News and Highlights

Pharmacy News: October 2016 (PDF)

Latest pharmacy news from Group Health for providers.

October Clinical Tips

See Clinical Pearls — recommendations you can integrate into your practice.

Patient Referrals into Seattle Area

When referring Group Health patients to the Seattle area for care, we ask all referring providers to explore the clinical excellence available at Group Health Medical Centers and encourage you to select Group Health first. See Provider Update, page 4.

Provider E-News

See monthly clinical practice and business updates.

New OneHealthPort Website

On Monday, Oct. 17, OneHealthPort's site will have a new design and functionality.

Updated Non-Contracted Provider Reimbursement Payment Policy (PDF)

See the latest updates, effective Oct. 1, 2016.

2016 Practitioner Satisfaction Survey

If you received a survey invitation from Group Health, please complete the survey by Oct. 31.

Formulary Decision Highlights: September 2016 (PDF)

Highlights from the Sept. 14 meeting.

Prior Authorization Changes for BRCA and Lynch Syndrome Testing (PDF)

Effective Dec. 1, prior authorization is required for BRCA and Lynch Syndrome testing.

Several Drugs to Require Prior Authorization

Effective Sept. 30, several drugs require prior authorization.

HEDIS Insight: Pediatric & Adolescent Well-Visits and Immunizations (PDF)

Quick reference guide of HEDIS measures for pediatric and adolescents includes coding information and tools for improving performance.

Provider Update: September 2016 (PDF)

Claim payment card, FluMist not recommended for 2016-2017 season, drug formularies, and more.

Changes to Medical Necessity Review Criteria for Group Health Options PPO (PDF)

See what services require review beginning Sept. 1.

New Payment Policy: Pharmacist Reimbursement (PDF)

See the latest updates, effective June 1, 2016.

Injectable Drugs Requiring Prior Authorization

Non-Medicare Drug List updated June 1.

2016 HEDIS Documentation and Coding Guidelines (PDF)

Group Health's quick reference guide of common HEDIS measures includes newly issued statin measures for patients with cardiovascular disease and diabetes.

Omni PPO Plans

See what's offered, which services require preauthorization, and get information about claims submissions.

Annual NCQA Notification

Updates to our guidelines, services, provider manual, and other important information.

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