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2018-05-11
Standard vs. High Tech Hourly Private Duty Nursing
To inform private duty nursing providers of the service codes to be used when requesting authorization and billing for standard and high tech private duty nursing services...
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2018-05-11
Claim Rejection Reason Reminder
A claim may be rejected if it is an exact duplicate of a previous claim submission. Failure to include the Treatment Authorization Codes (TAC) when submitting Medicare Advantage traditional home health claims will result in a rejection. ..
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2018-04-30
Eligibility and Benefits for New Jersey Carpenters Fund (Horizon Healthcare Services, Inc.)
To remind providers that continuous glucose monitors (CGM) are a non-covered benefit for Horizon Healthcare Services, Inc. (“Horizon”) members covered under the New Jersey Carpenters Fund Employer Group (Group Number 75938). Providers are required to verify eligibility and..
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2018-04-26
CMS Code Changes – Effective April 1, 2018
The purpose of this communication is to notify providers of changes to the Centers for Medicare and Medicaid Services (CMS) Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS), and how these changes may impact provider billing, fee s..
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2018-04-26
New Blue Cross Blue Shield Alphanumeric Subscriber IDs
Effective immediately, the Blue Cross and Blue Shield Association (BCBSA) is expanding the alpha prefix designation to accommodate alphanumeric values in Subscriber IDs.o Example of a new Subscriber ID: W5K123456789..
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2018-04-26
Fallon Medicaid Business
To inform Fallon Health providers that, effective March 1, 2018, Fallon is supporting 3 new Accountable Care Organizations (ACOs) to manage Medicaid members:o Reliant ACO /Fallon 365 Careo Wellforce ACO/ Wellforce Care Plano Berkshire ACO/ Berkshire Fallon Health Collabora..
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2018-04-24
2.Notice of Address Change – Paper Claims Sent via FedEx, UPS or Certified Mail
The purpose of this communication is to notify providers using Federal Express, UPS or Certified Mail of a change to the address for submitting paper corrected claims, reconsiderations, and appeals. ..
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2018-04-07
Medicare Advantage - Home Health Billing Reminder
To remind Home Health Providers of specific billing requirements for Medicare Advantage members. Claims that do not adhere to these requirements may be rejected or denied. ..
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2018-04-06
Changes to Provider Demographic Information
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application...
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2018-03-20
Correction - Cigna Breast Pump Kit Newsflash
To inform contracted providers who service Cigna members of a recent change to the fee schedule for billing a kit to support institutional (hospital grade) breast pumps...
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2018-02-26
Warning Code Tool
To remind providers of the importance of resolving all error messages, specifically ”Overlap Errors,” prior to submitting authorization requests on the Provider Portal: HomeBridge. ..
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2018-02-14
Rental vs Purchase Authorization Requests
To remind durable medical equipment (DME) sleep providers of their responsibility to use the correct Unit of Measure (UOM) when submitting requests for PAP therapy devices through the Provider Portal: HomeBridgeSM...
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2018-02-02
Compliance Reminder BayCare Health System County Coverage
To remind CareCentrix providers of their obligation to comply with the existing BayCare Health System carve-out process for certain Cigna members...
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2018-02-02
Claims Processing: Enhancements
To notify providers of a recent enhancement aimed at improving electronic and paper claim processing times. Effective immediately, providers are encouraged to include the patient’s health plan name on each claim submission...
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2018-01-29
New Pap Therapy Set-Up Form
Effective immediately, the newly updated CareCentrix / Sleep Management Solutions (SMS) PAP therapy set-up form is required for all patients participating in the CareCentrix/ Sleep Management Solutions (SMS) iComply Therapy Adherence Program. ..
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2018-01-13
Changes to Provider Demographic Information
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application...
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2018-01-11
CMS Code Changes Effective 1-1-2018
The purpose of this communication is to notify providers of changes to the Centers for Medicare and Medicaid Services (CMS) Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) and how they may impact provider billing, fee schedules, ..
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2018-01-05
New Cigna Time Audit Sheet
To inform providers of a new form required when requesting authorization for Private DutyNursing for Cigna members...
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2018-01-05
LT / RT Modifier Enhancement
To advise providers of a recent system enhancement related to LT ..
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2017-12-27
Medical Policy Resources Reminder
To remind providers that links to health plan medical coverage policies are available through both the Provider Manual and the Medical Coverage Policies links on the CareCentrix Provider Portal. ..
