Connect Archives

December 2010

Friday, December 10, 2010

NEW MEDICAID HMO PRODUCT

Health First Network has finalized a new contract with HealthEase to provide a managed Medicaid product to Escambia and Santa Rosa counties. The last contract we had with HealthEase was an “at risk” and ended on August 31, 2009. The contract ended due to cuts made in HMO reimbursement to HealthEase by the state. The fact of the matter is that the contract was just not doable for either of us. Since that time the state has restored some of the funding to the program for Area 1, our local area. This makes it a viable product again. The new contract with HealthEase will be different in that it is what is called a “messenger model” contract. HFNI is not at financial risk. We are going to perform some network development functions, your current credentials with HFNI will serve for the HealthEase product as we are delegated this function also and we are in discussions to perform medical management locally.

SUBMISSION OF MEDICARE AND MEDICAID NUMBERS

Attention Office and Facility Credentialing Coordinators: Please reference the link below for updated information on the HFNI initial credentialing and recredentialing applications. Complete and accurate applications with individual Provider Medicare and Medicaid numbers are required for all credentialing applications.

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HUMANA

We are pleased to announce that, effective 01/01/11, Health First Network has signed an agreement with Humana to participate in their HMO Medicare Advantage product.

Humana is Florida's largest Medicare health benefits company with more than 325,000 Medicare Advantage members statewide. For 2011, Humana will offer a low-cost Medicare Advantage HMO health plan in the Pensacola area, that has an affordable monthly premium, solid benefits including preventive care, on-call nurses and fitness center memberships at no additional cost, and a strong provider network in the Panhandle.

With more than 20 years experience in Florida's Medicare business, Humana has a commitment to serving seniors.

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HEALTHSPRING FORMULARY UPDATES

HealthSpring Health Plan has notified Health First Network of some Prescription Drug Benefit changes and Formulary changes for 2011, and new pharmacy initiatives that will become effective January 1, 2011 for HealthSpring members. HealthSpring members and HealthSpring providers are being notified of these changes in a series of letters being sent out by the Health Plan. For information on these changes and alternative options available, draft copies of these letter are attached below.

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UNITED WAY’S “DAY OF CARING”

Charles Brewer, HFNI, President & CEO On Friday, October 22nd, Health First Network staff members joined more than 1,200 other local volunteers to participate in the United Way's "Day of Caring". The Day of Caring is a one-day, community-wide event that utilizes individuals from various businesses and military commands to administer an assortment of volunteer projects at non-profit agencies and schools in our community.

Health First Network staff members spent their day at Lipsomb Elementary School helping children create recycled art from donated objects.