Providers News & Updates
4/16/10 Health Right, Inc. tansition letter past May 1, 2010: Health Right Transition
4/8/10 Correspondence from the DC Department of Health Care Finance which announces Health Right Inc.’s transition from DC Medicaid: DHCF Correspondence
3/19/10 Electronic Claims Submission Update: Emdeon Update Letter
11/17/09 HINI Information
1. 2009-2010 VFC Influenza Order Form
2. Influenza H1N1 (novel) RT-PCR CDC Update
3. Influenza H1N1 (novel) CDC Update - LAIV (nasal spray)
4. Trends: Rx-to-OTC & Generic Launch Alert.
11/5/09 Claims Update
Claims Update
Health Right is making strides to improve claims processing. Effective December 2009, HRI is transitioning to Emdeon for electronic claims submission. If your office is currently using Emdeon, you will be notified directly from Emdeon. Health Right will notify all contracted providers with further details when the implementation begins.
11/5/09 Authorization Requirements update
Authorization Requirements Update
MRI's and CT Scans Do Not Require prior authorization. However, PCPs will still need to provide the patients with the initial referrals to the specialist. After this initial referral, if further procedures or services are required, the specialist is responsible for obtaining authorization (if authorization is needed).
Please note that in order for services to qualify for not requiring prior authorization, the care must be referred to an In Network Provider and the care provided must be apart of the members benefit package.
Services that require prior authorization for case management purposes include: Dialysis, Chemotherapy, Radiation Therapy, Home Health, IV Infusion, DME greater than $500, Physical Therapy, Speech Therapy, and Occupational Therapy.
All out of network referrals and/or non covered or excluded services such as plastic surgery, sclerotherapy will continue to require prior approval. Finally, global authorizations issued to pregnant members covers routine prenatal services including office visits, routine testing, and transabdominal ultrasounds.
Fall/Winter Provider Newsletter 2008
4/16/10 Health Right, Inc. tansition letter past May 1, 2010: Health Right Transition
4/8/10 Correspondence from the DC Department of Health Care Finance which announces Health Right Inc.’s transition from DC Medicaid: DHCF Correspondence
3/19/10 Electronic Claims Submission Update: Emdeon Update Letter
11/17/09 HINI Information
1. 2009-2010 VFC Influenza Order Form
2. Influenza H1N1 (novel) RT-PCR CDC Update
3. Influenza H1N1 (novel) CDC Update - LAIV (nasal spray)
4. Trends: Rx-to-OTC & Generic Launch Alert.
11/5/09 Claims Update
Claims Update
Health Right is making strides to improve claims processing. Effective December 2009, HRI is transitioning to Emdeon for electronic claims submission. If your office is currently using Emdeon, you will be notified directly from Emdeon. Health Right will notify all contracted providers with further details when the implementation begins.
11/5/09 Authorization Requirements update
Authorization Requirements Update
MRI's and CT Scans Do Not Require prior authorization. However, PCPs will still need to provide the patients with the initial referrals to the specialist. After this initial referral, if further procedures or services are required, the specialist is responsible for obtaining authorization (if authorization is needed).
Please note that in order for services to qualify for not requiring prior authorization, the care must be referred to an In Network Provider and the care provided must be apart of the members benefit package.
Services that require prior authorization for case management purposes include: Dialysis, Chemotherapy, Radiation Therapy, Home Health, IV Infusion, DME greater than $500, Physical Therapy, Speech Therapy, and Occupational Therapy.
All out of network referrals and/or non covered or excluded services such as plastic surgery, sclerotherapy will continue to require prior approval. Finally, global authorizations issued to pregnant members covers routine prenatal services including office visits, routine testing, and transabdominal ultrasounds.
Fall/Winter Provider Newsletter 2008
