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Network Connection is our newsletter for contracted network providers and staff. It covers important information such as educational programs, policy changes and news about services.

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PAST ISSUES AND COMMUNICATIONS

This archive below hosts Presbyterian's provider network communications, organized by month of distribution. If you have any questions about a communication, or need to locate an older communication, please contact your Provider Network Operations relationship executive.

September 2023

2023 September Network Connection

Presbyterian Shares the September 2023 Network Connection Newsletter

Upcoming Behavioral Health Provider Trainings Invitation – Sept. 4, 2023

Automated Authorizations for Tonsillectomies

August 2023

Presbyterian Announces TytoCare, a No-Cost Telehealth Tool

Upcoming Behavioral Health Provider Trainings Invitation – Aug. 7, 2023

Help Improve Discharge Planning and Care Coordination for Members

University of New Mexico Health System is In-Network for Medicare Advantage Members

September 2023 Physical Health Provider Education Webinars Invitation Educational Materials for Children and Adolescents on Antipsychotic Medications

Reminder: Help Improve Discharge Planning and Care Coordination for Members

Update Provider Directory Information by Sept. 28 to Comply with the No Surprises Act - Letter

Provider Survey: Coordinating Care Between Physical and Behavioral Health Providers

Medical Drug Prior Authorization Updates - Emend, Ozurdex and Prolia/Xgeva

Reminder: Presbyterian Invites You to September 2023 Provider Education Webinars

July 2023

2023 July Network Connection

Presbyterian Shares the July 2023 Network Connection Newsletter

Rescheduled: Aug. 1 Nursing Facility Payment Concerns and Resolution Meeting

Upcoming Behavioral Health Provider Trainings Invitation – July 11, 2023

Centennial Care Rewards Program: Baby Bonuses

Invitation to Improving Member Engagement Training for Behavioral Health Providers

Avoid Denials for Patients with Multiple Health Plan Carriers and Benefit Plans

Long-Term Services & Supports (LTSS) Provider Assistance Resources

June 2023

Presbyterian Will Update its Medical Policy and PA Guide on July 1, 2023

You’re Invited to Upcoming Behavioral Health Provider Training – June 2023

Reminder: Presbyterian Invites You to June 2023 Provider Education Webinars

Reminder: Verify/Update Your Provider Directory Information by June 30

Presbyterian Invites You to September 2023 Provider Education Webinars

Nursing Facility Payment Concerns and Resolution Meeting – Aug. 1

Presbyterian Will Update its Medical Policy and PA Guide on Aug. 1, 2023

May 2023

2023 May Network Connection

Presbyterian Shares the May 2023 Network Connection Newsletter

Physical Health Provider Education Webinars Invitation – June 15 & 16 2023

Upcoming Behavioral Health Provider Trainings Invitation – May 3, 2023

Presbyterian Care Coordinators Resumed In-Person Home Visits

Personal Care Services Agency Staffing Shortages

Reminder: Ending of the COVID-19 Public Health Emergency

June 2023 Physical Health Provider Education Webinars Invitation Massage Therapy Benefit for State of New Mexico Employees How to Host a “Got Shots?” Back-to-School Event for Children and Adolescents

April 2023

Nursing Facility Payment Concerns And Resolution Meeting - May 2, 2023

Correction: Nursing Facility Payment Concerns And Resolution Meeting - May 2, 2023

Reminder: Behavioral Health Town Hall Invitation Q2

Centennial Care Behavioral Health Critical Incident Reporting Training Invitation Q2 Reminder

Reminder: Nursing Facility Payment Concerns and Resolution Meeting - May 2, 2023

Centennial Care Rewards Program: Baby Bonuses

Presbyterian Will Update its Medical Policy Manual and Prior Authorization Guide on June 1, 2023

Presbyterian Will No Longer Waive Prior Authorization Requirements for Facility Transfer Admissions

March 2023

2023 March Network Connection

Presbyterian Shares the March 2023 Network Connection Newsletter

Adult Protective Services (APS) Reporting through Critical Incidents Training Letter Notification

