ConnectiCare | Office Visit

ConnectiCare | Office Visit - May 2017

May 2017 - In this issue

Consult codes removed from schedule for commercial plans, effective July 1*
New diagnosis-related group (DRG) readmission policy
Upcoming member outreach for preventive care and diabetes screenings
Is there anything new with your practice? We want to know.
Recent provider headlines

Consult codes removed from schedule for commercial plans, effective July 1, 2017*

*June 2017 Update: Consultation codes for ConnectiCare commercial plans, including plans purchased through the Connecticut exchange, Access Health CT, will continue to be reimbursable to participating and non-participating providers. Please refer to the June 2017 Office Visit for details.

Consultation codes for ConnectiCare commercial plans, including plans purchased through the Connecticut exchange, Access Health CT, will no longer be reimbursable to participating and non-participating providers. This is effective for dates of services on or after July 1, 2017 and is consistent with the guidelines from the Centers for Medicare & Medicaid Services and our 2010 policy for ConnectiCare Medicare Advantage plans.

The affected consult codes are:

•	99241 – 99245
•	99251 – 99255

Instead, please use office visit and hospital care codes, if applicable, to bill for your services.

New diagnosis-related group (DRG) readmission policy

We are updating our diagnosis-related group (DRG) policy so it follows the guidelines set by the Centers for Medicare & Medicaid Services (CMS). The policy defines the payment guidelines for readmissions to an acute general short-term hospital occurring within 14 calendar days of the date of discharge from the same hospital for the same, similar or related diagnosis. This policy will go into effect July 1 for ConnectiCare Medicare Advantage and commercial plans.

View new policy

Members may be calling you to close gaps in care

We will soon send letters to some of your patients about the importance of:

•	Getting preventive care
•	Completing diabetes screenings needed to manage their condition effectively

We will urge members to contact you to make appointments as soon as they can to complete their missing screenings. Letters will be customized for each member. Preventive care measures to be highlighted are:

•	Annual physical
•	Colon cancer screening
•	Breast cancer screening
•	Cervical cancer screening
•	Flu shot

For members with diabetes, our letters will point out if they are missing:

•	HbA1c blood tests
•	Urine protein tests
•	Diabetic eye exams
•	Blood pressure readings

If you have patients with diabetes, please check their records and reach out to those who have gaps in their care.

Is there anything new with your practice? We want to know.

Our members rely on our provider directory to find doctors like you quickly and easily. Make sure our provider directory has the right information for you and your practice. If not, let us know.

Tell us if any of the following has changed for your practice:

•	tax ID number
•	national provider identification (NPI)
•	address
•	phone number
•	office hours
•	ability to accept new patients

Submit any changes by filling out our provider information update form and sending it back to us as noted on the form.

Recent provider headlines

Check out the latest Provider News & Headlines:

•	Preventive services: 2017 policy & coding updates effective May 1, 2017
•	Hospital-grade breast pumps will be available as preventive service
•	Flu coverage will include new vaccine after July 1
•	Our up-to-date telemedicine policy
•	Medicare news: Treatment of dual-eligible patients