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2017-12-22
2018 Benefit Reminders
To remind providers about the importance of confirming a member’s eligibility and benefits as the year draws to a close, to ensure authorizations are current, and to provide guidance for successful claims submission..
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2017-12-15
Holiday Home Care Referrals
With the upcoming holiday, we are asking to submit your referrals to CareCentrix as early as possible, so that we can ensure services are coordinated timely for your discharging patient(s)...
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2017-11-27
Medical Policy Resources Reminder
To remind providers that links to health plan medical coverage policies are available through both the Provider Manual and the Medical Coverage Policies links on the CareCentrix Provider Portal home page at www.CareCentrixPortal.com under the “For Providers” section...
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2017-11-18
Horizon Contiguous County Rules
To clarify the Horizon contiguous county rules which define whether a service provided to aHorizon member should be billed to CareCentrix or the member’s home plan...
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2017-10-27
Infusion Nursing Network Opportunity
The purpose of this communication is to notify home health agencies of a growing opportunity for specialty infusion nursing. CareCentrix has a network of home infusion pharmacies that dispense specialty infusion medication, pumps, and supplies directly to the patient’s hom..
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2017-10-27
Medical Policy Resources Reminder
To remind providers that links to health plan medical coverage policies are available through both the Provider Manual and the Medical Coverage Policies links on the CareCentrix Provider Portal home page at www.CareCentrixPortal.com under the “For Providers” section.CareCe..
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2017-10-16
Normal Saline Shortage
To inform providers of a supply disruption of IV solutions due to scheduled maintenance within Braun's manufacturing environment beginning in October. ..
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2017-10-13
Changes to Provider Demographic Information
To remind providers that they must timely notify CareCentrix of any changes in theirdemographic information or changes to the information submitted in their CareCentrixcredentialing application...
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2017-10-12
Provider submissions of authorizations and re-authorizations
Provider education for submitting authorizations and re-authorizations and direction to the providers on how and what to communicate to the patients. ..
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2017-10-12
Alert: CA Wildfires
Governor Brown Jr. has declared a State of Emergency in Solano, Napa, Sonoma and Yuba counties following the recent wildfires across the state and the high potential for increased wildfires to continue this year. ..
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2017-10-06
Hurricane Nate
To alert contracted providers in selected counties currently under hurricane watch or warningsabout CareCentrix’s operations in preparation for Hurricane Nate...
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2017-09-29
Medical Coverage Policy Updates
To notify providers that links to health plan medical coverage policies are now available on the CareCentrix Provider Portal...
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2017-09-28
Authorization Status Tracker
To inform providers of a new enhancement being implemented to our provider portal that will give providers information on the status of their authorization request...
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2017-09-27
Provider Warning Code
To inform providers of a new self-service feature, called Warning Code Tool, onour provider portal to enhance the provider experience. This tool allows a providerto see the most common errors and to make corrections to improve overallefficiencies...
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2017-09-27
New Cigna Dedicated 800 Number
To inform providers that CareCentrix has implemented a new toll-free number that has been created specifically for provider inquiries related to Cigna members such as authorization and claim inquiries...
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2017-09-20
Hurricane Jose
To alert contracted providers in selected counties currently under tropical storm or hurricane watch about CareCentrix’s operations in preparation for Hurricane Jose...
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2017-09-07
State of Emergency - Hurricane Irma
To alert contracted providers in Florida of CareCentrix’s operations in light of Executive Order 17-235 issued by Governor Scott, which declares a State of Emergency in all counties within the state of Florida, in preparation for Hurricane Irma...
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2017-09-06
Billing Changes for MED Services for Florida Blue
This communication is to notify providers that billing requirements have changed for MED (drug) services for Florida Blue members. ..
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2017-08-30
Critical Reminder Regarding Provider Portal
To remind providers of the clinical information needed to help ensure timely processing of authorizations through the Provider Portal...
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2017-08-30
New Precertfication Requirements
On June 1, 2017, precertification is required for Medicare Part B home health care services when the homecare requests are more than 60 consecutive days.This applies to all providers rendering home health care services for members enrolled in Aetna and Coventry Medicare A..
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2017-07-20
Notice of Medicare Non-Coverage Fax Requirement
To remind all participating home health providers that they are required to fax to CareCentrix every Medicare Advantage patient's completed NOMNC form. ..
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2017-07-20
Diabetic Equipment and Supplies for Lake County Board of County Commissioners
To notify providers that diabetic equipment (insulin pumps, tubing, etc.) and diabetic supplies (test strips, lancets, etc.) for Lake County Board of County Commissioners Florida Blue members are covered under both the Medical (Durable Medical Equipment "DME") and Pharmacy..
