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Spring 2020
Stay in the Know About Coronavirus

Find timely information to support your patients through telemedicine, testing, COVID-19-related coding and other resources we're sharing to help you during  this pandemic.
Additional Medicaid Resources
 
Additional questions and feedback regarding Medicaid policy can be directed to medicaid@medicaid.ohio.gov
OhioMHAS-certified providers can contact BH-Enroll@medicaid.ohio.gov .
Additional COVID-19 information and resources can be found at coronavirus.ohio.gov or by calling 1-833-4-ASK-ODH (1-833-427-5634).
List of Covered Drugs      

Our List of Covered Drugs (or "Drug List") provides the prescription drugs that are covered by Aetna Better Health of Ohio.
 
The Drug List also indicates if there are rules or restrictions on any drugs, such as a limit on the quantity. Each year, we send a copy of the Drug List, but some changes may occur during the year. To get the most current information about which drugs are covered, you can visit the plan's website at www.aetnabetterhealth.com/ohio. You will also find information about:
  • Covered drugs
  • Copayment information, including tiers
  • Drugs that require prior authorization
  • Limits on refills, doses, or prescriptions
  • Use of generic substitution, therapeutic interchange, or step-therapy protocols            
Member Rights and Responsibilities

As a practitioner who ensures high quality care for Aetna Better Health of Ohio members, you should be aware of the members' rights and responsibilities. Some of the rights we provide to our members are as follows:
  • A right to receive information about Aetna, our services, our practitioners and providers, and member rights and responsibilities
  • A right to be treated with respect and recognition of the member's dignity and right to privacy
  • A right to participate with practitioners in making decisions about their health care
  • A right to a candid discussion of appropriate or medically necessary treatment options, regardless of cost or benefit coverage
  • A right to voice complaints or appeals about Aetna or the care we provide
  • A right to make recommendations regarding Aetna's member rights and responsibilities policy
In addition, our members have the following responsibilities:
  • A responsibility to supply information (to the extent possible) that Aetna and our practitioners and providers need in order to provide care
  • A responsibility to follow plans and instructions for care that they have agreed to with their practitioners
  • A responsibility to understand their health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible
For a complete list of member rights and responsibilities, visit our website at www.aetnabetterhealth.com/ohio to see our Member Handbook.
Progesterone

Premature birth is the leading cause of serious health problems and death for newborn babies in Ohio.
Progesterone can help reduce the chances of a premature birth for some women.  Progesterone is known as the "hormone of pregnancy." It is a natural and important hormone because of the role it plays in getting pregnant and carrying the baby to full term. During pregnancy, every woman's progesterone levels naturally increase. Research has shown that women who have had a baby born more than three weeks early may benefit from extra progesterone in a future pregnancy. Her prenatal care provider can prescribe extra progesterone, if it is right for her.
But many women do not know about progesterone and have not talked with their prenatal care providers about whether it could benefit them. Other women have heard about progesterone but have received inaccurate information that may prevent them from considering it.
To understand and explain the potential benefit of progesterone please visit www.gowhenyouknow.org
 
Additional Resources:
Cultural Competency Training  
Providers and their office staff are responsible for ensuring all services, both clinical and non-clinical, are provided in a culturally competent manner and are accessible to all
patients.
 
This includes those with limited English proficiency, limited reading skills, hearing incapacity, or those with diverse cultural and ethnic backgrounds.
 
Providers should ensure that patients are effectively receiving understandable, respectful and timely care compatible with their cultural health beliefs, practices and preferred languages from all staff members. Providers should also honor members' beliefs, be sensitive to cultural diversity, and foster respect for members' cultural backgrounds.
 
If you have not previously completed Cultural Competency training please take a moment to watch the video below and visit   http://thinkculturalhealth.hhs.gov
 
https://youtu.be/dOZLf-RYvHk




Once completed, click the link below to acknowledge you have reviewed all of the material.
 
Fee Table
 
Providers must bill according to CMS and Medicaid guidelines. It is also the provider's responsibility to be familiar with the latest billing practices.   Aetna is not responsible for instructing providers how to correctly bill for services.  
 
Also, providers should frequently check the state's  Fee Schedule & Rates  website as updates are always occurring to the fee schedules for Medicaid.