Provider Resources

News and Announcements

February 2019

Providers Must Maintain Adequate Access to Covered Services

Contracted providers are required to maintain adequate access to covered services per Network Health policy. Highlights of the policy include the following obligations.

  • Providers must have after-hour call coverage. This might include a message directing members to the ER, stating an on-call doctor will call the member back, or an after-hour call service.
  • Next available appointments must meet the following standards.
    • Behavioral health or non-life-threatening emergency within 6 hours
    • Urgent care within 48 hours
    • Regular or routine within 10 days

For more information on Network Health provider policies, please visit Policies and Forms.

Read more in the latest issue of The Pulse

 

 

Every month, The Pulse newsletter delivers the latest industry news, claims updates, tips about programs available to you and your patients, pharmacy notifications, treatment information, code changes and more. 

Check out the latest issue of The Pulse


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January 2019

 

January 2019

Medicare formulary change: Steroid/Beta-Adrenergic inhaler $8

For 2019, the generic for AirDuo (Fluticasone/Salmeterol) will now be available at an $8 cost to members for one inhaler. The member’s $260 or $395 deductible also doesn't’t need to be satisfied if the member receives this generic (Fluticasone/Salmeterol) versus Advair, Breo Ellipta, Dulera or Symbicort.

The generic version of the inhaler not only offers significant savings to the member, but it also might increase compliance with using the inhaler as prescribed.

Read more in the latest issue of The Script

The Script is the quarterly newsletter produced by the Network Health pharmacy department to inform providers of current and upcoming pharmacy-related news.

Check out the latest issue of The Script

Script Newsletter Archives

January 2019


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