Provider Newsbrief

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 testing for purposes that are not medically necessary.

Access our COVID-19 web page for timely updates. Click here to go directly to our most recent COVID-19 Provider FAQ. 

Krista Hoglund, A.S.A., MAAA, has been named as Security Health Plan’s chief executive officer. A native of Exeland, Wis., Hoglund has been interim CEO for Security Health Plan since August 1. She was previously chief actuary and financial officer for Security Health Plan and spent 13 years in progressively advancing roles within Security Health Plan’s executive leadership, actuarial and business intelligence areas. Read more

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 Dec. 1, 2021.

You can find important information on services, standards and processes when you visit our Provider and Facility Manuals at www.securityhealth.org/providermanual.

Omada® is a personalized, virtual program that gives members the tools and support needed to help them lose weight, manage diabetes and improve overall health. The Omada program is covered by Security Health Plan benefits at no cost to the member and is being rolled out in January of 2022 for our fully insured large, small and self-funded groups (when the group elects to offer Omada, their qualifying members will be offered the service), and our Medicare Advantage members who qualify. Read more

Starting Jan. 1, 2022, Security Health Plan will pay up to $175 per calendar year toward the purchase of eyeglasses for members of its Medicare Advantage dual-eligible special needs plan, Ally Rx D-SNP. These members also have coverage for vision care and standard eyeglasses through the Wisconsin Medicaid program.

Reminder: Providers in the Ally Rx D-SNP network have stipulated to Security Health Plan that you accept both Medicare and Medicaid. Copays and coinsurance may not be collected by the provider from an Ally Rx D-SNP member. Providers should bill Medicaid as the secondary payer.

Security Health Plan is pleased to expand its Medicaid contract with the state of Wisconsin to now include the Medicaid Supplemental Security Income (SSI) program starting Jan. 1, 2022, in addition to serving BadgerCare Plus. Medicaid SSI health care coverage is for individuals age 65 or older, blind or disabled. Security will administer this program for individuals living in 12 counties throughout central and northcentral Wisconsin. Read more

Beginning Dec. 11, 2021, BadgerCare Plus, Medicaid and SeniorCare members with a MyACCESS account have been able to access digital versions of their ForwardHealth cards in the MyACCESS mobile app. An electronic or printed version of the ForwardHealth ID card should be treated exactly as the physical card. For more information from the Wisconsin Department of Health Services about digital or printed ForwardHealth ID cards, please read ForwardHealth UPDATE 2021-45.

Effective for dates of service on or after Jan. 1, 2022, Security Health Plan will follow ForwardHealth guidance to pay nursing home claims using the Health Insurance Prospective Payment Systems (HIPPS) code to reimburse claims on an acuity-specific basis. Information can be found in the ForwardHealth Update 2021-22, “Nursing Home Acuity-Based Billing.”