2022
Introduction of T1002 and T1003 for Private Duty Nursing Services
December 29, 2022
Health Partners Plans (HPP) would like to thank you for continuing to be a participating provider and would like to provide some NEW important and REMINDER information regarding Electronic Visit Verification (EVV). NEW EVV INFORMATION Per DHS Bulleti…
Policy Notification: Panniculectomy and Abdominoplasty
December 29, 2022
Thank you for being a Health Partners Plans (HPP) participating provider. We are contacting you today to inform you of a new policy available in our HPP Policy Bulletin Library. Effective 2/1/2023, HPP will be implementing a new medical policy: “MN.0…
New Diabetes Treatment and Management Tools
December 12, 2022
HPP would like to make you aware of new resources to assist with diabetes management. HPP recognizes the barriers to care and other challenges that individuals with uncontrolled diabetes face and we want to highlight strategies that our providers can…
The Winter Issue of Provider Check Up is Now Available!
December 9, 2022
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…
RSV Cases are Increasing
November 23, 2022
The Respiratory Syncytial Virus (RSV) season typically runs from November 1 through March 31. There has been an increase in RSV in children across Pennsylvania and around the country. CDC surveillance has shown an increase in RSV detections and RSV-a…
Blood Pressure Cuff Order Form Update
November 18, 2022
Health Partners Plans (HPP) is committed to providing you with tools and resources to assist with hypertension management. HPP would like to inform you about a recent update to the blood pressure cuff order form. The goal of updating the form is to r…
Developmental Screenings During Well-Child Visits
November 17, 2022
Thank you for being a participating Health Partners Plans (HPP) provider. As a healthcare provider, you play a critical role in monitoring children’s growth and development and identifying problems as early as possible. The American Academy of Pediat…
Waiver of Authorization Requirements for CHIP Outpatient Services
November 14, 2022
Effective September 1, 2022, Health Partners Plans (HPP) temporarily removed prior authorization requirements for both participating and non-participating providers in the outpatient setting for our KidzPartners (CHIP) membership. The outpatient sett…
Policy Notification: Continuous Glucose Monitors
November 9, 2022
We are contacting you today to inform you of a revised policy available in our HPP Policy Bulletin Library. Effective 12/9/2022, will be implementing a revised claim payment policy: RB.017.C Continuous Glucose Monitors (CGM's). You can access this po…
Policy Notification: Diabetic Retinopathy Screening and Fundus Photography
November 8, 2022
We are contacting you today to inform you of a revised policy available in our HPP Policy Bulletin Library. Effective 12/9/2022, HPP will be implementing a revised claim payment policy: RB.023.B Diabetic Retinopathy Screening and Fundus Photography. …
HealthChoices Expansion Continuity of Care Process Update
November 4, 2022
This is an update to a communication dated August 29, 2022. Health Partners Plans (HPP) would like to make you aware of our approach to improving access to care and overall patient experience for the HealthChoices (HC) expansion effective September 1…
The Fall Issue of Provider Check Up is Now Available!
November 2, 2022
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…
Policy Notification: Complement Inhibitors: Eculizumab (Soliris) & Ravulizumab (Ultomiris)
November 1, 2022
We are contacting you today to inform you of a revised policy available in our HPP Policy Bulletin Library. Effective December 1, 2022, HPP will be implementing a revised drug policy: DR.006.C Complement Inhibitors: Eculizumab (Soliris®) & Ravuli…
Controlling Blood Pressure
October 14, 2022
Health Partners Plans (HPP) would like to inform you about resources and information related to blood pressure management. Hypertension is one of the most common chronic conditions among the HPP population. HPP has identified opportunity for improvem…
You're Invited: Tobacco Recovery and Tobacco Cessation Counseling Certification Webinar
October 13, 2022
You’re invited to participate in Health Partners Plans and Community Behavioral Health webinar on Tobacco Recovery and Tobacco Cessation Counseling Certification on November 2, 2022, at 12:30 p.m. We hope this webinar will provide you with a better …
You're Invited: Cultural Competency and Disparities in Health Care Webinar
October 6, 2022
We’d like to invite you to a webinar, “Discussion on Cultural Competency and Disparities in Health Care,” on Wednesday, Oct. 19, from 12:30 p.m. to 1:30 p.m. HPP’s clinical programs work with your treatment plan to support your practice and your Hea…
You're Invited: Health Partners Medicare 2023 Benefits Overview Webinars
October 5, 2022
HPP continues to improve our Medicare line of business by enhancing benefits, expanding our provider network and building stronger relationships with our in-network providers. HPP invites you to learn more about our 2023 Medicare Advantage plans at …
