ConnectiCare | Office Visit - October 2020
ConnectiCare
October 2020 Office Visit

October 2020 - In this issue

Here’s what members said about their telehealth visits
Check ID cards for all commercial patients at every visit
Reminder: Express Scripts is providing commercial drug utilization management services
New secure provider website coming in 2021
Educate patients about the proper use of antibiotics to protect public health
New and updated payment policies now available online
Medical records review ongoing through March
Flu shot clinics at ConnectiCare centers
Best practices for children and adolescents on antipsychotics
Has any of your information changed? Let us know.
Recent provider news

Here’s what members said about their telehealth visits

ConnectiCare surveyed a panel of commercial and Medicare Advantage members who had telehealth visits with their doctors in April or May 2020. The survey found:

Members of all ages were satisfied with the care they received in telehealth visits after the public health emergency was declared in March.
Those under age 65 are highly likely to use telehealth again.
All members respect the value of face-to-face visits with doctors, but they also see telehealth as an important option for its safety and convenience.
See more of what members had to say.

Check ID cards for all commercial patients at every visit

We started to issue new member ID numbers and cards to commercial members, beginning with employer-sponsored plans who enrolled or renewed on Aug. 1, 2020 and after.

We will complete roll-out of the new member ID numbers for all our commercial plans on or about Jan. 1, 2021, when we issue new ID cards to our members with individual plans, including those sold through Access Health CT.

The new ID numbers start with the letter “K” followed by a 10-digit number. View a sample here. The new commercial member ID numbers are similar to the member ID numbers of our Medicare Advantage members. But Medicare Advantage ID cards clearly note the member has a Medicare Advantage plan.

Please note, until we complete the roll-out, you may still see some commercial patients with ID numbers that start with the numeral “9.”

It’s important to check ID cards and ID numbers for all commercial patients at every visit and sign in to our provider website to verify eligibility.

Make sure to use the new ID numbers for dates of services on and after Aug. 1, 2020.

Reminder: Express Scripts is providing commercial drug utilization management services

Express Scripts (ESI) is now performing most drug utilization management services for ConnectiCare commercial plan members, including those with plans sold through Access Health CT. Please submit requests for preauthorization, quantity limits and step therapy for commercial members to ESI. Here are details on how you can submit preauthorization requests through ESI’s Electronic Prior Authorization (ePA) option.

New secure provider website coming in 2021

ConnectiCare will introduce a new secure provider website next year. The website will offer features and new capabilities that will help you care for our members. Stay tuned for more information. We will keep you updated in the coming months.

Educate patients about the proper use of antibiotics to protect public health

Patients are often quick to request antibiotics when they have the symptoms of an upper respiratory infection. What they may not realize is that most upper respiratory infections are caused by viruses and not bacteria, and antibiotics aren’t suitable for viral infections.

We know it can be challenging to get your patients to understand this, and we’re here to help. Use our viral infection Rx pad to educate your patients about antibiotics and help guide the conversation when patients present viral infection symptoms.

For helpful information on antibiotic prescribing, including HEDIS quality measures and guidance, check out this provider resource.

U.S. Antibiotic Awareness Week: Nov. 18-24, 2020
At least 30% of antibiotics prescribed in outpatient settings in the U.S. are prescribed unnecessarily.
More than 2.8 million infections from bacteria are resistant to antibiotics each year in the U.S.
More than 35,000 people die annually as a direct result of antibiotic resistance.

Learn more about what you can do to raise awareness about the proper use of antibiotics.

*Source: Centers for Disease Control and Prevention. U.S. Antibiotic Awareness Week. Retrieved from https://www.cdc.gov/antibiotic-use/week/get-involved.html. Last accessed Oct. 16, 2020.

New and updated payment policies now available online

The following policies have been created or updated:

Payment Policy: ClaimsXten Coding Edit Rules (Commercial & Medicare): We created this policy to help you better understand the ClaimsXten edit rules we are applying to claims. This policy went into effect September 2020.
Payment Policy: Anesthesia Reimbursement (Commercial & Medicare): We have updated this policy to go into effect on Jan. 1, 2021. Please refer to the document for complete details.

You can access all our reimbursement policies online.

Medical records review ongoing through March

Optum or Ciox Health may contact your office from now through March 2021 about retrieving the medical records of your patients who have ConnectiCare commercial plans, including plans sold through the Access Health CT.

An Optum or Ciox Health representative will share safe options for records retrieval:

Uploading your charts remotely to the CioxLink portal (instructions will be sent to you directly), or
Arranging for a remote agent to download charts from your EMR directly by calling Ciox at 1-877-445-9293.

Health plans must submit accurate and complete diagnosis data for each member/patient to the Centers for Medicare & Medicaid Services (CMS). Optum and Ciox Health together will review the charts for 2020 dates of services on our behalf.

As our partners and “business associates,” as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Ciox Health and Optum are fully HIPAA compliant and are required to protect, preserve and maintain the confidentiality of any protected health information (PHI) obtained from clinical records provided by medical practices.

We appreciate your help. If you have questions, please call the ConnectiCare Provider Services at 1-800-828-3407.

Flu shot clinics at ConnectiCare centers

We’re holding flu shot clinics — open to the public — at our ConnectiCare centers in Manchester, Shelton and Waterbury. Flu shots will be given by appointment only, for everyone’s safety, with most insurance plans accepted.

Walgreens will administer the shots. Must be 18 or older to participate. Patients can find more information and make an appointment on our website.

As a reminder, here’s the list of flu vaccines we’ll cover for the 2020-2021 flu season.

Best practices for children and adolescents on antipsychotics

According to Optum Behavioral Health, children and adolescents on antipsychotic medications may have increased risk for certain health concerns, including:

Cardiovascular changes
Hyperprolactinemia
Metabolic changes, including weight gain
Type 2 diabetes

That’s why best practices encourage primary care providers (PCPs) to monitor the blood glucose and cholesterol of these patients. Doctors need to order the following metabolic tests after the first prescription for the antipsychotic medicine is given:

At least one test for blood glucose or HbA1c, and
At least one test for LDL-C or cholesterol.

Because of the health risks, the care for children and adolescents on antipsychotic medications need to be coordinated between the behavioral health practitioner prescribing the drugs and the PCP managing the patient’s medical issues.

The above recommendations are based on the American Academy for Child and Adolescent Psychiatry (AACAP), the American Psychiatric Association and the National Committee for Quality Assurance HEDIS® specification.

Has any of your information changed? Let us know.

Check our provider directory to make sure we have the right information for you and your practice. Our members rely on our directory to find doctors like you quickly and easily.

Relevant changes include your:

Tax ID number
National provider identification (NPI)
Address
Phone number
Office hours
Ability to accept new patients
Language spoken

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

Recent provider headlines

Check out the latest Provider News & Headlines:

Check ID cards and go to connecticare.com to check eligibility
A reminder about advising patients on Medicare plan enrollment
Anticipate prescription drug questions from Medicare members
Updated ambulatory surgery centers grouper policy
Info needed from providers with lab equipment or that perform lab testing
Medical policy criteria updated for bone mineral density studies
Our care management team is here to help you care for your patients
Use RadMD.com for clinical authorization submissions and information

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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.