OfficeLink Updates™
December 2023
Find updates on important changes to plans and procedures, behavioral health topics, drug lists, Medicare information and state-specific details.
You can now subscribe to OLU using an online form
You and your colleagues can now subscribe to OLU by filling out a simple form. It’s easy. Just click "Subscribe to OLU" below. Have your TIN (Tax Identification Number) and NPI (National Provider Identifier) number handy.
Featured this quarter
Earn a new Care Champion badge for your provider profile
We’ve created a new clinical educational hub for health care professionals. The hub, which includes courses, addresses health equity and related topics. The courses are meant to help care teams reduce the barriers that underserved and marginalized patients experience.
You can access the on-demand, free, accredited courses to earn digital Care Champion badges for your provider profile in three clinical areas of focus:
Culturally responsive PCP behavioral health care
To earn a badge, you’ll need to:
- Complete the foundational activity course
- Complete a role-specific course
- Complete the therapeutic-area-specific courses
Your digital Care Champion badge will be added to your profile and be visible to Aetna® members in our provider directories.
Explore our new patient well-being resources
Our new depression resources page and our new substance use disorder page allow you to easily access the information you need. Here’s what you’ll find:
Depression
- Depression screeners
- Resources to help patients find behavioral health programs and services
- CPT® codes*
Substance use disorders
- Substance use disorder screeners to use with patients across their lifespan
- Coding and reimbursement information for substance use disorder screening to simplify billing
- The Aetna® treatment provider directory and substance use disorder vendor partners for referral options
- Educational resources on relevant topics, including a podcast episode featuring two Aetna medical directors discussing practical ways you can help patients with substance use disorder
90-day notices and related reminders
Includes pharmacy updates
We regularly adjust our clinical, payment and coding policy positions as part of our ongoing policy review processes. Our standard payment policies identify services that may be incidental to other services and, therefore, ineligible for payment.
We’re required to notify you of any change that could affect you either financially or administratively at least 90 days before the effective date of the change. These changes may not be considered material changes in all states. Unless otherwise stated, policy changes apply to both Commercial and Medicare lines of business.
Use the drop-down box below to get a glimpse of the policy-related information you’ll need to know about this quarter.
State-specific updates
Find updates on state policies and regulations that matter to your practice. This quarter, you will find information regarding the following states:
- Colorado
- Florida
- Maine
- Massachusetts
- New Jersey
- New York
- North Carolina
- Ohio
- Pennsylvania
- Washington
Announcement for North Carolina providers
We’re getting ready for the North Carolina State Health Plan.
The first step is for you to join the Clear Pricing Project (CPP) by May 31, 2024.
Aetna® will be the new third-party administrator for the North Carolina State Health Plan beginning January 1, 2025. Open enrollment begins in the fall of 2024, which is when members will select a primary care provider (PCP).
Start by joining the CPP by May 31, 2024. If you’re a current CPP provider, you will need to re-enroll in the CPP with Aetna. Visit North Carolina State Health Plan for more information.
Note that the “GEHA will cease accessing the Aetna® National PPO network” article applies to these states:
Alaska, Arizona, Colorado, Connecticut, Georgia, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont and Washington
Note that the “Aetna® to enter the individual exchange market in five new states” article applies to these states:
Indiana, Kansas, Maryland, Ohio and Utah
Behavioral health updates
Behavioral health updates
A majority of patients treated in a primary care setting have a physical ailment that’s affected by anxiety, depression or another psychological issue. Without the right support, these issues are often underdiagnosed.
We help you stay informed about behavioral health topics so that you can deliver the best possible treatment to your patients.
Use the drop-down box below to read summaries of a few of the behavioral health articles you’ll find in this issue.
News for you
Find general information — like new services, tools and reminders — to help your office comply with regulations and administer plans.
Medicare updates
Get information, including timely reminders and guidelines, to help treat your Medicare patients.
Looking for more updates?
Notes
*FOR CPT® CODES: CPT® is a registered trademark of the American Medical Association. 2022 All rights reserved.
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Health benefits and health insurance plans contain exclusions and limitations.