Contracting Updates

To all Affinia Network Providers:

HAP:

Thank you for being providers of HAP Choice Medicare! As we kick off the new year, we would like to provide a few updates to make the transition for both you and our patients a bit smoother. While we work to continue educating and assisting PCP offices with HAP portal access, we want you to be aware that HAP has given us a 3 week grace period for PCP referrals to specialists. Meaning, until January 23, 2020 , there will not be a denial of service due to a missing referral.

During this grace period, Affinia is working to assist in obtaining vendor ID numbers and creating Administrators for portal access. More information will be shared in the next few weeks.

Please note, Affinia members are EXEMPT from using eviCore. Meaning, prior authorization is not required for high tech radiology, sleep studies, and cardiac rehab. Overall, prior authorization is ONLY required for inpatient admissions, behavioral health and chemical dependency services, and select prescription drugs.

OSCAR:

The Provider Resources Page has important information on how to set up access to the Provider Portal. Please note that Oscar will need to approve the administrator who first registers with the Portal. Each TIN will have this administrator approve others that register under that TIN. Should you need to make any changes to your Administrator please reach out to Affinia.

Download Oscar Updates

 

WELLCARE:

Please follow the links below to get set up. Again, each TIN will have an administrator.

MOLINA MEDICARE:

Molina Medicare has expanded into additional counties for 2020. It is now offered in Muskegon, Newaygo, Ottawa, Barry, Kent, and Montcalm counties.

Download Molina Complete Care Overview Download Molina Updates

 

If you have any questions, concerns, or issues, Example: Who is my administrator for Wellcare? please submit them to affinianetworkrelations@mercyhealth.com for assistance.

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