Electronic Visit Verification for Home Health Care Services (HHCS)
October 5, 2022
Section 12006 of the Twenty First Century Cures Act (Cures Act) and the Centers for Medicare & Medicaid Services (CMS) require the State of Pennsylvania to begin utilizing an Electronic Visit Verification (EVV) system for all Home Health Care Ser…
Updated Procedures Requiring Authorization
September 15, 2022
Following up to our communication dated September 9, 2022 – Resources for Prior Authorization Questions, we have since posted a document on our website which provides you authorization requirements at the procedure code level by line of business. Th…
Call Center Volumes – Resources for Prior Authorization Questions
September 8, 2022
Health Partners Plans (HPP) would like to make you aware of increased call volumes into our call centers. The increased volume is a direct impact from the HealthChoices expansion that went live on September 1, 2022. We appreciate your patience as we…
2022 MQCP Update
September 8, 2022
Thank you for being a Health Partners Plans (HPP) participating provider and for your continued participation in our Maternity Quality Care Plus (MQCP) program. HPP wants to make you aware of an update to the 2022 MQCP Manual. Changes are outlined b…
HealthChoices Expansion Update
September 1, 2022
HPP is excited to expand our award-winning Medical Assistance program into your communities effective September 1, 2022. Partnering with our provider network is an important part of our success and furthers our mission to build healthier lives and st…
2022 QCP Manual Update
September 1, 2022
Thank you for being a Health Partners Plans (HPP) participating provider and for your continued participation in our Quality Care Plus (QCP) program. HPP wants to make you aware of a few updates to the 2022 QCP Manual. Changes are outlined below: …
A Special Expansion Issue of Provider Check Up is Available Now!
August 31, 2022
A special expansion edition of the Health Partners Plans provider newsletter, Provider Check Up, is now available on our website. Learn more about provider services and support, overviews of different departments at HPP, provider education and train…
HealthChoices Expansion Continuity of Care Process
August 29, 2022
Health Partners Plans (HPP) would like to make you aware of our approach to improving access to care and overall patient experience for the HealthChoices (HC) expansion effective September 1, 2022. The changes identified below are specific to members…
Comprehensive Pediatric Education Packet
August 5, 2022
Thank you for being a Health Partners Plans (HPP) participating provider. We want to share new and updated materials to assist in caring for HPP’s pediatric members. The Comprehensive Pediatric Education Packet includes: Telemedicine Well Visit G…
New Portal Implementation Update: July 29, 2022
July 29, 2022
In response to concerns regarding the short window to register users for our new provider portal we are delaying full deployment to the new HP Connect platform. Here is what you need to know. Full transition to our new HP Connect platform will not…
New Provider Portal Implementation Update
July 15, 2022
As previously communicated, Health Partners Plans is getting closer to our single provider portal platform. To make this transition easier, we are retaining the name HP Connect,which will now be powered by HealthTrio. Our go live date is scheduled fo…
Medicare Sequestration Update
June 27, 2022
Effective July 1, 2022 and where applicable according to your contract with Health Partners Plans (HPP), HPP will resume sequestration reductions to our Medicare payments consistent with the Centers for Medicare and Medicaid (CMS) recent notice, whic…
HPP is Investigating Claims Payment Issue
June 22, 2022
Health Partners Plans is aware of an issue which caused claims processed on June 6, 2022 to incorrectly deny as not medically necessary. All claims with this adjudication date are being examined and, if required, will be re-adjudicated for accurate r…
COVID-19 Update: Retrospective Reviews
June 17, 2022
Thank you for being a Health Partners Plans (HPP) participating provider. We are providing updates to prior authorization requirements since our last communication dated January 27, 2022 (PC-420-NM-2022-0012 – COVID-19 Authorization Process Changes)…
COVID-19 Update: Authorization Process Changes – Update June 13, 2022
June 13, 2022
Thank you for being a Health Partners Plans (HPP) participating provider. We are providing updates to prior authorization requirements since our last communication dated June 1, 2021. The following requirements apply to Medicaid and CHIP lines of bu…
Provider Orientation and Training Webinar - June 22
June 8, 2022
Health Partners Plans (HPP) is hosting our 2nd quarter provider orientation and training webinar on June 22, 2022. HPP requires all participating providers to demonstrate that they are knowledgeable and trained on important topics and participate in …
Medicaid Expansion is Coming
June 2, 2022
As previously communicated, open enrollment of the HealthChoices program across the Commonwealth of Pennsylvania is coming soon. Since our last communication, the dates have changed and open enrollment will now occur from June 22 to August 16. All e…
