Provider Newsletter
The Navigator
Important news for Samaritan Health Plan Operations' network physicians and health care professionals.
Current Issue:
January 2012
Important plan changes, updates and announcements
- Preventive benefits updates
- New preventive services covered by Medicare
- Modifier SG no longer required
- Oregon Patient Centered Primary Care Home (PCPCH)
Provider resources
- Risk Adjustment and how you can help
- Claims submission reminders
- Modifiers 62 & 66
- National Correct Coding Initiative (NCCI) edits
- Referring to non-contracted providers
- V-Codes diagnosis
Newly paneled providers
Past Issues:
October 2011
Important plan changes, updates and announcements
- Samaritan Advantage Health Plan (SAHP) - 2012 Premium and Benefit Changes
- SHPO Provider Education - October 2011
- The Patient Centered Primary Care Home (PCPCH) in Oregon
Provider Services
- CMS risk adjustment payments
- Place of service coding for Urgent Care Clinic claims
- Diabetic claims coding for lancets and monitor strips
- Reminder to use NPI numbers on all HCFA 1500 claims
- National Correct Coding Initiative (NCCI)
- Body Mass Index (BMI) assessment project
- Clinical Practice Guidelines
- Advance Care Planning Project
Newly paneled providers
July 2011
Important plan changes,updates and announcements
- Quality improvement project: bone density screening
- Samaritan Healthy Kidsonnect: health care coverage from head to foot and everything in-between
- Provider survey—please let us know how we are doing
Provider resources
- Billing Add-On Codes (+)
- Modifiers 80 and AS
Newly paneled providers
April 2011
Important plan changes, updates and announcements
- HEDIS Chart review coming soon
- New quality management project, spirometry testing for COPD
- Samaritan Healthy KidsConnect adds new, unsubsidized plan for those
above 300% Federal Poverty Level (FPL)
Provider Resources
- Introduction to ICD10
- Implementation of National Correct Coding (NCCI) Clinical Edits
Newly paneled providers
January 2011
Important plan changes, updates and announcements
- HEDIS Provider Reports available
- New and revised clinical practice guidelines
Provider resources
- Measuring quality patient care
- 2011 benefit changes for Samaritan Choice Plans
- Recovery Audit Contractors (RAC)
- Important IHN health plan changes for 2011
- Emergent MRI/CT SCAN authorizations - no clinical review required
- Case Management Services - A resource to support your prescribed plan of care
Formulary updates
- 2011 Samaritan Advantage Atypical Antipsychotic Step Therapy requirements
Newly paneled providers