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2017-07-18
BayCare Health System County Coverage Carve Out
To remind CareCentrix providers of county coverage for the existing BayCare Health System carve out process for Cigna members. ..
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2017-07-14
Changes to Provider Demographic Info Q3 2017
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application. ..
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2017-06-15
New PAP Therapy Set-Up Form
Effective immediately, the newly updated CareCentrix / Sleep Management Solutions (SMS) PAP therapy set-up form is required for all patients participating in the CareCentrix / Sleep Management Solutions (SMS) iComply Therapy Adherence Program...
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2017-06-06
State of Illinois Health Benefit Plan Termination with Cigna and CareCentrix
Beginning July 1, 2017, Cigna and CareCentrix will no longer coordinate services for the State of Illinois Health Benefit Plan. Providers should work directly with the patient’s new carrier for services provided to State of Illinois members on or after July 1, 2017...
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2017-05-31
Home Sleep Test (HST) Program Reminder
To remind Home Sleep Test (HST) providers of their responsibility to update the Patient Management System (SleepUM) on a timely and accurate basis and in accordance with the terms of participation in the “Specialty Program” as referenced in the Provider Manual. ..
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2017-05-18
MOOG Infusion Pump Training Opportunity
To extend the opportunity for Home Health Agencies to learn how to become a proficient user of Cigna's Preferred Infusion Pump for IV services of their members. ..
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2017-04-21
Changes to Provider Demographic Info - Q2 2017
The purpose of this communication is to remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application. ..
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2017-04-18
Medicare Advantage - Oxygen Authorization Requirements
The purpose of this communication is to provide additional information about changes to the CareCentrix oxygen authorization requirements for Medicare Advantage members announced in our February 2017 Newsflash and effective April 10, 2017. ..
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2017-04-14
Notice of Address Change - Paper Claims Submissions
The purpose of this communication is to notify providers of a change to the address for submitting paper claims, recoupment requests, reconsiderations, and appeals to CareCentrix. ..
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2017-03-17
Florida Blue Self-Administered Drugs - Update
The purpose of this communication is to notify providers of recent changes to the Florida Blue self-administered drug process and how it will impact new and existing authorizations.Note: This change applies to commercial and Medicare Advantage members. Providers should alw..
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2017-02-15
Provider Demographic Changes
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application...
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2017-02-15
CMS Code Changes
The purpose of this communication is to notify providers of recent changes to CMS CPT Codes and how they will impact provider billing, fee schedules, and existing authorizations...
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2017-02-10
Oxygen Authorized Unit Change
To inform providers about a change to the CareCentrix authorization process for oxygen for patients covered under a Medicare Advantage Plan. ..
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2017-02-01
Rent to Purchase
The purpose of this communication is to remind providers of the capped rental and rent-to-purchase requirements under your provider agreement. ..
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2016-12-21
Provider Demographic Changes
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application...
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2016-12-02
Cigna Secondary Claims
The newsflash is intended to inform providers about changes to the claims submission process when Medicare is primary and Cigna is secondary...
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2016-12-02
2017 Benefits Reminder
The purpose of this newsflash is to remind providers about the importance of confirming a member’s proof of eligibility and coverage as the year draws to a close, to ensure authorizations are current, and to provide guidance for successful claims submission. ..
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2016-10-11
Horizon BCBSNJ Authorization Process
This document reviews the authorization process providers should follow when submitting service requests for Horizon BCBSNJ members receiving traditional home health and/or private duty nursing services on or after November 1, 2016...
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2016-08-29
Provider Portal Delays/Errors with Service Requests
You may intermittently experience delays and/or errors when submitting service requests and/or viewing authorizations via the CareCentrix Provider Portal. The CareCentrix team is diligently working to resolve the issue. ..
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2016-08-10
Pediatric Nursing Authorization Update
The purpose of this communication is to inform providers about a change to the CareCentrix authorization policy for pediatric nursing visits, specifically an expansion in the number of visits authorized upon initial request. This change will apply to all of the health pla..
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2016-08-08
Physical Therapy Authorization Update
The purpose of this communication is to inform providers about a change to the CareCentrix authorization policy for physical therapy visits, specifically an expansion in the number of visits authorized upon initial request. This change will apply to all of the health plan..