Notification of New Professional Telehealth Services Policy
June 1, 2022
We are contacting you today to inform you of a new policy available in our HPP Policy Bulletin Library. Effective 8/1/2022, HPP will be implementing a new claim payment policy: RB.024 Professional Telehealth Services (Medicaid and CHIP). You can acc…
Important Update to the Prior Authorization Process for Specialized Musculoskeletal Therapies
May 31, 2022
Effective July 1, 2022, Health Partners Plans (HPP) requires therapy providers to use the prescribing physician NPI as the requesting provider when submitting prior authorization (initial and continued care) requests to eviCore healthcare for the fol…
Inovalon ePass Update
May 31, 2022
Health Partners Plans (HPP) appreciates your participation in our network and we strive to make improvements to the delivery of services to our members/your patients at all times. We write you today with an important request. While updating your memb…
The Summer Issue of Provider Check Up is Now Available!
May 20, 2022
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…
HealthTrio Portal Implementation
April 29, 2022
Health Partners Plans (HPP) is getting closer to our single provider portal platform transition. We are on track to implement a soft launch of HealthTrio in the weeks ahead with a small portion of our network to perform testing. We expect to go live …
Available Now: HPP's 2022 Provider Access, Appointment and Telephone Availability Standards Survey
March 30, 2022
The 2022 Provider Access, Appointment and Telephone Availability Standards Survey is now available. Each year, HPP surveys our network to determine if PCPs are meeting the Access, Appointment and Telephone Availability Standards, as set by the Depar…
Crozer Health Update
March 24, 2022
Crozer Health has announced it will temporarily suspend services at the Delaware County Memorial Hospital in the Intensive Care Unit (ICU) and surgery departments beginning Tuesday, May 31, 2022, due to staffing issues that have challenged the health…
Medicaid Diabetes Prevention Program (DPP) Reminder and New Incentive
March 17, 2022
Starting in 2022, Health Partners Medicaid members who attend at least four Diabetic Prevention Program (DPP) core sessions are eligible to receive a free one-month membership to Weight Watchers of Philadelphia. This is an added incentive to encourag…
Join HPP for Q1's Provider Orientation and Training Webinar
March 15, 2022
HPP is hosting our first provider orientation and training webinar of the year on March 23, 2022 at 12:30 p.m. HPP requires all participating providers to demonstrate that they are knowledgeable and trained on important topics and participate in at l…
Getting Ready for HealthChoices Expansion
March 11, 2022
With the announcement from the Pennsylvania Department of Human Services (DHS) that the re-procurement of the HealthChoices program is set to go live on July 1, 2022, Health Partners Plans (HPP) has been working hard to get ready. We are excited to e…
You're Invited to HPP's Home Care Authorizations Webinar
March 7, 2022
You’re invited to participate in a webinar on home care authorizations on March 24, 2022 at 12:30 p.m. We hope this webinar will provide you with a better understanding of the criteria and documentation required to process a home care authorizatio…
Policy Bulletin Update: CMS and CMS and (DHS Payment Systems Update and Maintenance Payment Policy
March 7, 2022
A new policy is now available in our HPP Policy Bulletin Library. Effective March 1, 2022, HPP will be implementing a new claim payment policy: RB.028.A Centers for Medicare & Medicaid Services (CMS) and Department of Human Services (DHS) Payment…
New Provider Portal Announcement
March 2, 2022
Health Partners Plans is continuously working to improve our provider experience. Our goal is to ensure administrative ease and allow maximum time to care for their patients. With that in mind, we are excited to announce a new provider portal launchi…
Professional Claims and Referring Provider Documentation Requirements
March 2, 2022
Health Partners Plans (HPP) would like to remind billing staff that all billing requirements must be adhered to in order to ensure timely and accurate reimbursement. To be accepted as a valid claim, the submission must contain correct current coding,…
Register Now for HPP's Staff Engagement and Customer Service Webinar
February 28, 2022
Health Partners Plans (HPP) is hosting the final part of a series of webinars in collaboration with practice transformation consultant, Primary Care Development Corporation (PCDC). We invite you and your team to participate in the staff engagement an…
COVID-19 Update: Authorization Process Changes – UPDATE TO PRIOR COMMUNICATION, Extended to March 15, 2022
February 25, 2022
We are providing an update to the effective timeframe since our last communication dated January 27, 2022. The below applies to all lines of business managed by HPP and will remain in effect until March 15, 2022. Effective December 17, 2021: Post…
The Spring Issue of Provider Check Up is Now Available!
