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 

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. 

prior-auth-vendors

You can also access the NovoLogix online tool by clicking on the corresponding link within the E-Business menu:

novologix-tool

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:  

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.

View all medical policies.

 


 

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