Behavioral Health Town Hall Invitation Q2

Home and Community-Based Services Final Setting Rule Trainings

Reminder: Home and Community-Based Services Final Setting Rule Trainings Are This Week

Medicaid Benefits Renewal for Centennial Care Members

February 2023

Centennial Care Behavioral Health Critical Incident Reporting Training Invitation Q1 Second Reminder

Second Reminder: Behavioral Health Town Hall Invitation Q1

Use the Correct Taxonomy Code and Provider Type to Prevent Claim Denials

Update Provider Directory Information by April 1 to Comply with the No Surprises Act Sign Up to Receive Electronic Communications – Feb. 2023

Centennial Care Behavioral Health Critical Incident Reporting Training Invitation Q2

Provider Education Conference Invitation – March 31

2023 Presbyterian Individual and Family Plans and Networks

2023 Presbyterian Dual Plus Training is Available Adult Protective Services (APS) Reporting through Critical Incidents Training Invitation

January 2023

2023 January Network Connection

Behavioral Health Town Hall Invitation Q1

Centennial Care Behavioral Health Critical Incident Reporting Training Invitation Q1

The 2023 Practitioner and Provider Manuals Are Available

Nursing Facility Payment Concerns and Resolution Meeting - Feb. 7

Centennial Care Behavioral Health Critical Incident Reporting Training Invitation Q1 Reminder

How to Prevent Claim Denials in AuthentiCare

Reminder: Behavioral Health Town Hall Invitation Q1

Reminder: Nursing Facility Payment Concerns and Resolution Meeting - Feb. 7

Centennial Care Rewards Program: Baby Bonuses

Provider Education Conference Invitation – March 31 Home and Community-Based Services (HCBS) Final Setting Rule Memo

Presbyterian Shares the January 2023 Network Connection Newsletter

December 2022

Behavioral Health Town Hall Invitation Q4

Presbyterian Will Update its Medical Policy Manual and Prior Authorization Guide on Feb. 1

November 2022

2022 November Network Connection

Second Reminder: Risk of Pharmacy Claim Denials for Prescribers Not Enrolled in New Mexico Medicaid

Sharing Critical Incident Reporting Reminders

2022 Annual Critical Incident Reporting Training Attendance Changes to Enroll Eligible Members into the Synagis® Program for the 2022-2023 RSV Season (Letter)

Changes to Enroll Eligible Members into the Synagis® Program for the 2022-2023 RSV Season (eBlast)

Correction: Best Practices and Coding Tips for Audio Telehealth Services (Letter)

Correction: Best Practices and Coding Tips for Audio Telehealth Services (eBlast)

Reminder: Presbyterian Shares 2022 Behavioral Health Provider Education Webinars

Reminder: Presbyterian Invites You to 2022 Provider Education Webinars

Metabolic Screenings for Members on Antipsychotic Medications

Presbyterian Shares the November 2022 Network Connection Newsletter

October 2022

Nursing Facility Payment Concerns and Resolution Meeting - Nov. 1

Reminder: Risk of Pharmacy Claim Denials for Prescribers Not Enrolled in New Mexico Medicaid

Fall 2022 Health Equity Trainings Invitation

You're Invited to Dec. 2022 Physical Health Provider Education Webinars

You're Invited to Upcoming Critical Incident Reporting Training for Behavioral Health

Introducing Presbyterian UltraFlex (HMO-POS)

Presbyterian Shares a Guide to Coordinating Interpreter Services

Reminder: Fall 2022 Health Equity Trainings Invitation

Reminder: Nursing Facility Payment Concerns and Resolution Meeting - Nov. 1

2023 Presbyterian Dual Plus Training Is Available

Personal Care Services Provider Training Announcement

September 2022

2022 September Network Connection

Risk of Pharmacy Claim Denials for Prescribers Not Enrolled in New Mexico Medicaid

Behavioral Health Provider Education Webinars Q3/Q4 Invitation

Presbyterian Shares Care Coordination FAQs

Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide in November

Presbyterian Shares the September 2022 Network Connection Newsletter

August 2022

Information on Metabolic Monitoring for Children and Adolescents on Antipsychotics

Centennial Care Behavioral Health Critical Incident Report Training Q3 Invitation