February 25, 2022
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…
Improve Communication, Interactions by Using HPP's Quality Improvement Checklist
February 22, 2022
Health Partners Plans (HPP) is committed to helping our members maintain and improve health outcomes. The Health Outcomes Survey (HOS) is an annual survey that asks Medicare Advantage members to detail their interactions with their physicians and ot…
No Surprises Act - Provider Directory Update
February 15, 2022
On January 1, 2022, Section 116 of the Federal Consolidation Appropriations Act, which addresses provider directory accuracy, became effective. The Act regulates the responsibility of both payers and providers regarding provider information that appe…
Check Cycle Posting Update
February 14, 2022
Health Partners Plans had a processing issue with last week’s check cycle run that will cause a one-day delay in funding. You should see your electronic funds transfer on Wednesday, February 16. For any questions or issues, please reach out to Provi…
What is CAHPS? Webinar Announcement
February 11, 2022
Member satisfaction is a leading indicator in measuring overall quality of care and patient engagement. Starting in March, patients in your practice will receive the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, which asks p…
Diabetic Retinopathy Screening and Fundus Photography (Clarification)
February 11, 2022
This is a follow-up to the communication we released on January 14, 2022. Health Partners Plans (HPP) communicated a newly implemented claim payment policy: RB.023.A Diabetic Retinopathy Screening and Fundus Photography. We are writing to advise tha…
COVID-19 Update
January 28, 2022
Together, we are facing one of the most significant and wide-ranging health crises in recent memory. Health Partners Plans (HPP) is always looking for ways to partner with you to support the care of our members. We are providing an update to the eff…
HPP Upcoming Upgrade and Scheduled Portal Maintenance
January 28, 2022
HPP will be upgrading our backend systems HealthRules Payor and HealthRules Care Manager beginning on Friday, January 28, 2022 at 5 p.m. EST and will complete by Monday, January 31, 2022. This upgrade will affect data for Authorizations, Benefits &a…
Crozer Health Temporarily Suspending Select Services Due to Staffing Constraints
January 25, 2022
Crozer Health has announced it will temporarily suspend services at the Springfield Hospital Emergency Department and ancillary services beginning Friday, January 14, 2022, due to staffing issues that have challenged the health care industry across t…
Change in Reimbursement and Billing Practices for Pediatric Shift Care
January 14, 2022
Effective February 15, 2022, HPP will only reimburse providers 150% of contracted rate for multiple members who receive Home Health Aide (S9122) or Skilled Nursing (S9123/S9124) services in the same household by the same provider of care. Providers w…
Diabetic Retinopathy Screening and Fundus Photography
January 14, 2022
Health Partners Plans (HPP) wants to inform providers of a change to our HPP Policy Bulletin Library. Effective 1/1/2022, HPP implemented a new claim payment policy: RB.023.A Diabetic Retinopathy Screening and Fundus Photography. HPP considers Digit…
COVID-19 Update: Authorization Process Changes – UPDATE TO PRIOR COMMUNICATION
January 7, 2022
Together, we are facing one of the most significant and wide-ranging health crises in recent memory. Health Partners Plans (HPP) is always looking for ways to partner with you to support the care of our members. We are providing updates since our la…
Provider Network Enhancements: Jefferson Health Joins Medicaid, CHIP Networks
January 1, 2022
Building upon the provider network growth success we experienced in 2021, we are excited to announce the addition of Jefferson Health to our Medicaid and CHIP provider network. The addition of Jefferson Health brings Thomas Jefferson University Hosp…