OCTOBER 2020 | ISSUE NO.14
Contracting: Clinical Integration Payer Updates
Last month, we sent communication out on our recent contracting updates under our Clinical Integration program. These updates include a new contract with Anthem Health Plans, Inc., the new Anthem Blue Care Prime Network, and a new fee schedule with ConnectiCare Inc.

Please note: To access fee schedule information, you must contact FeeSched@communitymedgroup.org. This email will provide you with the appropriate information in a convenient format.

Telemedicine Policies
As carriers change their policies, we update our Telemedicine Billing Codes and Coverage Guidelines on our COVID-19 web page under 'Telemedicine Policies.'

Please use our website to check for updates to make sure you are using the most current guide.
Public Health Emergency Extended
The public health emergency (PHE) for the coronavirus pandemic (COVID-19) was set to expire Oct. 23. The PHE is now set to expire January 21, 2021.
Anthem
  • COVID- 19 updates are continuously changing. Make sure you are up to date with the latest information. Learn more >

  • Effective December 1, 2020, Medicare Advantage claims will be audited for correct level of service based primarily on the documented medical history, examination and medical decision-making. To make sure your claims are not denied, read more here >
CarePartners
  • Effective October 1, 2020 copays for all specialist visits, diagnostic labs, diagnostic tests and diagnostic x-rays for the period of October 1 to December 31, 2020 will be waived. CareAdvantage Preferred members can also apply their Wellness Allowance toward the purchase of fitness equipment such as treadmills, exercise bikes, free weights, resistance bands, weight stations (such as bowflex), jump ropes, and yoga mats. Learn More >
Cigna
  • Effective January 1, 2021, the Virtual Care Reimbursement policy ensures you can continue to receive ongoing reimbursement at face-to-face rates for virtual care provided to your patients with commercial medical coverage. Read more >

Harvard Pilgrim
  • With the flu season approaching and the simultaneous complications presented by the ongoing COVID-19 pandemic, it is more important than ever to emphasize the importance of getting vaccinated. Read more >


ConnectiCare
Commercial denial on G0444. G0444 is a Medicare code and was accidentally listed on our Commercial Preventive Grid. It was recently discovered and removed. Going forward, the only depression screening code listed on the Commercial Preventive Grid is 96127 with DX codes Z13.31 or Z13.32. Providers should submit 96127 for commercial members and G0444 for Medicare members for depression screening.
United Healthcare
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