Fall 2023

Calling all providers! To align with our partner Medica, we’re gradually moving to new, long-term business platforms. Effective for dates of service on and after Jan. 1, 2024, Prevea360 Health Plan Individual and Family (IFB) plans will move onto these platforms, with Commercial plans following in phases throughout 2024. We’ll be transitioning plans gradually so that providers can acclimate to changes involving smaller patient populations while continuing to use current platforms for other lines of business.

More for 2024

Announcing Availity as our new electronic data interchange (EDI) clearinghouse and provider portal vendor.

Your essential tool - 2024 member ID cards 

You’ll use our new and existing business platforms next year based on your Prevea360 Health Plan patient’s benefit plan. The member ID card will help you find your way! Remind your patients to bring their member ID card with them to their appointments.

Dialing in - new customer care numbers and automated phone technology to get the information you need

For business platforms under our new payer ID 41822, we’re adding new customer care phone numbers, expanded hours, and automated phone system technology to support both providers and members.

New Process for Annual Centers for Medicare and Medicaid Services-Based Fee Schedule Updates

We’re changing our timeframe for implementing annual Centers for Medicare and Medicaid Services (CMS) Resource-Based Relative Value Scale (RBRVS) and Relative Value Unit (RVU) fee schedule updates.

Provider News - will now be in your inbox monthly!

We’re moving our quarterly newsletter to a monthly to reach you more often!

Updates  Click below for more.

Important Links

Race and ethnicity during provider recredentialing

New comprehensive Medical Benefit Drug Program

Formulary management procedures

Accessibility of services standards

Screening patients for diabetic retinopathy

Notification necessary for provider demographic changes

Online educational tool for providers to share with patients