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Administrative Updates for Providers, Winter 2019

Oct 30, 2019
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Details on recently updated forms and resources for Providers

Forms and Resources for Providers

To ensure that your office is utilizing the most recent and applicable Health Options forms we encourage you to visit our website’s Resources area for Providers  and prior to submitting completed forms. The Resources area is located at: https://healthoptions.org/providers/resources.

Recently added or updated forms include:

  • 2020 Behavioral Health Prior Approval Form
  • 2020 Notification / Prior Approval Form
  • 2020 Medication Prior Approval Form (Medical via Health Options)
  • 2020 Therapies Prior Approval Form
  • Claims Reconsideration Form

Reminder: Use the Provider Credentialing and Change Form to submit provider and/or practice information changes. If billing information is changing, complete and submit the Billing Information Form with a current W-9 form to avoid payment interruptions or delays.  Both forms are available at the website address above.

SEE ALSO

Community Health Options announces the following changes:

 

The Prior Approval requirements are being removed for the following J-Codes under the Medical Benefit effective April 1, 2020.

 

 J-Code

Drug

 

 J-Code

Drug

 J9020

asparaginase

 

 J7401

mometasone furoate sinus implant

 J0291

plazomicin

 

 J9000

doxorubicin hcl

 J0706

caffeine citrate

 

 J9060

cisplatin, powder or solution

 J1130

diclofenac sodium

 

 J9100

cytarabine

 J1443

ferric pyrophosphate citrate solution

 

 J9175

elltiott's b solution

 J1580

gentamicin

 

 J9208

ifosfamide

 J1652

fondaparinux sodium

 

 J9390

vinorelbine tartrate

 J2185

meropenem

 

 Q2009

fosphenytoin

 J2278

ziconotide

 

 Q9950

sulfur hexafluoride lipid microspheres

 J7345

aminolevulinic hcl, 10% gel

 

 S0012

butorphanol tartrate nasal spray

 

The following J-Codes for oral medications will no longer be covered under the Medical Benefit, and will be covered under the pharmacy benefit only effective April 1, 2020

 J-Code

 Drug

 

 J-Code

 Drug

 J7340

 carbidopa/levodopa

 

 J8565

 gefitinib

 J7502

 cyclosporin

 

 J8705

 topotecan

 J7507

 tacrolimus

 

 S0088

 imatinib

 J7515

 cyclosporin

 

 S0137

 didanosine

 J7517

 mycophenolate mofetil

 

 S0138

 finasteride

 J7518

 mycophenolic acid