ConnectiCare | Office Visit - April 2020
April 2020 Office Visit

April 2020 - In this issue

Coronavirus (COVID-19) resources for our providers
CARES Act and over-the-counter medicines information for all ConnectiCare providers
Claims payment and electronic fund transfers
Medical policies updated
PCPs play key role in care of children with ADHD
Help your patients get or stay active with SilverSneakers
Recent provider headlines

Coronavirus (COVID-19) resources for our providers

We have set up a dedicated web page on our provider website to capture the ConnectiCare news and information you may need during this coronavirus (COVID-19) outbreak.

Please refer to this page often for the latest and most up-to-date information such as:

Telemedicine program expanded
Testing payment policy
Updates to preauthorization | home health care services | Passage referrals
and more.

Resources for your ConnectiCare patients
Feel free to direct patients to this dedicated webpage with information, news, and links to the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and the Connecticut Department of Public Health.

CARES Act and over-the-counter medicines information for all ConnectiCare providers

Based on the CARES Act, the federal stimulus bill, individuals with health savings, flexible spending, or health reimbursement accounts (HSAs, FSAs or HRAs) can now use those account funds to pay for over-the-counter drugs and medicines without needing a provider’s prescription.

Claims payment and electronic fund transfers

Your office may be seeing more checks coming to you by mail. Avoid the influx by signing up for electronic fund transfers (EFTs) through PNC Bank’s Remittance Advantage.

Once you sign up for EFT payments, you can receive direct deposits to your bank account(s) and view or download your electronic remittance advices (ERA) online. If you are already registered on PNC for ConnectiCare or other health plans, you don’t have to do anything.

Benefits of direct deposits and ERAs include:

Receive payments faster to help improve your cash flow.
Match payments to remittances quickly and easily.
Import files directly into your practice management system.
View remittances online and print if needed.
Use convenient search and reporting tools.

Go to to register. But before you do, sign into to get your “pay-to-provider ID number.” You need it to register for EFT payments.

If you have questions about PNC Remittance Advantage, call their help line at 1-877-597-5489 from 8:30 a.m. to 8:30 p.m. Monday through Friday or email

Please note, if you sign up for EFT through PNC for Medicare claims payment, you will still get EFT payments through Bank of America for Medicare Advantage claims with dates of services prior to Jan. 1, 2020, and for our commercial plans.

Medical policies updated

We have updated the following medical policies:

Medical Policy: Non-Emergent Transportation, Ambulance (Commercial)
Medical Policy: Non-Emergent Ambulance Services (Medicare)
Medical Policy: Functional Endoscopic Sinus Surgery (FESS) (Commercial)
Medical Policy: Rhinoplasty (Commercial)
Medical Policy: Amniotic Membrane Transplantation for Ocular Reconstruction (Commercial)

Please refer to the policies for details.

PCPs play key role in care of children with ADHD

Primary care physicians (PCPs) play an important role in identifying and treating children with attention deficit hyperactivity disorder (ADHD). As you are aware, interventions for the treatment of ADHD fall into two main categories:


Optum Behavioral Health, which manages and administers ConnectiCare’s behavioral health program, can assist you with referrals for psychosocial interventions such as behavioral therapy, teaching social skills, parent/child education about ADHD and appropriate school programming can be useful.

Pharmacological management most often includes, prescribing stimulants and non-stimulants. If medication is prescribed, please be sure to:

Write the prescription for 30 days initially so you can schedule a follow-up appointment.
Schedule a follow-up appointment with your patient within 30 days of writing the prescription.
Schedule at least two more follow-up appointments over the next nine months to make sure the dosage is correct.

As a reminder, follow-up care for children prescribed ADHD medication is a HEDIS measurement. HEDIS, which stands for Health Care Effectiveness Data and Information Set, is the quality measurement tool for the National Committee for Quality Assurance (NCQA).

Help your patients get or stay active with SilverSneakers

SilverSneakers® released a new series of videos designed to help people start a fitness routine, improve strength and balance, help reduce stress and manage pain. Encourage all your patients, with Medicare Advantage or commercial plans, to sign up today.

Recent provider headlines

Check out the latest Provider News & Headlines:

2020 updates to the standards of diabetes care
Change in preauthorization process for certain specialty drugs
Payment reminder: Reimbursement policy for drug and alcohol testing with commercial plans
Clinical details required for all routine ambulance service requests
Has any of your information changed? Let us know.
Changes to ConnectiCare center locations

Keep in touch

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ConnectiCare is a brand name used for products and services provided by ConnectiCare Insurance Company Inc., and its affiliates, members of the EmblemHealth family of companies.