Summer 2023

Changes Coming for Claims Processing and Resources: What You Need to Know

Our planned innovations with our partner Medica continue to take shape! While full details are still pending, in this article we share the latest information with our other partners - our valued providers.

Provider Experience Survey Results: What We Learned From You 

Thank you to providers and support teams for participating in our 2022 Provider Experience Survey!



Good Health Care Claims Habits, Featuring Taxonomy Codes

As Prevea360 Health Plan prepares for a new claims processing platform in 2024, it’s a great time to feature good claims practices for taxonomy codes.

Update to Credentialing/Recredentialing Document Submission Requirements 

A must-read for administrators who complete provider applications!

Updates  Click below for more.

Important Links

Reporting Procedures for Suspected Fraud, Waste, and Abuse Have Changed

Reminder: Include Supporting Documentation with Authorization Requests

Prior Authorization Changes for Continuous Glucose Monitoring Systems

Promoting Medication Adherence to Patients

Medicare Advantage Corner

o  New CMS CGM Criteria

Chlamydia Screening Rates Continue to Drop

Health Equity and Prevea360 Health Plan

Freedom from Smoking

Notification Necessary for Provider Demographic Changes

Provider Network Consultants

Termination of Doctor/Patient Relationship