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Newsletters and Updates

Provider alerts

November 7, 2019
Opioid use disorder eLearning module (PDF)
October 25, 2019
Changes to preferred drug list (PDL) (PDF)
September 16, 2019
Hepatitis A Vaccine Update (PDF)
August 30, 2019
Corrected claim submission time frame change (PDF)
July 22, 2019
Changes to preferred drug list (PDF)
July 1, 2019
Provider appeal time frame change (PDF)
June 14, 2019
Inpatient claims update (PDF)
February 19, 2019
Referring, Ordering, Prescribing, or Attending (ROPA) practitioner’s name and NPI required on claims for specific services (PDF)
January 1, 2019
HEDIS® medical record review reminder (PDF)
December 31, 2018
SMMC program transition notice for regions 2 and 3 (PDF)
December 30, 2018
HIPAA authorization reminder (PDF)
December 15, 2018
Correction to over-the-counter expanded benefit (PDF)

Previous provider alerts

2018
December 3, 2018
CMS-1500 emergent transportation claims submission (PDF)
November 30, 2018
Services requiring prior authorization under 2018-2023 Statewide Medicaid Managed Care (SMMC) contracts (PDF)
November 30, 2018
SMMC program transition notice for regions 5, 6, 7, and 8 (PDF)
November 9, 2018
New electronic funds transfer (EFT) resources (PDF)
November 8, 2018
Prestige Health Choice awarded National Committee for Quality Assurance (NCQA) accreditation (PDF)
September 12, 2018
CLIA ID number required for laboratory test claims (PDF)
September 11, 2018
Opioid supply limits modified (PDF)
July 30, 2018
Reminder to use claims modifiers 25 and 59 appropriately (PDF)
June 14, 2018
Nationwide scams involving faxed prescriptions (PDF)
April 27, 2018
Long-term care and mixed services claims (PDF)
April 26, 2018
Billing update for dialysis providers (PDF)
April 23, 2018
Corrected claims: Discontinue use of frequency code 6 (PDF)
April 2, 2018
Coastal Care Services® place of service 12 billing update (PDF)
April 1, 2018
HEDIS® training (PDF)
March 23, 2018
Requirements for expedited authorization requests (PDF)
March 19, 2018
OptumHealth℠ Care Solutions transplant claims submission process (PDF)
March 19, 2018
Direct secure messaging (DSM)  (PDF)
March 12, 2018
Anxiety disorders e-learning training module now available (PDF)
March 11, 2018
Important information regarding reimbursement for vaccines (PDF)
February 25, 2018
Using your CLIA ID when filing claims (PDF)
February 19, 2018
Basaglar® human insulin analog (PDF)
January 23, 2018
Hospice prior authorization requirements (PDF)
January 23, 2018
ICD-10 diagnosis guidelines notice (PDF)
January 12, 2018
Depression e-learning training module now available (PDF)
2017
October 23, 2017
2017 year-end provider incentive program to improve member health outcomes (PDF)
October 12, 2017
New list of HCPCS codes requiring prior authorization (PDF)
September 25, 2017
New requirement for expedited authorization requests (PDF)
August 24, 2017
New Submission Guidelines for Corrected, Replacement, or Voided Claims (PDF)
July 25, 2017
New submission guidelines for Medicare dual eligible claims (PDF)
July 9, 2017
Basaglar® human insulin analog (PDF)
May 5, 2017
Clinical policies now available (PDF)
May 2, 2017
Services requiring prior authorization (PDF)
2016
July 27, 2016
Zika virus update: Insect repellent added to expanded benefits (PDF)
May 30, 2016
Target pharmacy no longer in Prestige pharmacy network (PDF)
May 26, 2016
Prestige looks to ensure accurate encounter data (PDF)
April 21, 2016
Electronic remittance advice (ERA) modifications (PDF)
April 13, 2016
The Agency for Health Care Administration issues on-site activities alert (PDF)
February 12, 2016
Emdeon rebranded as "Change Healthcare" (PDF)
February 12, 2016
New requirements on claims for specific services (PDF)
Ordering, referring, or prescribing provider's name and NPI required
February 4, 2016
Notification of express enrollment for Medicaid recipients (PDF)

Connections provider newsletters

Read the latest issue, Connections - 2019 Issue 2 (PDF).

Previous newsletters

2019
2018
2017
2016