Behavioral Health Town Hall Invitation Q3

Centennial Care Behavioral Health Critical Incident Report Training Q3 Reminder

Physical Health Provider Education Webinars Invitation Q3/Q4

Long-Term Services and Supports Providers Survey

July 2022

Changes to the Observation Review Process

Become a Certified Telemental Health Provider

2022 July Network Connection Providers Must be Medicare Compliant Presbyterian Will Update its Medical Policy Manual and Prior Authorization Guide in September

Nursing Facility Payment Concerns and Resolution Meeting – Aug. 2

Reminder: Nursing Facility Payment Concerns and Resolutions Meeting – Aug. 2

Presbyterian Shares the July 2022 Network Connection Newsletter

June 2022

Supporting Presbyterian Members During the New Mexico Wildfires

Time is Running Out - Don't Miss Your Chance to Take Our Telehealth Strategy Survey

Transgender 101 and 201 Health Equity Training Invitation

Presbyterian Shares a Distinction Value-Based Program Flyer

Provider Survey Opportunity: Tell Us about Your Telehealth Strategy

Best Practices for Primary Care Providers Prescribing Antipsychotic Medications

Current Best Practices for Primary Care Providers Prescribing Antidepressant Medications

May 2022

2022 May Network Connection How to Host a "Got Shots?" Back-to-School Event for Children and Adolescents Claims Guidance for Medicare Advantage $250 Routine Eyewear Benefit Letter

Claims Guidance for Medicare Advantage $250 Routine Eyewear Benefit

Provider Survey Opportunity: Coordinating Care Between Physical and Behavioral Health Providers

Presbyterian Updated Its Process to Review Nursing Facility Claims

Updated Value-Based Insurance Design Model Hospice Benefit Component Notice of Election (NOE) and Claim Submission Information

Presbyterian Shares a Classic Value-Based Program Flyer

Centennial Care Behavioral Health Critical Incident Report Training Q2 Reminder

Centennial Care Behavioral Health Critical Incident Report Training Q2 Invitation

Behavioral Health Town Hall Discuss May/Q2 Reminder

Presbyterian Shares the May 2022 Network Connection Newsletter

April 2022

Updated Value-Based Insurance Design Model Hospice Benefit Component Notice of Election (NOE) and Claim Submission Information

2022 Health Equity Trainings

Behavioral Health Town Hall Discuss May/Q2 Invite

Presbyterian Shares a Pharmacy Formulary FAQ

NOTICE: Nursing Facility Payment Concerns and Resolution Meeting Date Change - April 5

Nursing Facility Payment Concerns and Resolution Meeting - May 3

Reminder: Nursing Facility Payment Concerns and Resolution Meeting - May 3

March 2022

2022 March Network Connection Centennial Care Rewards Program: Baby Bonuses

Behavioral Health Town Hall Discuss March/Q1 Invite

Nursing Facility Payment Concerns and Resolution Meeting - April 5

Presbyterian Shares the March 2022 Network Connection Newsletter

February 2022

Critical Incident Reporting Training for Behavioral Health

COVID-19 Testing Coverage Update Presbyterian Will Update its Medical Policy Manual and Prior Authorization Guide in March How to Prevent Claim Denials in AuthentiCare Law Requires Provider Directory Information to Be Verified Every 90 Days

Reminder: Law Requires Provider Directory Information to Be Verified Every 90 Days

Criteria for Submitting Manual Entry Claims through AuthentiCare

Centennial Care Behavioral Health Critical Incident Report Training Q1 Invitation

Nursing Facility Payment Concerns and Resolution Meeting - March 1

Reminder: Nursing Facility Payment Concerns and Resolution Meeting - March 1

January 2022

2022 January Network Connection Increasing Administrative Efficiency with Claims Editing System Enhancement 2022 Provider Manuals Are Available

Second Reminder: Nursing Facility Payment Concerns And Resolution Meeting - Feb. 1

