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2023

The Summer Issue of Provider Check Up is Now Available!

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/condition…

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Medicare Payment Delay

For the week of 5/22/2023, we are experiencing a 1-day delay in Medicare payment processing. For any questions, please contact the Provider Services Helpline at 1-888-991-9023 (Monday to Friday, 9 a.m. – 5:30 p.m.).

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HPP Policy Bulletin: Zolgensma

Thank you for being a Health Partners Plans (HPP) participating provider. We are contacting you today to inform you of a revised policy available in our HPP Policy Bulletin Library. Effective 6/23/2023, HPP will be implementing a revised drug policy:…

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Reminder: Tobacco Cessation Program

Health Partners Plans (HPP) would like to remind providers that per MA Bulletin 99-18-10 titled “Enrollment of Tobacco Cessation Providers,” an individual or entity must be approved by the Pennsylvania Department of Health (DOH) as a Tobacco Cessatio…

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Home Visiting Programs for Pregnant Members/New Parents

Thank you for being a Health Partners Plans (HPP) participating provider. HPP encourages in-network providers to refer pregnant members and new parents to an evidence-based home visiting program. All pregnant HPP members, and parents/guardians of chi…

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Guidance for Billing Avastin for Ophthalmic Use

Health Partners Plans would like to provide guidance to our network regarding billing Avastin for Ophthalmic indications. The table below provides accepted coding and requirements for reimbursement consideration for each. Code Definition  Lin…

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Announcing a Well Child Incentive Program

Health Partners Plans (HPP) would like to make you aware of anopportunity to earn additional incentive dollars on well-child visits for patients ages 11-21 from July 1, 2023, through December 31, 2023. Important Note: You MUST opt in no later than Ma…

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Member Redetermination Data Available

As you may know, effective April 1, 2023, the Pennsylvania Department of Human Services (DHS) returned to pre-pandemic renewal processing procedures for Medical Assistance and CHIP. All Medical Assistance and CHIP recipients need to complete an annua…

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HPP Policy Bulletin: Gene Therapy

Health Partners Plans would like to inform our provider partners of a revised policy available in our HPP Policy Bulletin Library. Effective May 24, 2023, HPP will be implementing a new drug policy: DR.014.A Gene Therapy. You can access this policy b…

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Vaccine Claim Processing Issue Identified

We have identified an issue when processing claims for vaccines which are resulting in inaccurate payments and/or denials. We are working to resolve the issue and will reprocess any claims requiring reprocessing.  There is no need to reach out to us …

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Announcing Our Pediatric Shift Care Incentive Program

Health Partners Plans (HPP) would like to make you aware of a new incentive program for pediatric nursing shift care services. The incentive went into effect on January 1, 2023 and is available to in-network home care providers. Home care agencies wi…

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HPP's 2023 Member Rewards Programs (Medicaid and CHIP)

Thank you for being a Health Partners Plans (HPP) participating provider.HPP would like to remind you about the HPP Rewards program that encourages Health Partners (Medicaid) and KidzPartners (CHIP) members to complete targeted health condition manag…

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HPP Policy Bulletin: DPP

Health Partners Plans would like to inform our provider partners of a revised policy available in our HPP Policy Bulletin Library. Effective May 8, 2023, HPP will be implementing a revised claim payment policy: RB.029.B Diabetes Prevention Program. Y…

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You're Invited: P4P Webinars

Thank you for being a participating Health Partners Plans (HPP) provider. You’re invited to participate in an upcoming webinar on HPP’s quality program, which rewards your practice’s performance for delivering quality services to our members. Please …

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Maternity Home Care Visits Coding

Thank you for being a Health Partners Plans participating provider and an active partner in our Baby Partners program. This program allows for home care visits by an in-network Home Care Agency to promote a healthy pregnancy and safe transition home …

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Telehealth for OB Services

Health Partners Plans recognizes the value of face-to-face provider visits to foster the patient/provider relationship, and we also know that telehealth provides a way to promote patients’ engagement in their health care.  The use of telehealth servi…

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Osteoporosis Management Measure

Thank you for being a Health Partners Plans (HPP) participating provider and for your continued efforts to manage our members’ health. HPP would like to share some helpful information about the Osteoporosis Management in Women Who Had a Fracture (OMW…

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Medication Management Support for Medicare Members

Health Partners Plans (HPP) is committed to helping our Medicare members manage chronic conditions through medication support and adherence activities. HPP would like to remind you that we have several resources to assist both you as providers and yo…

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Provider Orientation and Training Webinar

Thank you for being a Health Partners Plans (HPP) provider. HPP is hosting our first provider orientation and training webinar of the year on March 22, 2023.HPP requires all participating providers to demonstrate that they are knowledgeable and trai…

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Screening for Colorectal Cancer Saves Lives

In the spirit of Colorectal Cancer Awareness Month, Health Partners Plans (HPP) would like to remind you of recently expanded coverage for colorectal cancer screening. A number of screenings are covered for Medicare and Medicaid members as preventiv…

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Member Satisfaction with Provider Survey and QCP Changes

Member satisfaction remains a top priority for Health Partners Plans (HPP).We have seen an increase in the overall average scores within our QCP program due to your efforts to address member satisfaction. However, we acknowledge that there is still r…

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Meals as Medicine

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 Health Partners (Medicaid) members with complex health care needs, as well a…

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Utilizing Telehealth to Improve Patient Access

Health Partners Plans (HPP) encourages all providers to utilize telehealth when appropriate to improve and expand patient access to care. We want to narrow the gap for members to utilize telehealth services. Challenge The lack of universal access to…

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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/condition…

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Help Medical Assistance and CHIP Members Maintain Coverage

As you may know, effective April 1, 2023, the Pennsylvania Department of Human Services (DHS) will return to normal renewal processing procedures for Pennsylvanians enrolled in Medical Assistance and CHIP. All Medical Assistance and CHIP recipients w…

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HPP Policy Bulletin: Relizorb

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 3/22/2023, HPP will be implementing a new drug policy: RB.013.…

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New Online Provider Directory Announcement

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 online provider directo…

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HPP Policy Bulletin: Maternity Billing and Guidelines

We are contacting you today to inform you of a new policy available in our HPP Policy Bulletin Library. Effective 3/15/2023, HPP will be implementing a new claim payment policy: RB.031.A Maternity Billing and Guidelines. You can access this policy by…

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2023 Health Partners Medicaid Benefit Update: $0 Copays

In an effort to reduce barriers to care for our Medicaid population, effective January 1, 2023, Heath Partners Plans has adopted a $0 copay for all medical benefits for our Health Partners (Medicaid) health plan. We believe that greater access and lo…

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Register Now: Provider Education on Women's Health

Thank you for being a participating Health Partners Plans (HPP) provider. You’re invited to participate in an upcoming HPP webinar on women’s healthcare issues on January 27, 2023. This webinar will explain three measures that are included in the Nat…

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Notification of Changes in Medicare Part D Program Coverage

HPP is notify you of upcoming changes to Health Partners Medicare’s Part D program coverage. These changes were prompted by the Inflation Reduction Act (IRA), which contains widespread changes to the Medicare program that have taken effect starting i…

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2023 Ambulance Fee Increases

Thank you for being a Health Partners Plans (HPP) participating provider and for your continued efforts to manage our members’ health. Effective for dates of service on and after January 1, 2023, the Department of Human Services (DHS) will increase f…

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