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2016-08-05
Assignment of Benefits
The purpose of this communication is to educate providers about CareCentrix’s expectation that providers will obtain an assignment of benefits (AOB) from their patients and reflect that they have obtained such assignment in their claims submissions to CareCentrix...
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2016-08-01
RN Skilled Nursing Authorization Update
The purpose of this communication is to inform providers about a change to the CareCentrix authorization policy for skilled nursing visits, specifically an expansion in the number of visits authorized upon initial request. This change will apply to all of the health plans..
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2016-08-01
Horizon Home Health
The purpose of this communication is to inform providers that, effective November 1, 2016, the management of traditional home health for Horizon BCBSNJ members (including skilled nursing, home health aide, physical, occupational and speech therapy visits) and private duty ..
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2016-07-13
Reminder: Provider Demographic Changes
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application... ..
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2016-06-17
Horizon Diabetic Supplies
To inform providers about changes impacting diabetic supplies for Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) State members. .. ..
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2016-06-17
Coverage Policy Reminder: Lyme Disease
To remind all participating home infusion providers of CIGNA’s coverage policy regarding the treatment of Lyme disease...
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2016-05-23
Advanced Wound Care Product Coverage Changes
The purpose of this communication is to notify providers about Advanced Wound Care Products that may now be covered under the Horizon Care@Home Program for fully insured members, to review the products and services that remain excluded from the plan and to inform you about..
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2016-05-09
Horizon Home Health Claim Submission
Use this quick reference guide when submitting claims for home health services...
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2016-05-05
2016 NOMNC Fax Requirement and 179 NOMNC Training
Explains the NOMNC process and requirements to Medicare certified providers in FL and GA. ..
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2016-04-29
Reminder: Provider Demographic Changes
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application...
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2016-04-27
Be Healthy-Alignment Prefix Re-education
The purpose of the newsflash is to re-educate providers on the correct Be Healthy prefixes to be used and authorization best practices...
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2016-04-11
PEIA West Virginia Sleep Program Changes
To inform providers that PEIA West Virginia will be migrated to our Claims 2.0 operating model effective on 5/1/2016. Claims 2.0 is CareCentrix’s enhanced claims processing technology and operations designed to align with industry best practices and to improve overall pro..
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2016-03-30
BayCare Health System Carve Out Update For Cigna Members
To inform the CareCentrix provider network of a recent county coverage update to the existing BayCare Health System carve out process for Cigna members effective April 1, 2016. As a reminder, CareCentrix is the national ancillary provider for Cigna and coordinates home hea..
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2016-03-29
Cigna Global Liberty- Foreign Address
CareCentrix will be implementing a change on our portal. This change will affect patients with Cigna Global Liberty accounts...
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2016-03-15
Town Hall for Billing and Processing Updates
The purpose of this communication is to notify our home health and private duty nursing (PDN) providers of a Town Hall meeting that will take place on Monday March 21st, 2016 at 10:00 am EDT – 11:00 am EDT...
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2016-03-12
FAQ: 2016 CMS Procedure Code Updates
Frequently Asked Questions on CMS Procedure Code Updates..
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2016-03-11
Horizon Private Duty Nursing (PDN) Procedural Changes-FAQ
Frequently Asked Questions..
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2016-03-11
Horizon Private Duty Nursing Procedural Changes
The purpose of this communication is to notify our providers on the procedural updates to Private Duty Nursing (PDN) claims process for the Horizon Care@Home Program..
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2016-02-16
Changes to Provider Demographic Information
To remind providers that they must timely notify CareCentrix of any changes in their demographic information or changes to the information submitted in their CareCentrix credentialing application...
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2016-01-28
Medicare Advantage Member Billing Requirements
To remind home health providers of some of the billing requirements for patients with Medicare Advantage coverage (Medicare Advantage Members) and that Medicare Advantage Member claims that do not adhere to these requirements will be rejected..
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2016-01-25
CareCentrix to Manage BeHealthy Plan
CareCentrix to Manage BeHealthy and Florida Health Care Plan Medicare Advantage Members for Florida Blue..
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2016-01-15
FAQ Health Insurance Exchange Members - 90 Day Grace Period Reminder
90 Day Grace Period for Certain Members Enrolled in a Plan Through a Health Insurance Exchange..
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2016-01-15
Publix Members Alpha Prefix
This is to remind providers that, as of January 1st 2015, the alpha prefix for all Publix members changed from PBB to PXN. Claims with the incorrect prefix will be denied...
