Peach State Health Plan Blog

Dear Provider:

The 2010-2011 Flu Season is underway and the CDC (Centers for Disease Control and Prevention) recommends that everyone, 6 months or older receive an “annual influenza vaccination”.

As you already know, the flu (influenza) is an infection of the nose, throat, and lungs caused by the influenza viruses. The flu vaccine is the best way to protect against the flu. Please encourage your Peach State patients to obtain a flu shot regardless of their age; including your pregnant members, since pregnancy can increase the severity of the flu. According to the CDC, this year’s seasonal flu vaccine includes protection from the 2009 H1N1 virus, and two other influenza viruses (an H3N2 virus an influenza B virus).  

To ensure accurate and timely claims processing, please adhere to the benefits and billing requirements provided in this notification.  

 Providers should report these services using one of the following CPT codes.

90655- Influenza virus vaccine, children 6-35 months (preservative free); intramuscular

90656- Influenza virus vaccine, individuals 3 years and above (preservative free); intramuscular

90657- Influenza virus vaccine, children 6-35 months; intramuscular

90658- Influenza virus vaccine, individuals 3 years and above; intramuscular

90660- Influenza virus vaccine, (FluMist); intranasally

Diagnosis Code: V04.81

Note: Providers who receive their vaccine through Vaccines for Children (VFC) will be reimbursed for the administration fee only.

We are pleased to offer expanded coverage to all eligible adult Peach State members (ages 18 and over) to receive the flu shot at either their physician’s office or select participating pharmacies. Members must be at least 18 years old to receive their flu shot at the pharmacy and must present a valid prescription for the flu shot to the pharmacist. Members who are under 18 years of age must receive their flu shot from their doctor’s office. To locate a local participating pharmacy, please refer to the attached participating pharmacy list.

Peach State wants our members to stay healthy during this flu season! Please encourage all members to get their Flu Shot Today! If you have questions or need more information, please contact Peach State Provider Services at 1-866-874-0633.

Sincerely,

Peach State Health Plan

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Dear Peach State Provider:

Recently you received an invitation from Peach State Health Plan (Peach State) to attend our town hall meeting in Columbus at the Columbus Convention and Trade Center on Tuesday, December 7, 2010.  The goals of the meeting were to give providers and other interested stakeholders an operations update on calendar year 2010 activities, discuss new initiatives planned for 2011, and establish a forum for dialogue with our senior leadership team.

Following our invitation outreach efforts, we have found that most of our providers have indicated that they are satisfied with the current means for receiving updates and engaging in dialogue with Peach State.  For this reason, we have decided to postpone this town hall meeting and work towards putting together another event in early first quarter of 2011. Please accept our apology if this comes as an inconvenience. Thank you for your understanding and for the excellent care you provide to our members. 

Should you have questions or need assistance, please contact us at 1-866-874-0633.  

Sincerely,

Kevin Sears

Vice President of Provider Affairs

Peach State Health Plan

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Dear Peach State Provider:

The attached communication has been developed to share information regarding  our policies, procedures, benefits, and  updates. Please select the link below to review. For concerns or copy requests, contact the Provider Relations Department, 866-874-0633, Monday – Friday, 7am – 7pm.

Provider Watch – October 2010 (PDF)

Thank you

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Please select the link below to review the fall Provider Report newsletter. For questions or concerns, please contact the Provider Relations Department, 866-874-0633, Monday-Friday, 7am-7pm.

Provider Report _ Fall 2010

Thank you~

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Effective December 1, 2010, Peach State Health Plan™ (Peach State) will be implementing a new outpatient OB Ultrasound (US) management program. This program includes the management of non-emergent, OB Ultrasound services to include prior authorization.

Peach State and NIA welcome you to attend one of our upcoming Provider Education Webinars to learn more about NIA’s OB Ultrasound management program and what it means to you. An hour-long Provider Education webinar will take place on the following dates and times:

• Thursday, November 4^th @ 12:00 p.m.
• Friday, November 12^th @ 8:00 a.m.
• Monday, November 15^th @ 12:00 p.m.
• Wednesday, November 17^th @ 8:00 a.m.
• Friday, November 19^th @ 12:00 p.m.
• Tueday, November 23^rd @ 8:00 a.m.
• Monday, November 29^th @ 8:00 a.m. & 12:00 p.m.
• Tuesday, November 30^th @ 8:00 a.m. & 12:00 p.m.

 You will need a computer with Internet access to view the education materials presented during the Webinar.

Please RSVP at least 1 week prior to the education seminar you plan to attend by calling an NIA representative at (800) 327-0641. After your RSVP, you will receive a confirmation email from NIA for the Webinar session you selected. The confirmation email will also include a toll-free dial in number with access code and web meeting address.

Peach State and NIA look forward to working with you to ensure that your Peach State Health Plan patients receive OB Ultrasound services delivered in a quality, clinically appropriate fashion.

This entry is filed under Blog, News.