Provider Resources

News and Announcements

January 2019

Providers must update data quarterly

Validate information with Dial America or via email roster

We validate provider information quarterly and when new information is sent from a contracted group. Contracted providers and provider groups are required to participate in this process as part of their contractual obligation.

Dial America is a vendor that Network Health uses to update provider information as regulated by CMS. Please make sure to update your information with them when they call. If you do not provide the information to Dial America, Network Health must follow up with your staff. 

If you would rather not provide information over the phone, you have the option to submit your roster via email on a quarterly basis to Provider Informatics at provinfo@networkhealth.com. For more information on what information is required, please read the Provider Data Validation policy.

Report changes in provider participation

It is also a contract requirement to promptly (within 30 days) inform Network Health of any provider participation changes such as location changes, terminations, part-time covering or no longer excepting new patients. Failure to report this information in a timely fashion affects the state and federal continuity of care provision for our members.

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


Pulse Newsletter Archives

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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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