Connect Archives

July 2014

Wednesday, July 23, 2014

HUMANA UPDATE

Due to circumstances beyond HFNI’s control, the implementation of HFNI’s medical management of Humana’s Medicaid population has been delayed for six months. This means that the Humana contract effective with MMA implementation on August 1, 2014 will be a messenger model contract. As part of the current contract, HFNI is delegated to handle Provider Relations and Credentialing effective 8/1/14.

HFNI is prohibited, by federal anti-trust laws, from negotiating payment terms in messenger model contracts.

HFNI continues to work with Humana to refine the terms of their relationship. Humana has provided HFNI with a Letter of Intent indicating their intention to delegate medical management to HFNI beginning approximately February 1, 2015. We will continue to keep you informed as the terms evolve.

CAQH UPDATE

Attention Providers: If you need to make changes to your profile please use the Provider Update/Change Request Form located on the HFNI website. In order for changes to be completed, an updated W-9 must be submitted. Please fax the updated W-9 to the attention of Jennifer Sullivan or Shelby Villar at 850-438-0298. Also, if you have a CAQH Account please make sure everything is kept current by reviewing your profile every 4 months. If there are changes to be made, update the changes and resubmit a physically signed attestation. Thank you for your prompt attention concerning this matter.

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MODERN HEALTHCARE™ ARTICLE: CLASHING RULINGS ON EXCHANGE SUBSIDIES RAISE FEAR OF INSTABILITY

Healthcare providers and insurers fear that today's conflicting appellate court rulings on the legality of Obamacare premium subsidies offered through the federal insurance exchange could have a destabilizing effect on the newly expanded insurance market. To continue reading story please click on the link below.

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BAPTIST HOSPITAL RANKED IN THE TOP 10 LOCALLY AND TOP 25 STATEWIDE BY U.S. NEWS & WORLD REPORT™

Baptist Health honored among the top 15% in the nation with 27 “high-performing” badges in 11 medical specialties. All eligible Baptist Health hospitals ranked in the top 10 locally and top 25 statewide. To continue reading story, click the link below.

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HFNI WELCOMES NEW STAFF MEMBER

Sharon George is HFNI’s new Operations Project Coordinator/Human Resources. She brings 30 years of experience in business including accounting, operations management and human resources.

Sharon loves tennis and has been very involved in the Pensacola tennis community. She has served as President of the Greater Pensacola Tennis Association as well as being on the boards of the Florida Section of the USTA and the Greater Pensacola Ladies Tennis League.

HEALTHSPRING MEDICARE ADVANTAGE HMO TRANSITION FOR CLAIM PROCESSING

Effective 1/1/14 Health First Network, Inc. (HFNI) / MED3000 is no longer responsible for processing claims for Healthspring Medicare Advantage HMO.

Health First Network, Inc. will continue to work with Healthspring, giving support to our providers for that product.

It is very important that all claims with dates of service prior to January 1, 2014 are filed to HFNI / MED3000 no later than June 30, 2014 at the address below.

HealthSpring Medicare HMO
PO Box 11547
Pensacola, FL 32524

All claims received after June 30, 2014 for dates of service prior to January 1, 2014 will be denied timely, NO EXCEPTIONS will be made.

All claims for dates of service after December 31, 2013 should be filed to:

Healthspring Medicare Advantage HMO
PO Box 981804
El Paso, TX 79998
Electronic claims: Emdeon Payor ID 63092

Please contact Jenny Caillouet at 850-438-4487 if you have any questions.


NEW MAILING ADDRESS

Please note that Health First Network, Inc. has a new mailing address. Please update your records to reflect:

Health First Network, Inc.
PO Box 11427
Pensacola, FL 32524-1427

JOB POSTINGS PAGE

HFNI has created a new “Job Postings page” in an effort to help our physician offices fill job vacancies.

If you would like to advertise open employment opportunities on the HFNI website, please contact Jenny Caillouet at 850-438-4487.

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NEW PHYSICIANS JOINING THE NETWORK

Health First Network would like to welcome the most recent physicians to join the Network:

Huey McDaniel, M.D. Vascular Surgery
Khalid Moussa, M.D. Gastroenterology
William Schwartz III, M.D. Maternal & Fetal Medicine
Michael Tavernaris, M.D. Family Practice

** To determine which health plans each physician is participating in check the “Find A Doctor” section on the HFNI website.

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