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April 2024 Newsletter

Spring in Our Steps Springtime – it’s a time when nature awakens around us and the world seems full of freshness, beauty, renewal and hope. Here at the health plan, we have an extra spring in our step this season – and it’s because of you. We’ve noticed all the hard work you’ve done recently to help our members receive the absolute best care, partnering with us and coordinating with the many resources we offer. We can’t thank you enough. It’s because of your skill, knowledge and dedication that our members are experiencing renewal, hope and vibrant health, just like the springtime blooming all around us.

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Urgent FLASH: Announcing EFT Payments/835 Remittance Files

We’re pleased to announce that electronic funds transfer (EFT) payments to providers will be available this week. Each Tax ID Number must be registered with Zelis to receive EFT payments and 835 remittance files – otherwise you’ll continue to receive paper checks and remits. Please use the link below to get registered with Zelis:

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URGENT Flash: Claim Payments via Zelis

We are pleased to announce that payments to Providers via Zelis will start this week. Payments will be made via paper check and remittances. The checks and remittances will come together to Providers in one envelope/package. This week’s payments are expected to begin mailing by April 5.  Electronic payments and 835 files will be available in the coming weeks.

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URGENT FLASH: Announcing New Claims Clearinghouse – Optum iEDI

With the cyberattack at Change Healthcare, we’ve worked diligently to get options in place for providers to submit claims electronically. On March 12, we announced that we were live with Availity clearinghouse and we immediately began receiving EDI claims.

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URGENT FLASH: Checking Prior Authorization Requirements in Tapestry Link

Health AllianceTM recently updated the Prior Authorization Routing tool available within the Tapestry Link. With the update, it’s now possible for you to check the prior authorization (PA) requirements for a specific patient (who’s a member of one of our plans), based on their specific plan, coverage and benefits.

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