory COVID-19 Testing Update

Health Partners Plans (HPP) recently identified a discrepancy in the reimbursement for COVID‐19 testing to participating laboratories. HPP corrected the discrepancy, retroactive to April 1, 2020, to reflect a payment equal to 100% of the Pennsylvani…

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Non-Participating Laboratory COVID-19 Testing Update

Health Partners Plans (HPP) recently identified a discrepancy in the reimbursement for COVID-19 testing to non‐participating laboratories. HPP corrected the discrepancy, retroactive to April 1, 2020, to reflect a payment equal to 100% of the Pennsyl…

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340B Hospital Billing Reminder

Health Partners Plans (HPP) would like to remind you that all billing requirements must be adhered to in order to ensure that required data is captured. To be accepted as a valid claim, the submission must contain correct current coding, including bu…

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2021 Medicaid/CHIP Member Rewards

HPP is excited to announce the continuation of HPP Rewards, our popular incentive program for Health Partners (Medicaid) and KidzPartners (CHIP) members. All Medicaid and CHIP members will receive rewards points for completing specific health activi…

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COVID-19 Vaccine Administration by Pharmacies

Health Partners Plans (HPP) will follow policies related to coding and reimbursement issued by the Centers for Medicaid & Medicare Services (CMS) and the Pennsylvania Department of Human Services (DHS). CVS/caremark, HPP’s contracted PBM, has im…

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COVID-19 Antibody Therapy Administration

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

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