Featured story:

Federal changes providers should know about in the new year

There are two federal changes that impact the health care industry, effective January 1, 2022: the No Surprises Act (as part of the Consolidated Appropriations Act of 2021) and the Transparency in Coverage rule. Both directly apply to commercial and self-insured coverage. Continue reading to learn more about how these federal changes impact you as a provider.

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In this issue:

• Verify your directory entry 
• Mandated reimbursement for services related to testing and treatment for COVID-19
• Site of service feature
• Hospital inpatient utilization report 
• New ID cards
• My Care Family transplant process
• Annual Updates to Physician and Outpatient Fee Schedules
• Available provider resources
• Medical policy updates
• Code updates

Featured story:

What to know about kids and COVID-19

As part of an integrated health system, our team at AllWays Health Partners remains committed to ensuring access for our members to critical healthcare services throughout the COVID-19 pandemic. Now that children ages 5 to 11 who live or go to school in Massachusetts are eligible to get the Pfizer vaccine, we wanted to share some recent findings from one of our system’s experts: Lael Yonker, MD Director, Pediatric COVID-19 Biorepository and Director, MGH Cystic Fibrosis Center at the Massachusetts General Hospital for Children. 

Keep reading

In this issue:

• New federal requirements for provider directory information
• New ID cards
• Available resources
• Preventative behavioral health service for Mass Health patients
• Medical policy updates
• Code updates
• Formulary updates

Featured Story:

Pediatrician Perspective Part 1: should I vaccinate my child?

Now that the FDA has authorized vaccination for adolescents ages 12-17, parents have questions. After surveying some of our members about concerns and hesitancy, we compiled some of the most common questions to ask Pediatrician and Medical Director at AllWays Health Partners, Dr. Lisa M. Scarfo, MD. Continue reading for part 1 of 2 to learn what Lisa had to say about getting kids vaccinated, the impact this year has had on students' development, and how to get adolescents socializing with their friends again safely.

As you probably noticed from our email, they way we're sharing our newsletter has a new look and feel based on your feedback. If you'd like to share your thoughts on on similar items in the future, join our online advisory group today.

Featured Story:

Do your patients know about the all-new AllWays member mobile app?

Now, your patients can manage their healthcare on the go with our all-new AllWays member mobile app. The easy-to-use app simplifies searching for providers, accessing plan information, and contacting our customer support team. To learn about all the features designed to improve your patients' healthcare experience, visit allwayshealthpartners.org/memberapp

In this issue:

• Upcoming webinar: new authorization process for high-tech and cardiac imaging
• Message from the Pharmacy Team
• New member search tool
• Revised medical policies
• Code updates

Featured story:

Answering patients' questions about the vaccine

No matter your specialty—your patients may have questions about the COVID-19 vaccine. In a recent member survey, 74% of respondents marked their PCP or other doctors as the most reliable vaccine information source. Now that anyone aged 16+ is eligible to receive a COVID-vaccine in Massachusetts, patients are looking to providers for guidance.

We encourage you to visit our vaccine resource page for the most updated materials and visit our Best Practice blog for helpful tips. Below you'll find three of our most recent articles:

• Tips for talking to patients about vaccine side effects
• Vaccine hesitancy continues after the first dose—so here’s what providers can do to make sure patients get their second dose
• Tips for encouraging patients to pre-register for a COVID-vaccine

In this issue:

• Tumor treating fields InterQual criteria
• High-tech and cardiac imaging
• United claims in Massachusetts and Rhode Island
• Medical policy updates
• Revised medical policies
• Forumulary updates
• CPT code updates

Featured story:

Browse our new vaccine resource page 

Massachusetts will open the final phase of the vaccine rollout to the general public on April 19, 2021. If patients are hesitant to get the vaccine, we've created a dedicated COVID-19 vaccine page with a curated collection of resources for you and your patients: 

• Videos and FAQ for common vaccine concerns from Lawrence General Hospital
• Mass General Brigham vaccine FAQ (multiple languages)
• Vaccine and pregnancy (mass.gov)

In this issue:

• Medications obtained through the medical benefit
• New products
• New vaccine resource page
• New guidelines
• Hospital inpatient utilization report
• New, revised, and retired medical policy updates
• New codes
• CPT code updates
• Drug code updates