Payment Issued to HCQS Providers

Informing Providers of Updated Third-Party Liability Requirements

Presbyterian Is Issuing Payment to Nursing Facility Providers

Reminder: Nursing Facility Payment Concerns And Resolution Meeting - Feb. 1

Nursing Facility Payment Concerns And Resolution Meeting - Feb. 1

Presbyterian Shares the January 2022 Network Connection Newsletter

December 2021

Presbyterian Will Update its Medical Policy Manual and Prior Authorization Guide in January

Nursing Facility Payment Concerns And Resolution Meeting - Jan. 4

Presbyterian Implements $0 Behavioral Health Cost-Share for Most Services

Presbyterian Expands Initial Facility Admission from 3 Days to 10 Days

Presbyterian Implements Temporary Changes to Prior Authorizations for Facility Admissions

November 2021

2021 November Network Connection Effective Jan. 1, 2022: Medicare Providers Should Submit Claims to Presbyterian for Monoclonal Antibody Treatments and the COVID-19 Vaccine

October 2021

Presbyterian Will Update Its Medical Policy Manual and Prior Authorization Guide in November Presbyterian Offers New Vision Benefits in 2022 2022 Dual Plus Training Invitation Tax ID numbers Will Be Required on All Prior Authorization Requests Presbyterian Clarifies Effective Date for Updates Made to the Medical Policy Manual and Prior Authorization Guide in October

September 2021

2021 September Network Connection Presbyterian Will Update Its Medical Policy Manual in October

August 2021

Presbyterian Shares NMDOH Press Release about $100 COVID-19 Vaccine Incentive

Behavioral Health Town Hall Invitation

Presbyterian Is Issuing Payment to Providers in the Hospital Access Program

Presbyterian Shares Hospice VBID Fact Sheet and FAQs

2021 Centennial Care Critical Incident Reporting Training Invitation

July 2021

2021 July Network Connection Required Information on Prior Authorizations for Home Health Care Supplemental Payment Issued to Providers in Accordance with Special COVID-19 Letter of Direction #21

June 2021

Payment Issued to Providers in Accordance with Special COVID-19 Letter of Direction #21 Important Information Regarding Bioidentical Hormone Replacement Therapy Air Ambulance Flyer Presbyterian Centennial Care Behavioral Health Providers Can Now Submit Electronic Prior Authorizations Presbyterian Launches a New Network on the New Mexico Health Insurance Exchange Correcting Information about Prior Authorizations for Wheelchair Bases and Walkers

May 2021

2021 May Network Connection Presbyterian Will Update the Prior Authorization Guide Update to Notification of Admission Authorization Requirements for Maternity Stays Collaborating with PCPs to Ensure Members Receive COVID-19 Vaccine

April 2021

Chronic Pain Management Algorithm Critical Incident Reminders

March 2021

Medicare Providers Must Comply with FDR Requirements 2021 March Network Connection Presbyterian Will Update its Prior Authorization Guide

Presbyterian Shares Resources for its Site of Service Initiative

Payment Issued to Nursing Facility Providers in the Value-Based Purchasing Program

February 2021

2021 March Provider Education Conference Invitation

Presbyterian Issued Payment to HCQS Providers

Submit Medicare Advantage Claims for COVID-19 Vaccine to CMS

January 2021

Presbyterian Selected to Participate in the Hospice Value-based Insurance Design Model Presbyterian Updated its Prior Authorization Guide Presbyterian Increased Rates for PCS Providers

Presbyterian Shares Member COVID-19 Vaccine Communication

2021 January Network Connection

December 2020

Clarifying Billing Practices for Acupuncture and Chiropractic Providers Presbyterian Updates its Prior Authorization Guide Presbyterian Updates Fax Number on Notice of Medicare Non-coverage Forms

Department of Health Launches COVID-19 Vaccine Registration Website

Required Information on Claims from Independent Labs

November 2020

Presbyterian Adds New Prior Authorization Tools to the myPRES Provider Portal 2020 November Network Connection

October 2020

2021 Dual Plus Training is Available

September 2020

2020 September Network Connection

August 2020

PEC Invitation Letter PEC Invitation

July 2020

2020 July Network Connection Presbyterian Updated its Prior Authorization Guide Presbyterian Centennial Care and Commercial Products No Longer Cover Enbrel Products