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2016-01-07
Important Horizon Home Health Aid Notice
Important Communication Regarding Authorization Requests and Claims Submissions for Home Health Aide Services..
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2016-01-06
Health Insurance Exchange Members - 90 Day Grace Period Reminder
To provide you with information on how you can identify Health Insurance Exchange members who receive an Advanced Premium Tax Credit (a federal subsidy) and are in a premium grace period (the “APTC Members”) and how CareCentrix will process claims for these members...
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2015-12-16
HealthNet Termination Announcement
Beginning March 10, 2016, CareCentrix will no longer coordinate services for HealthNet...
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2015-09-21
Important Horizon Blue Cross Blue Shield of New Jersey Communication
Important Horizon Blue Cross Blue Shield of New Jersey Communication Regarding Pre-Service Out-of-Pocket Estimates, Claims Submissions, and Multiple Payor Scenarios..
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2015-09-04
Fallon Total Care Update
To inform network providers, effective Sept 30, 2015, Fallon Total Care will end its participation in the Commonwealth's One Care program...
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2015-07-01
Horizon BCBSNJ Authorization Request
For a new Horizon BCBSNJ authorization request or issues with an authorization please call (855) 243-3321. Follow the IVR prompts to press (1) for providers then (1) for intake then (4) for CareCentrix contracted provider...
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2015-05-18
Horizon Member Transition
To inform network providers of the upcoming member transition program known as TransApp which will be available to help transition Horizon members to CareCentrix beginning May 26, 2015...
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2015-05-13
Multiple Per Diems for Florida Blue – Effective May 1st, 2015
To notify providers of a change to the Florida Blue payment policy on multiple, concurrent per diems for Home Infusion Therapy.To educate providers on how to request authorization and submit Florida Blue claims for per diem home infusion codes when multiple medications ar..
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2015-05-04
Update: Revised BlueCard Process
To announce that the revised BlueCard process will be implemented on May 10, 2015. Beginning on that date, CareCentrix network providers must obtain required authorizations directly from the BlueCard member’s home plan. A CareCentrix authorization is no longer required. ..
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2015-04-27
Fractional Units
To inform network providers of a change to CareCentrix’s fractional units billing policy effective May 1, 2015..
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2015-04-17
CareCentrix Provider Portal
To inform all providers that the CareCentrix Provider Portal will not be accessible from Saturday at 11PM EST through Sunday at 5AM EST while CareCentrix implements an important maintenance update...
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2015-04-17
Certain Applications Not Accessible for 6 Hours this Weekend
To inform all providers that certain CareCentrix applications will not be accessible from Saturday 11PM ET - Sunday 5AM ET while we implement an important maintenance update..
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2015-04-01
CareCentrix and Horizon Healthcare Services, Inc. Sign 5-Year Agreement
HARTFORD, Conn. – February 3, 2015 – CareCentrix, the leader in managing patientcare to the home, announced today that it has entered into a 5-year agreement withHorizon Healthcare Services, Inc., New Jersey’s oldest and largest health insurancecompany, to provide Homecare..
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2015-03-24
Provider Portal Passwords
To inform providers that all Provider Portal passwords must be reset every 90 days and to provide guidance on selecting strong passwords. ..
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2015-01-27
Importance of Providing Correct Ordering Physician Information
To remind you about the importance of providing current and correct ordering physician information with each authorization request...
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2015-01-15
Utilization Review Standards for Cigna Members
To give Providers information about the utilization review standards applicable to Cigna members. ..
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2015-01-13
Billing for Home Care Services Performed On Same Day
To remind providers that services performed on the same day, with the same HCPCS/CPT/modifier combination, must be billed on the same claim line with the appropriate quantity or on separate lines of the same claim form with the appropriate base code/add-on code combination..
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2015-01-09
Update: Revised BlueCard Process
To announce that the revised BlueCard process will be implemented in early February 2015. In preparation for this change, CareCentrix will offer extensive provider training to all FL network providers beginning on January 8th, 2015. ..
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2015-01-06
Criteria for “Urgent” Requests
Please be mindful when designating authorization requests as “urgent” on the CareCentrix portal. ..
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2014-12-09
Complimentary Webinar: December 10, 2014 @ 1 p.m.
To discuss those trends, CareCentrix Chief Growth Officer Steve Wogen will participate in a complimentary Health Business Group Webinar on Dec. 10, “Home Health: Opportunities for ACOs, health plans and investors.” He will deliver insights on the expanded role and effectiv..
