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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

August 2018

Highlights
New Partnership Leverages Digital Tech for Care Management

Harvard Pilgrim is working with Wellframe to deliver care management support and programming to members directly on their mobile devices.

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Voluntary Home Infusion Program for Remicade and IVIG

Beginning on Sept. 1, Harvard Pilgrim will be offering a voluntary home infusion program for infliximab and immunoglobulin (IVIG) treatment in conjunction with Coram CVS Specialty Infusion Services.

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Promote the Flu Vaccine to Your Patients for the Upcoming Season

With the 2018-2019 flu season approaching, it is crucial to emphasize the importance of getting vaccinated to our member population.

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New HCPCS Codes for Hemlibra and Luxturna

Harvard Pilgrim covers the medications Hemlibra (for the treatment of hemophilia A) and Luxturna (for the treatment of biallelic RPE65 mutation-associated retinal dystrophy) for our commercial members.

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Home Care Providers: Billing for Postnatal Skilled Nursing Home Visits

Harvard Pilgrim would like to provide some clarification regarding the correct method of billing for postnatal home health visits for skilled nursing care, to ensure that the correct cost sharing applies and the claim is appropriately processed.

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HPHCURRENT EVENTS

New Partnership Leverages Digital Tech for Care Management

Voluntary Home Infusion Program for Remicade and IVIG

CLINICIAN CORNER

Promote the Flu Vaccine to Your Patients for the Upcoming Season

New HCPCS Codes for Hemlibra and Luxturna

Opdivo Approved for an Additional Indication

Rebinyn and Durolane to be Covered with Prior Authorization

Prior Authorization No Longer Required for Cologuard Test

Members’ Rights and Responsibilities

Pharmacy & Therapeutics Committee Meeting Update

Recognizing Generalized Anxiety Disorder in the Primary Care Setting

OFFICE ASSISTANT

Home Care Providers: Billing for Postnatal Skilled Nursing Home Visits

270/271 Eligibility Response Update and Telemedicine Billing Reminders

Billing for Facility-Based Urgent Care

QMB Members Cannot be Billed for Medicare Parts A and B Cost-Sharing

PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator