Provider Resources

News and Announcements

July 2019

Claims Submitted with Incomplete Information Will Be Rejected

Network Health’s goal is to process all claims at initial submission. Before we can process a claim, however, it must be a clean or complete claim submission.

If any of the necessary information is missing from the claim, we will not be able to process your claim in a timely fashion and it will be rejected.

To facilitate the timely processing of your claims, please follow the Claims Procedures and Polices provided.

If you are unable to find a claim on your remit report, please check the rejection report in the provider portal.

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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please use the "help me find..." search bar
located at the top of the page. 

July 2019
June 2019
May 2019
April 2019
March 2019
February 2019
January 2019

 

July 2019

Network Health Launches New Clinical Newsletter

Last month, Network Health added a clinical-focus newsletter to our suite of provider communications which currently includes The Pulse (for operations news, such as claims updates) and The Script (for pharmacy news and updates).

The Consult is a monthly communication to strengthen collaboration with clinicians. Together, we can ensure our members, your patients, are satisfied they receive the best quality care in the right place at the right time.

This newsletter will notify you about our member programs designed to close care gaps, inform you about initiatives around specific quality measures, and share highlights and success stories from our health management teams and network providers.

Every month, we will feature a clinician doing innovative work in his or her practice to improve health outcomes and patient satisfaction.

Read more in the latest issue of The Consult

 

Every month, The Consult tells you about our member programs designed to close care gaps and initiatives around specific quality measures, and shares highlights from our health management teams and network providers.

Check out the latest issue of The Consult

Consult Newsletter Archives

To search newsletter archives by keyword, 
please use the "help me find..." search bar 
located at the top of the page. 

July 2019
June 2019

June 2019

Retail Pharmacy Network to Transition from CVS to Walgreens

On January 1, 2020, Network Health will transition to Express Scripts (ESI) as the pharmacy benefits manager for all lines of business. ESI has provided pharmacy benefits management for Network Health Medicare members since 2005. Through the transition, the major retail pharmacy network will switch from CVS/caremark™ to Walgreens.

For our members’ convenience, Network Health will provide access to Walgreens pharmacies beginning August 1, 2019. CVS/caremark™ will continue to be in-network until December 31, 2019. This gives you and your patients time to work with a Walgreens pharmacist to transition pharmacy files from CVS/caremark™ (or any pharmacy).

If members decide not to participate in the early transition to Walgreens, we have advised them to refill prescriptions the last week of December 2019 to cover their medication needs until they can transfer their pharmacy files to an in-network pharmacy on January 1, 2020.

Members and providers can search the entire updated pharmacy network, both retail and mail order, through Find a Pharmacy starting November 1, 2019.

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

To search newsletter archives by keyword,
please use the "help me find..." search bar
located at the top of the page.

June 2019
January 2019


Network Health
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