Connection supplemental articles and policies – September 2015
Supplemental articles
- There are no supplemental articles this issue.
Payment policies
Effective November 1, 2015, see all policies under Payment policies.
New payment policies
Revised payment policies
Details about the changes are indicated on the policies:
- Adult Foster Care – Updated reimbursement section to align with new MassHealth regulations regarding alternative placement days
- Aging Service Access Points (ASAP) – Updated Appendix A
- Assistant Surgeon – Updated billing/coding section
- Limited Service Clinics – Moved to new plan template and updated billing/coding guidelines section
- Outpatient Drugs – Moved to new plan template and updated Exhibit A
- Post-operative Nasal Debridement – Moved to new plan template and updated the billing/coding guidelines section
- Radiology / Diagnostic Imaging – Moved to new plan template and updated the reimbursement, prior auth, and billing/coding guidelines sections
- Sleep Management Services – Moved to new plan template and updated reimbursement section
- Vaccine – Updated Addendum A to reflect new state-supplied coverage of 2 codes and Addendum D to reflect ICD-10 changes
- Vision Services – Moved to new plan template and updated reimbursement and billing/coding sections
- Well-Baby/Well-Child Care Visits – Moved to new Plan template and updated reimbursement section
Annual review
The following policies were reviewed as part of our annual review process and were moved to the new plan template:
- Clinical Trials
- Maximum Units
- Member Liability
- Neonatal Intensive Care Services
- Newborn Services
- OB GYN
- Observation
- Palliative Care Consult
- Physician Standby
- Preoperative Autologous Blood Donation
- Preventive Services
- Provider Audit Policy
View these and all policies under Payment policies.
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