Provider Updates
2021
- Provider Accessibility Initiative Letter - July 1, 2021 (PDF)
- Ambetter COVID-19 Prior Authorization Reinstatement - June 1, 2021 (PDF)
- Allwell COVID-19 Prior Authorization Reinstatement - June 1, 2021 (PDF)
- Continuity of Care Bonus Program (Formerly Pay for Performance) - May 21, 2021 (PDF)
- COVID-19 Telehealth Guidance for Providers - April 30, 2021 (PDF)
- DME Glove Rate Adjustment - April 1, 2021 (PDF)
- Medicare Blood Pressure Cuffs CBP Initiative - April 22, 2021 (PDF)
- Johnson and Johnson Vaccine Pause Alert - April 20, 2021 (PDF)
- Medicare Add-On Exclusions for Inpatient Claims Letter- April 5, 2021 (PDF)
- Medicare Part D Vaccination Claims - March 12, 2021 (PDF)
- COVID-19 Telehealth Guidance for Providers - January 26, 2021 (PDF)
- COVID-19 Telehealth Guidance for Providers - January 7, 2021 (PDF)
2020
- Verifying Eligibility: HCBS/LTSS Benefits 12.28.2020 (PDF)
- COVID-19 Vaccine: Member Engagement Tips for Providers 12.11.2020 (PDF)
- PA Health and Wellness Provider Accessibility Initiative 12.15.2020 (PDF)
- COVID-19 Medicare Notice of Vaccine Billing Guidelines 12.2020 (PDF)
- COVID-19 Medicaid Notice of Vaccine Billing Guidelines 12.2020 (PDF)
- COVID-19 Marketplace Notice of Vaccine Billing Guidelines 12.2020 (PDF)
- Attention Nursing Facilities - Important Eligibility Reminder and Notice 12.7.2020 (PDF)
- Medicare Prior Auth List 2021 11.9.20 (PDF)
- Ambetter from PA Health & Wellness Physical Medicine QRG 9.2.20 (PDF)
- Ambetter from PA Health & Wellness Physical Medicine Provider FAQ 9.2.20 (PDF)
- Ambetter from PA Health & Wellness Physical Medicine Tip Sheet Checklist (PDF)
- NIA Expansion Letter (PDF)
- COVID-19 MA & Marketplace In Network COVID Care 10.23.20 (PDF)
- COVID-19 Public Health Emergency Period Extended - 10.12.20 (PDF)
- New Prepay Correct Coding ICD-10 Diagnosis Edits (PDF)
- PHW Flu Prevention Tips 9.17.2020 (PDF)
- EVV Communication - Effective 10.19.2020 (PDF)
- Transgender Therapy Virtual Sessions 2020 on 9-18, 10-16, 11-13, 12-11 (PDF)
- PHW DME Provider Training 8-21-2020 (PDF)
- COVID-19 Emergency Period Extended 7.28.2020 (PDF)
- DME Training FAQ 7-14-2020 (PDF)
- COVID-19 Public Health Emergency Period Extended 8-3-2020 (PDF)
- COVID-19 Billing Guidance for Testing, Screening, and Treatment 8-3-2020 (PDF)
- COVID-19 Telehealth Guidance 8-3-2020 (PDF)
- COVID-19 Medicare CARES DRG Increases 6-15-2020 (PDF)
- COVID-19 Medicare Cost Share Waivers Extension 6-3-2020 (PDF)
- HHAeXchange Guardrails Effective June 1, 2020 - 5-28-2020 (PDF)
- COVID-19 Billing Guidance for Testing Screening Treatment 5-13-20 (PDF)
- COVID-19 Provider Facing Web Content 5-13-20 (PDF)
- COVID-19 Telehealth Guidance for Providers 5-13-20 (PDF)
- Guidance on Hospital Responses to COVID-19 5-12-20 (PDF)
- COVID-19 Interim Nursing Facility Guidance 5-12-20 (PDF)
- COVID-19 PHW Authorization Instructions 5-7-20 (PDF)
- COVID-19 Personal Assistance Services Cheat Sheet for Providers 4-13-20 (PDF)
- COVID-19 Cheat Sheet for Providers 4-13-20 (PDF)
- PAI Executive Summary (PDF)
- COVID-19 Screening and Treatment Guidance for All Providers (PDF)
- COVID-19 Office of Mental Health and Substance Abuse FAQ's 3-25-20 (PDF)
- PA Department of Human Services, Front Line Worker during COVID-19 State of Emergency Document 3-26-20 (PDF)
- COVID-19 PA Health & Wellness Telehealth Guidance 3-24-2020 (PDF)
- COVID-19 Communication from National Imaging Associates (NIA) 3-16-2020 (PDF)
- COVID-19 Extended Coverage Announcement 3-12-20 (PDF)
- COVID-19 MA Coverage 3-11-20 (PDF)
- COVID-19 Guidance and Action 3-11-20 (PDF)
- COVID-19 Frequently Asked Questions 3-12-20 (PDF)
- COVID-19 In-Home Care Guidance 3-11-20 (PDF)
Commonwealth Coronavirus Resources
Federal Coronavirus Resources
Additional Coronavirus Resources
- Provider Accessibility Initiative COVID-19 Web Series
- COVID-19 and People with Disabilities
- Essential Services: Maintaining Access to Personal Attendants During the COVID-19 Epidemic
Additional Resources
2019
- Medicare Beneficiary Identifier 11-7-19 (PDF)
- NF Update 10-17-19 (PDF)
- Appointment Availability 10-7-2019 (PDF)
- Provider Communications Payment Update 10-1-19 (PDF)
- PHW PDPM Guidance 10-1-19 (PDF)
- State Critical Incident Reporting Requirements 8-22-19 (PDF)
- Billing Update 6-28-19 (PDF)
- DRG Letter 3-29-19 (PDF)
- Provider Authorization Update 1-30-19 (PDF)
- Provider Communication - Authorizations in HHAeXchange 1-14-19 (PDF)
- Provider Communication - Billing and Claims 1-10-19 (PDF)
2018
- Provider Communication Policy Update 12-3-18 (PDF)
- Medicaid Payment Policy Update Inpatient Professional Claims 11-26-18 (PDF)
- Systemic Issue Causing CHC Disenrollment 7-2-18 (PDF)
- Updated Clinical Influenza and Streptococcus Group A 6-21-18 (PDF)
- Participant Winter Weather Alert 3-12-18 (PDF)
- Service Coordination Clarification 3-9-18 (PDF)
2017
- CHC Provider - Service Coordination 8-1-17 (PDF)
- CHC Provider - Service Coordination 8-1-17 (PDF)
- Understanding Community HealthChoices versus HealthChoices 7-7-17 (PDF)
- CHC Overview 7-17-17 (PDF)
- CHC Provider Third Party Liability 6-14-17 (PDF)
- CHC Provider Relationship 6-2-17 (PDF)
2016
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