NY Cigna Behavioral Providers

Effective August 1, 2011, NY Cigna Behavioral providers will have 120 days for timely filing of claims.  Participating provider agreements require claims be submitted with 60 days from the date of service but in accordance with NY state law, Cigna Behavioral gives NY providers an additional 60 days to submit claims.  Questions can be taken directly at Cigna Behavioral by calling 800.926.2273.

Online recredentialing for Value Options

Providers are now able to access their recredentialing application online when logging onto ProviderConnect at http://www.valueoptions.com/providers/Providers.htm.  Value Options recredentials providers on a tri-annual basis and contacted providers several months prior to their recredentialing date.  Use your user id and password for access to ProviderConnect and your recredentialing application once contacted by Value Options.

New 5010 standards

Are you getting ready???? More posts to come......

CV's required for Magellan Re-Credentialing

In addition to an up to date file with CAQH (Council for Affordable Quality Healthcare), Magellan is also requiring providers submit a detailed CV for completing the credentialing/re-credentialing process.  Magellan feels the information contained in your CV will assist them in matching your skills with the needs of their members.  For more information visit www.magellanprovider.com and review the latest provider focus newsletter.  For CAQH file updates visit https://upd.caqh.org/oas/

Great Lakes Health Plan has a new behavioral health vendor

UBH has become the new behavioral healthcare vendor and affiliate company for GLHP effective 1/1/2011.  GLHP began sending letters out to providers in December inviting them to participate in the UBH network.  Courtesy par status with UBH will be extended to all GLHP providers until 3/31/2011.  Providers can contact customer service at 800.903.5253

Harvard Pilgrim Providers

Outpatient authorizations are no longer required for patients seeing an in network provider. For those that aren't aware, behavioral health services are managed by United Behavioral Health.

MHN's New Outpatient Management Process

Starting 10/15/2010, MHN eliminated the re authorization process and introduced a new registration process.  All MHN providers seeing clients on an outpatient basis have had to deal with those re authorization "kits".  These kits were used for requesting more outpatient authorized sessions.  Well, no more!  MHN has done away with the kits/outpatient treatment request forms.  Providers will now be required to only notify MHN that a patient is in treatment.  No forms will be mailed to provider.  The client will be able to utilize all sessions available on their plan without requiring an authorization.