Notice to Be Healthy Providers: CBHI Article regarding Behavioral Health Screenings August 19, 2010
Posted by mhumel2 in : HNE/Industry News and Information , add a commentPlease click on the link to view article.
MCO BH Screening Text 8-10.doc
MHQP Survey Results:Massachusetts patients assess their experiences with primary care in first comprehensive survey since state health reform implementation August 18, 2010
Posted by mhumel2 in : HNE/Industry News and Information , add a commenthttp://campaign.constantcontact.com/render?v=0013fJXCVJ8X4G_C8Fg9xirH4XNBvF3rZS29S-6k3GXmAkSz773erLSTy9tRFdSS7GGz4DkvVB78k0CQH_z1-pvc707OHoAovaWcEd53DEI2gSZmVnz_vFxiIX13EuktTRshbjshstdiZw5pZTi9rT6gFtfXzRAGw_3ZCMci3lTNA7U7M096Kg0ymeWW3be5sjjwEoiDTCAfp_8pXZj9dNW5rG8UjLu2Zk1hORNr9YF4kSbeBUWzNttcH5rCIqQ78dgmeyo_K-AzWkOsGaBL03YoTI0Vjs7lelWcueTJSHFmRZwe8rrxw94wMdR7Q4lmfBekH4Beq1GLFc%3D
Early Intervention Changes August 18, 2010
Posted by mhumel2 in : HNE/Industry News and Information , add a commentEarly Intervention Mandate
On June 30, Governor Patrick signed the Massachusetts budget bill for fiscal year 2011. The budget bill included an amendment to existing insurance mandates, specifically regarding Early Intervention services. Health plans and insurers are prohibited from charging a copayment, co-insurance, or deductible1 for medically necessary early intervention services provided on or after July 1, 2010. This applies to services furnished by an early intervention provider for an enrolled child from birth until his or her third birthday for plans that provide coverage for dependents.
HNE is in the process of updating affected plans to remove all member copayments, co-insurance, and deductibles1 on medically necessary early intervention services. This change applies to all of HNE’s fully funded plans. For self funded plans, we will give groups the option of applying this benefit for plan effective dates beginning October 1, 2010.
If you have questions regarding this change, please contact your HNE Provider Relations Representative.
1 For HSA-compliant plans, early intervention services still will be subject to the overall plan deductible, but not the copayment or co-insurance.
HNE’s 2010-2011 Flu Policy August 17, 2010
Posted by mhumel2 in : Policy/Administative Reminders , add a commentInfluenza Virus/Flu Vaccine: HNE covers the flu vaccine for any member over six (6) months of age. The flu vaccine may be obtained through the PCP. If the PCP does not have flu vaccine, it may be obtained elsewhere, however, the member would have to pay for it and then submit for reimbursement. They will need to submit their itemized receipt to HNE attn: Member Services. We will then log their request and submit to Claims for processing. If the member pays for the flu shot out of pocket at a clinic, work etc….we will reimburse 100% of the charge. If the member gets this at their PCP office or an in-plan provider office and we are billed for the administration of the shot along with the actual immunization, an OV copay would apply. For GIC members, the flu shot is on the preventative code list for children up to the age of 18, which means no copay would apply.
HNE does NOT cover the Live Attenuated Influenza Vaccine/FluMist® as this is intranasally administered to “healthy” people 5-49 years of age who wish to avoid influenza. However, HNE has allowed coverage effective August 1, 2009 for FluMist (CPT 90660) for members aged 2-18.
2010-2011 Flu Vaccine Information Statements August 16, 2010
Posted by mhumel2 in : HNE/Industry News and Information , add a commentNotice from Department of Health & Human Services regarding Flu Vaccine August 16, 2010
Posted by mhumel2 in : HNE/Industry News and Information , add a commentPlease see attached regarding this years Flu Vaccine:
Dr Schuchat’s 2010 Letter to Providers (2)
Important Notice to Participating HNE Providers Regarding Paper Explanation of Payment July 29, 2010
Posted by mhumel2 in : Notice of Policy Changes , add a commentWe initially notified you on July 1st that the paper EOPs would be turned off effective August 2nd. This date has changed to September 7th. You will continue to receive paper EOPs until then. Our IT Department is currently revamping the HNEDirect site to make it easier for you to access the electronic EOP once the paper is turned off.
Please contact Provider Relations at 413-233-3313 if you have any questions or concerns.
Important Notice to Participating HNE Providers Regarding Paper Explanation of Payment July 1, 2010
Posted by mhumel2 in : Notice of Policy Changes , 7commentsPlease note: Your Explanation of Payment (EOP) now is available on HNEDirect.com. Starting August 2, 2010, we no longer will send the paper version of the EOP with your check.
Signing up for HNEDirect is easy:
1. Go to hne.com
2. Click “HNEDirect” in the lower, right hand corner
3. Click “Login Screen” at the end of the introduction
4. Click “Need to Register?”
5. Follow the simple, step-by-step instructions to sign up
After you register, we’ll confirm your account and send you a confirmation email.
In addition to viewing your EOP on-line, you also will have the option to print it if you need a paper copy.
If you have any questions, please contact Provider Relations at 413-233-3313 or toll-free at 800-842-4464, extension 5000, Monday through Friday. A representative is available to speak with you between the hours of 8:00 a.m. and 4:30 p.m. Eastern Standard Time.
Thank you.
MHQP Releases 2009 Massachusetts Statewide Patient Experience Survey Results June 24, 2010
Posted by admin in : HNE/Industry News and Information , add a commentMassachusetts patients assess their experiences with primary care in first comprehensive survey since state health reform implementation
Boston, MA-June 24,2010 - A report released today by Massachusetts Health Quality Partners (MHQP) provides the first comprehensive assessment of how patients rate their experiences with primary care since the state’s groundbreaking health reform law was implemented.
Coming July 1, 2010 HNE is introducing the newly Enhanced Provider Portal on HNEDirect!!! June 16, 2010
Posted by mhumel2 in : HNE/Industry News and Information , 2commentsAttention HNE Providers! Thanks to your feedback we are adding several new features to HNEDirect:
• We are adding additional copayment information, including OB/GYN and Physical and Occupational Therapy
• We are posting a link on each member screen to that member’s chart of benefits (COB). The COB outlines comprehensive member benefit information, including member financial liability, prior approval requirements, and coverage limits.
• We are making the on-line Explanation of Payment (EOP) easier to understand.
If you have questions once you log into the site or you would like to request an on-site training, please contact Provider Relations at 413-233-3313.