Provider Newsbrief
June 2021
Security Health Plan distributes Provider News digitally. Every other month, Provider Newsbrief focuses on policy changes, prior authorizations and other information for providers that is time-sensitive. 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.
COVID-19 update
National Public Health Emergency extended again
Many Security Health Plan policies and coverages related to the COVID-19 pandemic are in effect until the end of the National Public Health Emergency. All indications are the public health emergency could run through at least the end of 2021. Read our updated COVID-19 Provider FAQ for more information.

Wisconsin DHS offers guidance for increasing COVID-19 vaccinations
The Wisconsin Department of Health Services (DHS) has created a guidance document linked here, COVID-19: Increasing Vaccination in Primary Care Settings P03006, to help providers think through bringing vaccine to primary care settings, including information about becoming an approved provider (or getting the proper documentation if an entity is already connected to an approved vaccinator), vaccine ordering, vaccine wastage considerations and strong recommendations. Read more.
Check back often to see how Security Health Plan processes help minimize COVID-19 impact on providers
Security Health Plan has developed processes for providers and a webpage to help answer questions about COVID-19 testing and treatment. Access our COVID-19 web page for timely updates. Also see the COVID-19 Provider FAQ for complete information on vaccines, new COVID-19 codes and other questions about testing and treatment.
Policy review
Security Health Plan policy review - Effective June 2021
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 at www.securityhealth.org/providers. Read more for policy reviews and changes effective June 1, 2021.
Important online information is a click away
You can find important information on services, standards and processes when you visit our Provider and Facility Manuals at www.securityhealth.org/providermanual.
Security Health Plan updates
New Enrich plan launches July 1 for large employers in three southern Wisconsin counties
By KATE SCHMUTZER, Contracting Manager
Security Health Plan is introducing a new health plan, Enrich, for large employer fully insured and self-funded members in three southern Wisconsin counties. The plan will be effective July 1, 2021.
 
Enrich is a focused network plan designed to simplify the path to health care through Security Health Plan’s partnership with the Marshfield Clinic Health System and the University of Wisconsin Health System. This plan will be available in Dodge, Columbia and Jefferson counties. There are a limited number of other providers considered in-network for this plan. They have been notified via letter.
 
IMPORTANT: The Security Health Plan member ID card will denote Enrich. Should an Enrich member visit a provider not included in the Enrich network, that visit will be considered out of network.
Security Health Plan changes extended nationwide network vendor to Zelis
Security Health Plan’s extended nationwide network vendor for all plans with nationwide access is changing from First Health to Zelis effective July 1, 2021. All members affected by this change are receiving a letter and new ID cards in June 2021 in preparation for the July 1 effective date. Read more
Auditing of FDR entities recommences in June 2021
By ALLIE WEIN, Privacy Specialist
Auditing of Security Health Plan’s First Tier, Downstream and Related Entities (FDRs) recommenced on June 1, 2021. Security Health Plan audits each of our FDRs once every 3 to 5 years. Those FDRs that had been selected for an audit in 2020 and whose audits were postponed due to COVID should expect to find themselves audited sometime in 2021. Read more
Prior authorization updates
eviCore updates prior authorization codes and makes key changes to imaging guidelines
By THERESA STERNIK, Health Services Clinical Manager
eviCore Healthcare is updating certain prior authorization codes for radiology, effective July 1, 2021, and cardiology, effective Sept. 1, 2021.
Read more for prior authorization code updates.

eviCore is also making key changes to imaging guidelines, effective Sept. 1, 2021.
Read more for the extensive list of key changes.
Magellan updates pharmacy prior authorization portal
By AMANDA SIEGLER, Clinical Pharmacy Specialist
Effective Aug. 5, 2021, the Magellan website is getting a makeover and an even more secure way to log in to the prior authorization platform. Read more for what providers need to know, need to do and FAQs regarding the new Magellan portal.
Reminders
Services that are not covered or require prior authorization;
complications arising from non-covered services are also not covered
Providers are reminded that experimental/investigational services, cosmetic services and some reconstructive services are non-covered services that may require prior authorization and may not be covered. In addition, services and procedures provided in connection with or resulting or arising from complications of non-covered services also will not be covered. 
 
Security Health Plan does not cover services or complications arising from any non-covered service. Exclusions in our members’ Certificate include "services resulting or arising from complications of, or incidental to, any service not covered under the Certificate or Schedule of Benefits." In this situation the member will be responsible for charges.
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