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February 2020
Featured Story: Online prior authorizations for medical specialty drugs available starting February 13
Beginning February 13, network providers will be able to submit online medical specialty drug prior authorizations through the NovoLogix online prior authorization tool. Online submission is fastest way to request and receive a decision on your prior authorization. Requests that meet criteria may be approved in seconds.
In This Issue
- Online prior authorizations for medical specialty drugs available starting February 13
- Welcome: New additions to our growing network
- Medical policy
- Formulary updates
- HCPCS Code updates
- MassHealth acute hospital bulletin: new requirement for completion of data fields on claims for clinician-administered drugs
- Contact information
Online prior authorizations for medical specialty drugs available starting February 13
Beginning February 13, network providers will be able to submit online medical specialty drug prior authorizations through the NovoLogix online prior authorization tool. Online submission is fastest way to request and receive a decision on your prior authorization. Requests that meet criteria may be approved in seconds.
Access the NovoLogix online authorization tool via the Provider Portal
All registered AllWays Health Partners provider portal users will have direct access to the NovoLogix online prior authorization tool. No additional registration will be required.
On the provider portal homepage, you will see a new Prior Auth Vendors section. Click on the corresponding link to access NovoLogix.
You can also access the NovoLogix online tool by clicking on the corresponding link within the E-Business menu:
Register for the Provider Portal
If you are not currently registered for AllWays Health Partners' provider portal, sign-up today at allwaysprovider.org. Visit our provider portal resource page for more information about the registration process or email prweb@allwayshealth.org.
NovoLogix Resources
Here are some useful information on how to submit prior authorizations through NovoLogix:
Our provider community continues to grow in MA, NH and RI
As mentioned in a recent Best Practice Provider Blog post, we've experienced significant growth in our provider network in 2019. In both Rhode Island and New Hampshire, we've seen a percent increase in the triple digits during our inaugural year as AllWays Health Partners. In New Hampshire alone our provider network size grew almost 500% in 2019.
Here's a look at some providers who joined the AllWays Health Partners network within the past year:
- Worcester Physical Therapy Services, Inc
- Meredith Berger RDN Nutrition Counseling, LLC
- Drizik Eyecare, Inc
- Jay D. Segel
- Charles D. Leahy
- Granite State Physical Therapy
- Lisa Schroeder Physical Therapy
- Liberated Nutrition, LLC
- Wright & Associates Family Healthcare
- Mount Auburn Physical Therapy Associates, PC
If you are not yet contracted with AllWays Health Partners, submit your online request today to get started.
News from around our network: Improving care coordination and access to care
As we begin the new year, we are thrilled about a new collaboration between One Medical and Partners Community Physicians Organization. This partnership aims to achieve greater care coordination and expanded access to primary care by clinically and digitally integrating the two organizations. We look forward to hearing more about the results of this new collaboration and the positive impact to patient care.
Medical policy
The following medical policy updates are effective February 1, 2020:
- Provenge – Annual review. References updated.
- Kymriah – Annual review. Policy criteria clarified; removed "within 3 months". References updated.
- Yescarta – Annual review. Policy criteria clarified; removed "within 3 months". References updated.
- Lutathera – Annual review. References updated.
- Home Prothrombin Time Monitoring – Annual update. References updated.
Formulary updates
AllWays Health Partners regularly reviews and updates our formulary to ensure alignment with the industry. Check out the latest updates effective April 1, 2020.
For the latest information on our pharmacy programs, visit our online formulary today.
Code updates
Stay current on the latest code and reimbursement updates. Check out the latest updates:
MassHealth acute outpatient hospital bulletin: new requirements for completion of data fields on claims for clinician-administered drugs
MassHealth now requires the National Drug Code (NDC) field, in addition to all previously required fields, to be completed on most claims for clinician-administered drugs. For outpatient hospital claims received on or after March 1, 2020 and with service dates on or after January 1, 2020, AllWays Health Partners will process these claims as outlined in the MassHealth Acute Outpatient Hospital Bulletin 34.