Point32Health non-emergent ambulance reimbursement
Integrated Point32Health Ambulance and Transportation Services Payment Policy and reimbursement update.
Integrated Point32Health Ambulance and Transportation Services Payment Policy and reimbursement update.
Modifier CS should no longer be used and claims with it may deny.
Effective Jan. 1, 2024, LMFTs and LMHCs will be recognized as Medicare-eligible providers.
Reminders for providers regarding Qualified Medicare Beneficiary enrollee exemption from cost-sharing liability.
Updated criteria and medical necessity guidelines for Jan. 1, 2024.
When terminating from network, please identify two alternate available providers.
Point32Health provides care management services for adult and pediatric members.
Point32Health’s approach to chronic condition management through patient-centered care.
Providers who are planning to offer concierge medicine services to eligible members are required to provide advance notice.
New requirements will apply to the 2024 Part B Step Therapy program.
In accordance with Centers for Medicare and Medicaid Services (CMS) policy, for dates of service on or after July 1, 2023, Point32Health now requires providers to append modifier JW or JZ when reporting a drug from a single-dose vial or package.
AbleTo’s personalized therapy program is now available to Tufts Health Direct, Tufts Health Together-MCO, and Tufts Medicare Preferred members, and will continue to be offered to Harvard Pilgrim Health Care commercial and Stride (HMO/HMO-POS) Medicare Advantage members.
Integra will soon begin to assume management of the DMEPOS provider network for Point32Health’s Senior Products, starting on July 1, 2023 for Tufts Medicare Preferred and Tufts Health Plan Senior Care Options, and on Sept. 1, 2023 for Harvard Pilgrim Stride (HMO)(HMO-POS) Medicare Advantage.
Effective for dates of service beginning July 1, 2023, the medications identified in this article will no longer be offered through CVS Caremark as part of Tufts Health Plan’s office-administered medical drug/white bagging program.
As previously communicated and effective for dates of service beginning April 1, 2023, Tufts Health Plan is insourcing claims pricing and processing for home infusion services for Tufts Health Plan Commercial, Tufts Medicare Preferred and Tufts Health Plan Senior Care Options.
Read more for helpful updates and reminders to keep in mind this month. Topics include required data elements for coordination of benefits claims, opioid treatment performance specifications, and reminders regarding stretchers and the standard form for chemotherapy prior authorization.
Effective for dates of service beginning April 1, 2023, Tufts Health Plan is insourcing claims pricing and processing for home infusion services for Tufts Health Plan Commercial, Tufts Medicare Preferred and Tufts Health Plan Senior Care Options.