Tag: Molina
Health Plan Representatives Updated 8/4/2025
The Health Plan Representatives List has been updated. This is a good tool to print and have close by when you have an issue.
The biggest change for claims issues will be HealthSpring (HCSC) formerly Cigna MA. Here is how:
- Email ALL claims issues to [email protected]
2. HealthSpring has supplied the spreadsheet that MUST be used. A link is provided below, or you may call POET, we will be glad to email you an electronic copy.
Only the columns with Red Lettering, need to be filled out by the Physician’s office.
4. Always feel free to copy [email protected] if you would like POET to be in the loop.
5. If you have a time sensitive, special, or just an issue you would like to discuss with POET, please call (936) 637-7638.
Updated Plan Reps
The Health Plan Representative Contact List has been updated.
Health Plan Representatives Updated 2/25/2021
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Medicaid Map Updated 09/24/2020
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Molina update March 23, 2020
From Molina March 23,2020:
All MCOs:
Claims for Telephone (Audio-Only) Medical Services
Background: Providers may bill codes 99201-99205 and 99211-99215 for dates of service of March 20, 2020, through April 30, 2020, to receive Medicaid reimbursement for telephone (audio-only) medical services.
Key Details: To help ensure continuity of care during the COVID-19 (coronavirus) response, HHSC is authorizing providers to bill codes 99201-99205 and 99211-99215 for telephone (audio-only) medical (physician delivered) evaluation and management services delivered on March 20, 2020, through April 30, 2020.
Providers should continue to use the 95 modifier to indicate that remote delivery has occurred.
Telephonic evaluation and management services are not to be billed if clinical decision-making dictates a need to see the patient for an in-person or telemedicine (video) office visit within 24 hours or at the next available appointment. In those circumstances, the telephone service shall be considered a part of the subsequent office visit.
If the telephone call follows an office visit performed and reported within the past seven calendar days for the same diagnosis, then the telephone services are considered part of the previous office visit and are not separately billed.
Additional Information:
Providers can refer to the Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook for additional information about the Texas Medicaid telemedicine services benefit.
Resources: http://www.tmhp.com/Pages/Medicaid/Medicaid_Publications_
ProviderManual_Curr ent.aspx
Contact: [email protected][embeddoc url=”https://community.poetllc.org/wp-content/uploads/2020/03/Molina-03232020.pdf” download=”all” viewer=”google”]
Molina, Claims for Telephone (Audio-Only) 3/23/2020
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Molina Agreement 9/1/2011
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