Provider News
November 2021
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.
Important changes to COVID-19 coverages and waivers to take effect Jan. 1, 2022
Effective for dates of service on or after Jan. 1, 2022, Security Health Plan is making significant updates related to COVID-19 coverages and waivers. Read more for changes to inpatient/observation cost sharing, prior authorization requirements and test for purposes that are not medically necessary.
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Access our COVID-19 web page for timely updates. Click here to go directly to our most recent COVID-19 Provider FAQ.
Proud of it
Security Health Plan supports anti-vaping efforts for local students
Security Health Plan is pleased to support Columbus Catholic School's (CCS) Vape-Free project. Vaping supplies and e-cigarettes are difficult to detect and can look similar to USB flash drives, pens and other school supplies. The CCS Vape-Free program will purchase vape detectors for bathrooms to get students the help they need and educate them on the harmful effects of vaping. For more information on the harmful effects of vaping, visit TobaccoIsChanging.com.
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. 
Coding corner
Accurate HCC coding benefits providers, patients and
health plans
By BRENDA ANDERSON, Revenue Management Educator
You are asked to be complete and accurate in your documentation and coding to promote correct Hierarchical Condition Category (HCC) code capture. Have you wondered what an HCC is, why it is important and what impact it has for you and your patients? This article will help clarify this and provide resources to learn more about HCC coding. Read more
Policy review
Security Health Plan policy review - effective November 2021
By KAREN BORGEMOEN, Registered Nurse/Team Leader
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 Nov. 1, 2021.
Security Health Plan updates
Security's Medicare Advantage plans to require home health agencies to submit 1-time Notice of Admission
By JENNIFER DENNEE, Government Policy & Reimbursement Specialist
Effective Jan. 1, 2022, Home Health Requests for Anticipated Payment (RAPs) will be eliminated and replaced by submission of a 1-time Notice of Admission (NOA) for all home health agencies (HHAs). HHAs must submit a NOA to their Medicare contractor within five calendar days from the start of care date. The NOA is a 1-time submission to establish the home health period of care and covers contiguous 30-day periods of care until the individual is discharged from Medicare home health services. Read more 
Wisconsin Department of Health Services (DHS) delays hard launch for electronic visit verification (EVV)
Consistent with ForwardHealth Update 2021-40, "Electronic Visit Verification Soft Launch Phase Has Been Extended," Security Health Plan's Medicaid managed care plans will extend the "soft launch" for EVV for personal care and applicable supportive home care services. EVV has been required since Nov. 2, 2020. Previously DHS announced a ‘hard launch’ date of Jan. 1, 2022. However, that has been postponed and a new ‘hard launch’ date has not been set. For more details on EVV refer to Security Health Plan’s "Personal Care Services/Electronic Visit Verification (EVV)" Provider Manual page. Select Medicaid Managed Care - Benefit Information - Personal Care Services. 
MultiPlan helps Security Health Plan resolve coordination of benefits determinations
MultiPlan, formerly Discovery Health Partners, assists Security Health Plan to resolve coordination of benefits (COB) situations where the patient's primary insurance should have paid first. MultiPlan Corporation acquired Discovery Health Partners in the first quarter of 2021 and currently is transitioning Discovery to the MultiPlan brand.
Providers will continue to receive all COB communications from Security Health Plan.
Prior authorization updates
New cardiology and radiology codes to require prior authorization through eviCore Healthcare  
By THERESA STERNIK, Health Services Clinical Manager
Effective Jan. 1, 2022, new cardiology and radiology codes will require prior authorization through eviCore Healthcare. Read more for the detailed list of codes.
Clinical documentation required for prior authorizations  
By KAREN BORGEMOEN, Registered Nurse/Team Leader
Prior authorizations can be submitted via the Security Health Plan portal or by faxing the prior authorization form to Security Health Plan at 715-221-6616. When submitting the prior authorizations via the portal or fax, clinical information must be attached to support the requested services. Clinical information could include physician notes, telephone notes, consult notes, therapy notes, lab results, x-rays, high-end imaging and other test results. If the clinical information to support the request is not attached to the request, this can delay processing of the request.
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?
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.
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
715-221-9640 (TTY 711), fax changes to us at 715-221-9699 or email us at shpprd@securityhealth.org.
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