ConnectiCare | Office Visit

ConnectiCare | Office Visit - April 2021

April 2021 - In This Issue

It’s Coming! A New Provider Portal
ConnectiCare and EmblemHealth Team Up for Tristate Access
Bridge Program Access: Recognizing ConnectiCare and EmblemHealth Employees
National Minority Health Month
Reimbursement Policies – Updates and Reminders
Sign-up for EFT/ERA
ConnectiCare Tools, Resources and Notifications
Recent Provider News

It’s Coming! A New Provider Portal

As promised, ConnectiCare is happy to share more news about the new provider portal we are developing. Here are some of the benefits and enhancements you can look forward to:

•	The ability to consolidate accounts for ConnectiCare and EmblemHealth under one user ID so you can view your patients’ data whether they are members of either company without having to sign in and out between websites.
•	A new Message Center, including secure messaging and the ability to submit attachments.
•	You will be able to create, submit, and view preauthorizations online.
•	You will also be able create a bulk eligibility report and to download it in an Excel format.
•	Additional user roles and permissions that better align with job functions and offer more access options – it’s currently just two roles (admin, non-admin).

We are also enhancing security in the new portal by using multi-factor authentication. This means you will be required to use your email address when you sign in. Moving forward, you will no longer be able to share email accounts, as each user name will require a unique email associated with it.

What You Can Expect Next

In the coming months, we will be sharing training materials to guide you through the sign-in process, navigation of the portal, and other new features and functionalities. Additional information around the sign-in process will be coming soon.

ConnectiCare and EmblemHealth Team Up for Tristate Access

As a ConnectiCare provider, you may be able to see members from our affiliate company, EmblemHealth, if you are in the ConnectiCare Choice Network. ConnectiCare and EmblemHealth allow their members, in specific networks and plans, to access providers from both companies. This allows our members more choices, and the opportunity to get care where and when they need it.

This table shows the combinations of EmblemHealth networks and plans that have access to ConnectiCare’s Choice Network. This is in addition to expanded access available to members in the Bridge Program (see next article for more information on the Bridge Program).

Commercial	Medicare
Millennium Network and Commercial Select Care Network • HIP Prime HMO • EmblemHealth HMO Plus • EmblemHealth EPO Value • EmblemHealth EPO Value HDHP • EmblemHealth PPO Value	VIP Prime Network • EmblemHealth VIP Premier (HMO) • EmblemHealth VIP Rx Carve-Out (HMO)
Prime Network • HIP Prime HMO • HIP HMO Preferred (City of NY) • EmblemHealth HMO Plus • EmblemHealth HMO Preferred Plus • HIP Prime POS • HIP Prime POS (City of NY) • HIPaccess I • HIPaccess II • EmblemHealth EPO Value • EmblemHealth EPO Value HDHP • EmblemHealth PPO Value • GHI HMO (City of NY) • Vytra HMO (City of NY) • EmblemHealth Platinum PPO-N • EmblemHealth Platinum Premier-P • EmblemHealth Platinum Value-P • EmblemHealth Gold PPO-N • EmblemHealth Gold Premier-P • EmblemHealth Gold Value-P • EmblemHealth Gold EPO Virtual-N • EmblemHealth Silver Premier-P • EmblemHealth Silver Value-P • EmblemHealth Silver Plus H.S.A. • EmblemHealth Bronze Premier-P • EmblemHealth Bronze Value-P • EmblemHealth Bronze Plus H.S.A.	VIP Bold Network • EmblemHealth VIP Gold (HMO) • EmblemHealth VIP Gold Plus (HMO) • EmblemHealth VIP Rx Saver (HMO) • EmblemHealth VIP Part B Saver (HMO) • EmblemHealth VIP Go (HMO-POS) • EmblemHealth VIP Essential (HMO) • EmblemHealth VIP Value (HMO) • EmblemHealth VIP Passport (HMO) • EmblemHealth VIP Passport NYC (HMO)

This 2021 Summary of Companies, Lines of Business, Networks & Benefit Plans, which reflects both ConnectiCare and EmblemHealth, provides details on PCP and referral requirements, out-of-network coverage, copays, and maximum out-of-pocket limits. Sample EmblemHealth member ID cards may be found in the EmblemHealth Provider Manual.

Bridge Program Access: Now Includes Our Own ConnectiCare and EmblemHealth Employees

In addition to self-insured employer groups who access our administrative services only (ASO) Bridge Program, in 2021 we offered our own employees access to the Bridge Program if they have one of the following plans:

•	CCI EPO HDHP, HSA
•	CCI EPO Hospital Deductible, HRA
•	EH EPO Value
•	EH PPO Value

The Bridge Program “bridges across” five networks to give our members expanded access to care. You are considered in-network for a member seeking care if you are part of any of the networks listed below and the word “Bridge” appears on the member’s ID card. The Bridge Program includes:

•	ConnectiCare Choice Network
•	EmblemHealth Insurance Company Prime Network (formerly HIPIC)
•	EmblemHealth Plan, Inc. National Network (formerly GHI)
•	QualCare Network
•	First Health Network

Please be sure your office staff understands this and doesn’t mistakenly turn our employees or their families away.

April is National Minority Health Month

April is National Minority Health Month and the theme is #vaccineready. The COVID-19 pandemic has hit our racially and ethnically diverse communities harder than others, according to the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH). We encourage you to talk to your patients about the importance of getting vaccinated, address their concerns about the vaccine, and remind them to practice social distancing and wear a mask. If you want to know why the words you choose when talking about vaccinations can make a difference, download our helpful guide, Words Matter: Driving Vaccine Adoption Through Effective Communications.

Reimbursement Policies – Updates and Reminders

The COVID-19 Vaccine and Monoclonal Antibody Infusions Reimbursement Policy has been updated to include new codes.

Please remember to include CLIA numbers on all claims that have laboratory codes. See our Payment Policy: Laboratory/Venipuncture (Commercial and Medicare).

You can access all our policies on connecticare.com/providers.

Through ECHO Health, Inc., you can receive direct deposits to your bank account(s) (known as electronic funds transfer (EFT)) and view or download your remittances online (known as electronic remittance advice (ERA)). Electronic transactions are fast, convenient, and reduce the risk of lost or stolen payments. This solution is free and allows you to reduce payment processing costs and improve cash flow. Visit ECHO, click on the “Click Here” button, and follow the instructions to enroll. Learn more.

ConnectiCare Tools, Resources, and Notifications

The Provider’s Guide to Preventive Health Services for Your Patients (Medicare) – This guide was updated in March to align with CMS 2021 Preventive Services and the material reorganized to make it easier to use.

Recent Provider Headlines

Check out recent provider news:

•	Contraceptive coverage in Mass. – 12-month refills allowed
•	Beginning May 1, ConnectiCare to provide care management to kidney patients
•	Medicare Site of Service – New form
•	Do not bill dual eligible and QMB members who have full Medicare benefits
•	Medicare Outpatient Observation Notice (MOON)
•	Study finds home blood pressure best approach for diagnosing hypertension
•	Real-Time Prescription Benefit Tool
•	CMS updated COVID-19 vaccine information in toolkit
•	Preauthorizations required for hospital discharges to skilled nursing facilities
•	Telehealth services
•	Billing for Medicare members’ COVID-19 vaccines
•	ACA member medical record reviews began this month
•	Four new reimbursement policies
•	Claims coding edits effective May 25, 2021
•	ConnectiCare tools, resources, and notifications

Keep in Touch

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.

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