Formularios y documentos para proveedores
Special Needs Plan (SNP) Model of Care Training & Medicare Compliance Program Guidelines
Social Services Announcement
This is a reminder about the invaluable support available through our Social Services Department. The department is dedicated to assisting members in addressing non-medical needs that impact well-being and care outcomes.
Services Provided Include:
- Telephonic assessments: To evaluate member’s needs and strengths. It aims to identify resources and support systems.
- Community Resources: Help connecting members to housing, food assistance, financial aid, and other local resources.
- Behavioral Health Support: Referrals for counseling or mental health services.
- Member Education: Resources to promote self-sufficiency and empower individuals.
Special supplemental benefits for the chronically ill (SSBCI) Eligibility Changes
Effective January 1, 2025, HealthSun Health Plans, Inc. (HealthSun) will change its process for approving members for special supplemental benefits for the chronically ill (SSBCI), such as groceries, utilities, chronic meals (for more than 90 days), and nonemergency transportation to non-health-related destinations.
Special Supplemental Benefits for the Chronically Ill (SSBCI) Eligibility Changes Bulletin
Special Supplemental Benefits for the Chronically Ill (SSBCI) HealthSun Provider Form
Shift to Fax for Pre-Certification Approval Notifications Notice July 11, 2024
In the coming weeks, HealthSun will implement a new procedure for the issuance of pre-certification approval and denial notifications. We will transition away from mailing physical approval and denial letters to instead issuing the notifications via fax to all providers and facilities. Member notifications will not be impacted.
This change is being made to provide more timely approval and denial notifications to providers and institute a more efficient process overall. We believe this improvement will expedite the notification process.
If you have any questions or concerns, please contact us at (877) 999-7776. Monday- Friday, 8:00AM to 5:00pm. We will notify you when this change is ready to go live.
Avisos y actualizaciones para proveedores
Anuncios de proveedores
- *Shift to Fax for Pre-Certification Approval Notifications Notice July 11, 2024
- Attention HealthSun Providers, effective 01/01/2020, HealthSun will be changing to a new Pharmacy Benefit Manager (PBM)
- Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID–19 Public Health Emergency
- Notice of Health Plan Accreditation Survey - December 4th to December 6th, 2023
- Social Services Bulletin
- Update to the Model Admission Questions for Providers to Ask Medicare Beneficiaries
Información sobre el COVID-19 para proveedores
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