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2014-11-08
Change to Authorization Process for Cigna Shared Administration Plans
To notify those providers servicing patients covered under a Cigna Shared Administration (SAR) plan of a change to the precertification process effective November 15, 2014. ..
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2014-10-30
Update: BlueCard Process
To inform Providers that CareCentrix is delaying the implementation of its revised BlueCard process until further notice. ..
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2014-10-27
Explanation of Payment (EOP) and Electronic Remittance Advice (ERA)
To inform providers that CareCentrix EOPs and ERAs will utilize industry standard ANSI codes (Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC))...
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2014-10-07
Additional Physician Information
To provide guidance for our providers on the correct completion of physician information on institutional paper and electronic claims submitted to CareCentrix. If the patient has a referring or rendering Physician that is different from the attending Physician, then this i..
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2014-09-08
CareCentrix Rebranding
To notify our providers of changes to the CareCentrix brand that will go in place starting September 9th, 2014. This change is in support of our company vision: “A world where anyone can heal or age at home”...
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2014-08-27
Clean Claim Requirements: Taxonomy Code
To remind all providers that the taxonomy code is a required data element on both paper and electronic claims submitted to CareCentrix. This data element is required under HIPAA for electronic claims submissions under the 5010 format and is required by most other networks ..
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2014-08-25
Provider Portal Enhancements
To notify you that CareCentrix is in the process of making enhancements to our Provider Portal. Providers may notice a new drop down for claims inquiries, reconsiderations and appeals. These functionalities are not yet available for use and providers will be redirected to ..
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2014-07-30
CareCentrix HCPCS Modifier Combination Reminder for DME Providers
To remind Durable Medical Equipment Providers to submit claims with a HCPCS/modifier combination that is recognized in the CareCentrix Crosswalk to help ensure that claims are not rejected or denied due to an incorrect HCPCS/modifier combination. ..
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2014-07-17
Invalid and Incorrect HCPCS/Modifier Combinations
To educate providers about claim rejections and denials based on invalid or incorrect HCPCS/modifier combinations and how these rejections and denials can be prevented and corrected so that a claim can be accepted for processing by CareCentrix. ..
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2014-07-08
HIPPS Requirement FAQ
Provider Frequently Asked Questions July 2014..
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2014-06-18
Medication Pricing Update
As provided under your CareCentrix Provider Agreement, you are reimbursed for drugs in accordance with the average wholesale price. Effective June 1, 2014, due to recent market conditions, there will be a pricing change to the following medications..
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2014-06-04
Health Insurance Prospective Pay System (HIPPS) Code Mandate
To inform network providers that, effective July 1, 2014, the Centers for Medicare and Medicaid Services (CMS) requires providers to submit Health Insurance Prospective Pay System (HIPPS) codes on home health care services claims for Medicare Advantage members. ..
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2014-05-30
Notice of Medicare Non- Coverage (NOMNC) for Medicare Advantage Members
To remind providers that they are required to follow CMS requirements relating to Notices of Medicare Non-Coverage (NOMNC) with respect to their Medicare Advantage patients. Under CMS requirements, providers are required to deliver a NOMNC letter to a Medicare Advantage p..
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2014-04-24
CareCentrix Direct Is Here!
We are excited to remind you that CareCentrix Direct will be available for all of our health plan customers’ members on April 28, 2014. CareCentrix Direct is an enhancement that allows enrolled providers to receive automated, electronic notifications of new referrals. ..
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2014-04-23
Service Authorization Forms: Diagnosis Codes
To inform providers that Service Authorization Forms (SAFs) will no longer show diagnosis codes. ..
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2014-04-22
Referring Physician NPI Claims Requirement
To remind providers of the importance of including the referring physician name and National Provider Identifier (NPI) numbers on both paper and electronic claims submitted to CareCentrix. ..
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2014-03-31
Florida True Health to End Medicaid Coverage in Volusia County
To inform you that, effective May 1, 2014, Florida True Health/True Blue will no longer provide coverage for Medicaid members residing in Volusia County, Florida. As such, CareCentrix will no longer coordinate services for Florida True Health/True Blue Medicaid members tha..
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2014-03-12
Health Plan Exchange and Grace Period Information
To provide you with information on how you can identify members enrolled in a plan through a Health Insurance Exchange who receive an Advanced Premium Tax Credit and have a 90 day premium grace period (the “APTC Members”) and how CareCentrix will process claims for these ..
