Provider News
March 2022
Security Health Plan distributes Provider News digitally. Information in this newsletter is important for care providers, clinic managers, patient assistance, coding and other clinic staff. Please share with your colleagues.

If you wish to receive this monthly newsletter, please create a Provider Portal account by contacting your practice's organization administrator. If you don't have an organization administrator, click here to set one up.
Security Health Plan continues to monitor COVID-19
Access our COVID-19 web page for timely updates or Click here to go directly to our most recent COVID-19 Provider FAQ.
Use Provider Portal to verify claims information
Claim status, eligibility, benefits and prior authorization requirements can be verified on the Security Health Plan Provider Portal. Click here for information on Provider Portal access and other ways to get the information you need by email, phone and fax. 
Proud of it
Security Health Plan and Marshfield Clinic Health System join Portage County Literacy Council's efforts to teach English to refugees
Starting a new life in a country hundreds of miles from home is scary, especially if you don’t know the language. This is the reality for refugees from Afghanistan and other war-torn countries who will relocate to Central Wisconsin in the coming months.
Coding corner
Updated coding recommendations focus on CVA and MI
By BRENDA ANDERSON, Revenue Management Educator
The Office of the Inspector General (OIG) recently completed audits of several U.S. health plans and reported significant overpayments to those plans based on inaccurate coding of cardiovascular diagnoses. Read more for recommendations to mitigate audit risk.
Policy review
Security Health Plan March 2022 policy updates
By KAREN BORGEMOEN, Registered Nurse/Team Leader
Security Health Plan reviews medical policies on a monthly basis. Medical policies are found in the provider section of the Plan's public website. Read more for policy reviews and changes effective March 15, 2022.
Security Health Plan updates
New biologic added to Security Health Plan's Medicare Part B step therapy program
By KURT WITTIG, Clinical Pharmacy Specialist
Security Health Plan adds Infliximab to the list of drugs in its Medicare Part B step therapy program, effective July 1, 2022. General criteria for step therapy approval continues to be updated.
Behavioral health survey coming soon
As part of a new requirement from the Wisconsin Department of Health Services (DHS), Security Health Plan must ensure that age-appropriate behavioral health screening and assessment tools are used for Medicaid patients age 18 and under in primary care settings. Read more
Preventive benefit changes coming in 2023
Security Health Plan’s top priority is the health and well-being of our members. We also work hard to reduce waste so we can continue to provide our members with high quality, affordable health care coverage. Read more
Prior authorization updates
Common reasons prior authorizations are denied
By THERESA STERNIK, Health Services Clinical Manager
If you're experiencing high denial rates even though you are following guidelines that govern clinical and/or medical necessity criteria, your case request might be missing some key information. Read more
New eviCore guidelines released for cardiology guidelines
By THERESA STERNIK, Health Services Clinical Manager
New eviCore updates are in place for cardiology guidelines. The updates relate specifically to cardiac imaging and are effective as of April 1, 2022. Read more
First Tier, Downstream and Related Entities (FDR) compliance requirements
Security Health Plan is responsible for fulfilling the terms and conditions of our contracts with the Wisconsin Department of Health Services and/or the Centers for Medicare and Medicaid Services and meeting applicable compliance program requirements. Security Health Plan requires each practice, as our first tier delegated business partner, to complete an annual Delegated Business Partner Attestation to ensure you are also in compliance with the same compliance program requirements, applicable laws, rules and regulations as our downstream entity.

Read more for details about the FDR Attestation and Security's tools to assist you in meeting your regulatory requirements.
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