Care management Medicare role change
Point32Health is making adjustments to certain care management functions to better coordinate on transitions of care for our members.
Point32Health is making adjustments to certain care management functions to better coordinate on transitions of care for our members.
The Massachusetts BHHL has launched a resource directory — behavioral health providers are encouraged to confirm their practice is listed.
Bill capped rental DME items with the appropriate capped rental modifier.
Select Senior Products members can opt into our in-home urgent care program, instED.
A recent CMS memo clarifies coverage associated with the Jimmo Settlement.
Point32Health provides complex care management services individually tailored to patients.
Point32Health’s chronic condition management programs reinforce clinician treatment plans.
Integrated Point32Health Ambulance and Transportation Services Payment Policy and reimbursement update.
Modifier CS should no longer be used and claims with it may deny.
Effective Jan. 1, 2024, LMFTs and LMHCs will be recognized as Medicare-eligible providers.
Reminders for providers regarding Qualified Medicare Beneficiary enrollee exemption from cost-sharing liability.
Updated criteria and medical necessity guidelines for Jan. 1, 2024.
When terminating from network, please identify two alternate available providers.
Point32Health provides care management services for adult and pediatric members.
Point32Health’s approach to chronic condition management through patient-centered care.
Providers who are planning to offer concierge medicine services to eligible members are required to provide advance notice.
New requirements will apply to the 2024 Part B Step Therapy program.
In accordance with Centers for Medicare and Medicaid Services (CMS) policy, for dates of service on or after July 1, 2023, Point32Health now requires providers to append modifier JW or JZ when reporting a drug from a single-dose vial or package.
AbleTo’s personalized therapy program is now available to Tufts Health Direct, Tufts Health Together-MCO, and Tufts Medicare Preferred members, and will continue to be offered to Harvard Pilgrim Health Care commercial and Stride (HMO/HMO-POS) Medicare Advantage members.
Integra will soon begin to assume management of the DMEPOS provider network for Point32Health’s Senior Products, starting on July 1, 2023 for Tufts Medicare Preferred and Tufts Health Plan Senior Care Options, and on Sept. 1, 2023 for Harvard Pilgrim Stride (HMO)(HMO-POS) Medicare Advantage.