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2014-02-17
ICD-10 FAQ
What should providers do to prepare for the transition to ICD-10?Providers should monitor direction from CMS on the ICD-10 implementation at http://www.cms.gov/Medicare/Coding/ICD10. As the planning and implementation strategies move into the next phase of implementation, ..
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2014-01-28
Eligibility and Benefits Verification
To remind network providers of their responsibility to verify patient eligibility and benefits with the health plan identified on the patient identification card prior to rendering services. Verifying patient eligibility and benefits is especially important at the beginni..
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2014-01-07
Eligibility and Benefits Verification
To remind network providers of their responsibility to verify patient eligibility and benefits with the health plan identified on the patient identification card prior to rendering services. ..
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2013-11-20
Action Required: New 837I EDI Submission Process
To inform providers that CareCentrix has enhanced our claims process to now accept 837i Institutional Healthcare Claim submissions electronically through Availity and Emdeon effective November 18, 2013...
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2013-09-11
Referring Physician NPI Claims Requirement
CareCentrix would like to remind all providers of the importance of including the referring provider/physician name and National Provider Identifier (NPI) numbers on both paper and electronic claims submitted to CareCentrix. ..
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2013-08-23
CareCentrix to Manage Services For Florida True Health Members In Additional Counties
Effective September 1, 2013, CareCentrix will be the preferred provider of durable medical equipment/medical supplies, home health, home infusion, and orthotic/prosthetic services for Florida True Health members in Okeechobee, Osceola, Martin, Palm Beach, Seminole and St. ..
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2013-08-20
Introducing CareCentrix Direct
To introduce CareCentrix Direct as the new name of an enhancement announced in July. This enhancement will allow providers to receive automated, electronic notifications of new referrals available to their agency. These referrals can be accepted on the CareCentrix portal..
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2013-08-16
HCPCS Simplification Phase II – ‘Go Live’ Now August 22, 2013
•Implementation of HCPC Simplification Phase II has been delayed from August 17, 2013 to August 22, 2013•We appreciate your patience as we delay implementation to help ensure quality execution of this important change•For additional background on the HCPC Simplification pr..
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2013-08-15
Service Authorization Forms: Incorrect HCPC/Modifiers Codes Corrected
•To inform providers that they may have received a Service Authorization Form (SAF) showing incorrect HCPC/modifier code combinations, which do not match their contract or the billing crosswalk. CareCentrix has corrected and reissued SAFs to all impacted providers...
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2013-08-15
Notice of Medicare Non- Coverage (NOMNC) for Aetna and FL Blue/ BlueCard Medicare Advantage Members
•Remind providers when accepting a MEDICARE ADVANTAGE Aetna, FL Blue or FL Blue BlueCard patient, you are required to follow CMS requirements. CMS requires that you deliver a Notice of Medicare Non-Coverage letter (NOMNC) to all Medicare Advantage patients prior to dischar..
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2013-08-09
CareCentrix HCPCS unit of measure (UOM) MED Simplification
•CareCentrix supports service excellence and operational efficiency for our providers. We have listened to your requests and are further simplifying our billing process. •Therefore, we would like to remind Home Infusion Providers that CareCentrix is adopting HCPCS UOM (u..
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2013-07-20
Activation for New Enhancement – Electronic Notification of Referrals
To notify CareCentrix Providers that we are introducing an exciting new enhancement to our provider portal in the fall of 2013 that will allow providers to receive automated, electronic notifications (via email and/or text message) of new referrals available to them. The..
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2013-07-20
Cigna Global Plan Changes to MMI
•To provide a courtesy notification to our network that several non-managed Cigna Global plans (previously called Cigna International non United Kingdom) have changed to Managed plan types...
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2013-07-19
Cigna Global Plan Changes to MMI
•To provide a courtesy notification to our network that several non-managed Cigna Global plans (previously called Cigna International non United Kingdom) have changed to Managed plan types.•As with all Managed plans, and now including members with group numbers listed belo..
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2013-05-13
CareCentrix HCPCS unit of measure (UOM) MED Updates
•To notify Home Infusion Providers that CareCentrix is moving to HCPCS UOM (units of measure) for all the drugs in our database, effective on August 1, 2013. •An electronic listing of the new billing codes, in HCPC units of measure, will become available on July 1, 2013, ..
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2013-05-10
Action Required: Secure Email Communications
Effective June 3, 2013, CareCentrix will support two modes of secure email communication with our providers: •TLS (Transport Layer Security), and •CRES (Cisco Registered Envelope Service)..