June 2020

June Provider Education Conference Invitation NMIC "Got Shots?" Campaign New Routine Vision Agreement with Superior Vision

May 2020

2020 May Network Connection Suboxone Provider Letter

April 2020

COVID-19 PHP Telehealth Provider Instruction ABA COVID-19 SBH Guidance BHSD Communication

March 2020

2020 March Network Connection 2020 PQIP à la Carte Letter March 2020 PEC Invitation Letter

February 2020

Presbyterian's New Standard Prior Authorization Form

January 2020

2020 January Network Connection Update to Presbyterian's Coverage of Continuous Glucose Monitors and Supplies Continuous Glucose Monitor Criteria

December 2019

Medicare Initial Determinations and Appeals Presbyterian Rolls Out Phase 2 of New Claims System

November 2019

2019 November Network Connection Centennial Care Implements Daily Cumulative Opioid Dosing Limits 2020 Dual Plus Training Is Available

October 2019

Provider Access Survey Letter Centennial Care Critical Incident Training Announcement

September 2019

Network Connection September 2019

August 2019

Presbyterian Dual Plus Training Reminder Provider Education Conference Invitation MCO Critical Incident Training Invitation

July 2019

Medicare Merit-based Incentive Payment System Payment Letter Network Connection July 2019

June 2019

Depression Diagnosis and Treatment Webinar

May 2019

Network Connection May 2019

April 2019

New Behavioral Health Fee Schedules

March 2019

Network Connection March 2019 2.0 Transition Member PCS Authorizations FAQs - All MCOs

February 2019

Register for One of Our Upcoming March Provider Education Conference Webinars Accurately Billing Reduces the Risk of Claims Denial Submit All Prior Authorizations by Fax or through the myPRES Provider Portal

January 2019

2019 Practitioner and Provider Manuals Are Available 2019 Medicare Part D Opioid Policies Presbyterian Implements New Claims and Editing Systems 2019 Presbyterian Dual Plus Training Network Connection January 2019

December 2018

Risk of Claims Denial for Centennial Care Members Who Are Eligible for Medicare

November 2018

Network Connection November 2018 Presbyterian Coverage For Flu Vaccines Important Information Regarding Nursing Facility and Hospiceartment

October 2018

Providers should enroll with the New Mexico Human Services Department Presbyterian Fax Number to Non-portal Critical Incident Report Reminder: Enroll in Presbyterian’s New Electronic Payment Platform URGENT: Enroll in the Presbyterian ePayment Center or Risk Payment Delays Presbyterian Extended the Enrollment Period for ePayments

September 2018

Network Connection September 2018 United Healthcare Centennial Care Members Obstetrical Ultrasound Prior Authorization Requirement

August 2018

Enroll in Presbyterian’s New Electronic Payment Platform Critical Incident Training Invite - All MCOs 2018 Providers Who Render Services to Eligible Dual Plus Members are Required to Complete Annual Training UnitedHealthcare Centennial Care Members Will Transition to Presbyterian Health Plan, Inc.

July 2018

Presbyterian Will Apply Medical Care Credits to All Appropriate Category of Eligibility Evacuation Plan for Nursing and Assisted Living Facilities The National Drug Code Is Required on All Medication Claims Introducing a New Electronic Payment Platform Network Connection July 2018

June 2018

Presbyterian Updates its Fluoride Dental Varnish Project EVV Support Broker FAQ

May 2018

Network Connection May 2018 Pharmacy and Therapeutics (P&T) Committee Provider Update

April 2018

CMS to Issue New ID Cards to Medicare Members

March 2018

EPSDT Private Duty Nursing Claim Form Update CARELink Health Homes - Bernalillo CARELink Health Homes - DeBaca CARELink Health Homes - Hidalgo CARELink Health Homes - Lea CARELink Health Homes - Quay CARELink Health Homes - Roosevelt CARELink Health Homes - Kewa Sandoval CARELink Health Homes - Sandoval Pharmacy and Therapeutics Committee Provider Update First Quarter 2018 Enhanced AuthentiCare System Network Connection March 2018

February 2018

Requirements for Requesting a Nursing Facility Level of Care

January 2018

Network Connection January 2018