Security Health Plan distributes
Provider News
digitally. Information in this newsletter is important for care providers, clinic managers, patient assistance, coding and other clinic staff. Please share with your colleagues.
If you wish to receive this monthly newsletter, please create a Provider Portal account by contacting your practice's organization administrator. If you don't have an organization administrator,
click here
to set one up.
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Check back often to see how Security Health Plan processes help minimize COVID-19 impact on providers
In response to the novel coronavirus (COVID-19) outbreak, Security Health Plan has developed processes for providers and a webpage to help answer questions about testing and treatment. Access our
COVID-19 web page
for timely updates.
Click here
to go directly to our most recent COVID-19 Provider FAQ.
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Coronavirus COVID-19 interim policy coverage for telehealth services
Effective immediately, Security Health Plan will cover telehealth services as outlined in its Telehealth Medical Policy through July 31, 2020. View
Telehealth Medical Policy
.
Security Health Plan continues to re-assess and update this policy as necessary as situations change during the coronavirus COVID-19 pandemic. The coverage outlined in the Telehealth Medical Policy will cover providers who are credentialed and affiliated with Security Health Plan. Telehealth visits will be reimbursed according to the provider’s current Security Health Plan contracted rate. The member’s plan cost sharing will apply.
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Neighbors helping neighbors: Care managers ease Security Health Plan members' minds
When Security Health Plan member John Monnier was diagnosed with a brain tumor he found support in the last place he imagined: his health insurance company.
"I never expected my health insurance company to come to bat for me," Monnier said. "It is true - Security is about neighbors helping neighbors. Every time I needed her, I'd call Sandy and it was just like calling up my neighbor."
Read more
about how Monnier's care manager helped him navigate his diagnosis, treatment and recovery.
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Use Provider Portal to verify claims information
Claim status, eligibility, benefits and prior authorization requirements can be verified on the Security Health Plan Provider Portal.
Click here
for information on Provider Portal access and other ways to get the information you need by email, phone and fax.
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New ICD-10-CM code used for confirmed COVID-19 cases
By BRENDA ANDERSON, Revenue Management Educator
COVID-19 has affected the lives of everyone in our country. Healthcare providers are making sacrifices to care for their patients. It is likely that we will all know someone who was infected or has been affected by COVID-19. The world of diagnostic and hierarchical condition coding (HCC) has been affected by COVID-19 also. The Centers for Disease Control and American Hospital Association released a new ICD-10-CM code, effective April 1, 2020.
Read more
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Security Health Plan policy review - May 2020
By KAREN BORGEMOEN, Nurse Navigator / Medical Policy Nurse
Security Health Plan reviews medical policies on a monthly basis. Medical policies are found in the provider section of the Plan's public website.
Read more
for policy reviews and changes effective May 1, 2020.
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Provider expertise requested for medical policies and criteria
As Security Health Plan reviews and develops clinical criteria on Medical and Interpretation Policies, we ask providers with particular professional knowledge or clinical expertise on certain subjects for their input and opinions.
To receive payment, providers must meet all policy criteria outlined for the specific service provided.
Please review the current month’s medical policy updates and/or changes at
www.securityhealth.org/medicalpolicies.
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Security Health Plan updates
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New SimplyOne network simplifies path to health care for some Security Health Plan members
By KATE SCHMUTZER, Contracting Manager - MCHS Provider Network
Security Health Plan is introducing a new health plan for some members effective July 1, 2020, called SimplyOne. This new narrow network plan was designed to simplify the path to health care through Security Health Plan’s partnership with Marshfield Clinic Health System. This plan is currently available to employers located in the following counties: Marathon, Lincoln, Portage, Wood, Juneau, Adams, Waushara, Waupaca, Shawano, Clark, Taylor, Price, Oneida, Vilas and Iron. There are a limited number of other providers that are considered in-network for this plan. They have been notified via letter.
IMPORTANT: The Security Health Plan member ID card will list SimplyOne. Should a SimplyOne member visit a provider not included in the SimplyOne network, that visit will be considered out of network.
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Online enhancements improve Security Health Plan members’ experience
Over the past few years we have heard from our members on how they think we can improve our online member tool,
My Security Health Plan.
We've listened and have worked to meet their expectations. We pride ourselves on having
world-class customer service
and we want to make sure our members have the same great experience whether they call into our Customer Service Department, chat with us online or log in to their
My Security Health Plan
account. We are also working to expand access to these services within our mobile app.
Read more
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Important online information is a click away
For a list of information available at your fingertips in the provider manual,
click here
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Prior authorization updates
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Prior authorizations for acute rehabilitation admissions must be obtained from naviHealth
By LAURIE ROCK, Health Services
Clinical Manager
Effective May 18, 2020, Security Health Plan covers medically necessary inpatient rehabilitation. Precertification of all inpatient rehabilitation admissions is required. Providers must prior authorize Acute Rehabilitation with naviHealth by calling 1-855-512-7002 or faxing 1-855-847-7243. Affiliated providers will notify naviHealth of all proposed transfers to an acute, inpatient rehabilitation facility.
Providers must prior authorize Long Term Acute Care admissions with Security Health plan by faxing 715-221-6616. Affiliated providers will notify Security Health Plan of all proposed transfers to a Long Term Acute Care Facility.
naviHealth will follow the inpatient stay concurrently for medical necessity and intensity of service. Alternate levels of care will be discussed with the attending physician as appropriate.
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Help patients find you
- Has your practice moved?
- Have you changed the name or ownership of your practice?
- Do all of your providers accept new patients?
- Is anyone seeing patients in a new or different location?
- Has anyone left your practice or been replaced in the last year?
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Help patients find you by keeping information about your practice current with Security Health Plan.
Security Health Plan’s online provider directory is the primary provider search tool we offer our members. Members use the “Find a Doctor” directory to search for providers who can fill their specific care needs, whether they’re looking for a primary care provider who sees children, a specialist with privileges at a specific hospital, or an affiliated nursing home near their aging parents.
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To help patients find you, visit
www.securityhealth.org/directory
. Whether you’re a provider, a practice or a facility, please review the directory information for accuracy.
Be sure to contact us right away with any needed updates: You can report a change to Provider Relations staff. Call us at
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