Providers in the know: February 2021 edition

Featured story:

COVID-19 vaccine updates

With the vaccine rollout underway, we’ve compiled some of the most common questions your patients are asking in an easy-to-read FAQ . We cover where and when patients can the vaccine along with eligibility, payment, efficacy, safety, and mask wearing post-vaccination.

Reference these questions and more on our Coronavirus Resource Center for patients, providers, and employers. We'll continue to update the information regularly. So check back frequently and share the link with your patients. 

In this issue:

  • COVID-19 vaccine updates
  • Reminder
  • Inpatient PA waiver extension
  • Medical Policy Updates
  • HCPCS Code Updates

Reminder: new products in 2021

Since we've launched new products in 2021, remember to utilize the directory before making a referral. This ensures that you are able to refer patients to providers that are part of their member network.

If you missed either of our new product training webinars, you still have time to sign up for our final session on Friday, February 12, 2021 from 12:00PM to 1:00PM

Inpatient prior authorizations 

Per DOI requirements, AllWays Health Partners will be reinstating prior authorization requirements for in-patient hospital admissions on March, 31, 2021. 

The provider should notify us within 48 hours of admission and submit an update a minimum of every 5 days to support discharge planning. 

For more information about our policies during the pandemic, visit our COVID-19 FAQ for providers

Medical Policy Updates

Medical Policy Updates2-1

HCPCS Code Updates

Not Covered Experimental and Investigational:

HCPCS codes14

Not Covered per Benefit:

HCPCS codes2B

Covered when Prior Authorized:

HCPCS codes3

Covered with No Prior Authorization:

HCPCS codes4

Covered but Not Reimbursed:

HCPCS codes6

Resubmit with CPT Code:

HCPCS codes7

Resubmit with CPT Code for Commercial; Not Reimbursable for MassHealth:

HCPCS codes8

Reportable Only; Not Reimbursable:

HCPCS codes9

HCPCS codes10

HCPCS codes11HCPCS codes13