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2013-02-08
BCBS Federal Employee Plan (FEP) Policy Reminder
Remind providers of the registration and claims policies for Federal Employee Plan (FEP) members. For FEP members, the provider’s servicing location that dispenses/ships the service dictates which Blue Cross plan should be billed. ..
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2013-01-21
New Address for Claim Reconsiderations
Effective January 23, 2013, providers need to submit Claim Reconsiderations and Claim Appeals to CareCentrix to a new address...
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2013-01-17
Clinical Document Requests
Inform providers that effective February 18th, providers will be required to submit clinical documents via the provider portal at the time of authorization and prior to claims processing...
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2013-01-14
Provider Portal Enhancements
On Sunday January the 20th, we will be implementing some key enhancements to our provider portal Please note, implementing these enhancements will require the portal to be brought down for 4 hours from 11pm on 1/19 to 2am on 1/20..
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2013-01-11
Requirements for Continued Participation in the CareCentrix Florida Provider Network
Remind CareCentrix Florida network providers about the metrics that CareCentrix uses to evaluate a network provider’s performance and determine continued participation in the CareCentrix provider network. ..
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2013-01-03
CareCentrix to Manage Durable Medical Equipment/Medical Supplies, Home Health, Home Infusion, and Orthotic and Prosthetic Services for Florida True Health
Effective February 1, 2013, CareCentrix will be the preferred provider of durable medical equipment/medical supplies, home health, home infusion, and orthotic/prosthetic services for Florida True Health members. ..
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2012-12-20
Provider Portal Enhancements
On Sunday December the 16th, we implemented an enhancement to our provider portal. The enhancement surrounds member search and eligibility..
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2012-12-13
Power
Notification to providers of the correct process for requesting Custom and Rehab equipment ..
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2012-12-13
Cut Off Dates for 2012 Benefit Year
Remind providers to inform patients that items authorized in 2012, but not shipped until 2013, will be applied towards the patient’s 2013 benefit and deductibles..
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2012-11-30
Our Claims Address Has Changed!
Please note that the address for paper claims has changed. In addition, zip-codes provided in an earlier message about this change have now been updated...
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2012-11-09
Transition Guidelines for the TennCare Managed Medicaid Program
CareCentrix and the Volunteer State Health Plan (VSHP) announced in September that we were restructuring our relationship to support members in Tennessee...
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2012-11-05
Lovelace and ABQ Update
Effective November 8, 2012 ABQ Health Partners will be terminating their contract with Lovelace Health Plan and as a result Lovelace members will need to transfer to new physicians. ..
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2012-10-29
Hurricane Sandy
Important information regarding hurricane Sandy..
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2012-10-25
Referring Physician NPI Claims Requirement
CareCentrix would like to remind all providers of the importance of submitting the referring physician NPI on both paper and electronic claims submitted to CareCentrix..
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2012-09-18
Cigna HMO Authorization Process
Please see the attached for updated information on the Cigna HMO authorization process...
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2012-09-11
Urgent/Expedited Care Requests
It is extremely important that authorization requests are appropriately categorized as either non-urgent or urgent based on the circumstances of the patient so that truly urgent cases can be appropriately prioritized and timely processed. Please read the attached NewsFl..
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2012-09-10
**NEW** Claim Education Tools Available on Provider Portal
CareCentrix has re-vamped its provider education section on the provider portal, offering several new self directed educational tools focused on claims and billing. Please check out the new traning videos!..
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2012-09-06
Provider Portal Enhancements
CareCentrix has implemented some key enhancements to its provider portal. Please open the attachment to learn more...
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2012-08-29
Hurricane Isaac
CareCentrix is providing important information in anticipation of hurricane Isaac, expected to reach southern Florida late Sunday...
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2012-08-22
Authorization Requests No Longer Accepted Via Fax
Effective March 1, 2012, CareCentrix will no longer accept authorization requests from providers via fax...
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2012-08-14
Cigna Retro-Authorization Policy
Reminder of the policy regarding “retro-authorization” requests..
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2011-08-21
CareCentrix Policy Reminder: Authorization Rules PTA/COTA
Rehab para-professionals (PTA or COTA) used to support a physical or occupational therapy plan of treatment must be authorized as a para-professional. CareCentrix will only authorize para-professionals where both state licensure and health plan contract allows for these se..
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2011-08-21
Enhancement: Provider Portal Authorization Status Lookup
CareCentrix is adding another great feature to our provider portal to allow our providers to conveniently obtain the current status of Referral and Reauthorization requests submitted via the portal...
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