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COVID-19 resources

Frequently asked questions

Everything you need to know about working with us during the pandemic.
Visit the My Care Family FAQ.

Table of Contents



The Massachusetts State of Emergency ended on June 15, 2021, and we’re currently reviewing policies that were established during this time. We’ll share updates about our policies here, so please continue to check this FAQ.

If a topic isn't addressed here, please follow our standard policies and procedures as outlined in our medical policies, payment policies, authorization guidelines, provider resources, or your contract. 

Please refer to the COVID-19 payment policy for more information. AllWays Health Partners is in compliance with all relevant Massachusetts regulations related to COVID-19 during the public health emergency.  

General information

The best source for credible news on COVID-19 is the CDC (Centers for Disease Control and Prevention). You can check their website to find the latest updates and recommendations, including resources like:

The Massachusetts Department of Public Health is also a helpful resource for more of the latest updates.

You can also refer to our FAQ for members.

Vaccine information

Throughout the COVID-19 pandemic, AllWays Health Partners has ensured timely access to critical health care services for our members. As part of that commitment, AllWays will cover the administration of all COVID-19 vaccines that receive emergency use authorization (EUA) or full approval from the Food and Drug Administration (FDA), at no cost to our members.

Please note that all vaccine providers administering a dose of COVID-19 vaccine in the Commonwealth must report administration to the Massachusetts Immunization Information System within 24 hours.

Throughout the COVID-19 pandemic, AllWays Health Partners has ensured timely access to critical health care services for our members. As part of that commitment, AllWays will cover the administration of all COVID-19 vaccines that receive emergency use authorization (EUA) or full approval from the Food and Drug Administration (FDA), at no cost to our members.

Code

Description

Effective

Comment

 

91300

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use

12/11/2020

 

 

 

 

Pfizer vaccine BioNTech Covid-19

0001A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose

12/11/2020

 

Report for the administration of Pfizer vaccine 91300, first dose

0002A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose

12/11/2020

Report for the administration of Pfizer vaccine 91300, second dose

0003A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; third dose

8/12/2021

Report for the administration of Pfizer vaccine 91300, third dose

0004A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; booster dose

9/22/2021

Report for the administration of Pfizer vaccine 91300, booster dose

91307

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use

10/29/2021

Pfizer-BioNTech pediatric vaccine

0071A


Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose

 

10/29/2021

Report for the administration of Pfizer vaccine 91307 first dose

0072A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose

10/29/2021

Report for the administration of Pfizer vaccine 91307, second dose

91301

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use

12/18/2020

Moderna vaccine Covid-19

0011A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose

12/18/2020

Report for the administration of Moderna vaccine 91301, first dose

0012A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose

12/18/2020

Report for the administration of Moderna vaccine 91301, second dose

0013A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage; third dose

8/12/2021

Report for the administration of Moderna vaccine 91301, third dose

91303

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5mL dosage, for intramuscular use

2/27/2021

Johnson and Johnson vaccine Covid-19

0031A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5mL dosage, single dose

2/27/2021

Report for the administration of Johnson and Johnson vaccine 91303

0034A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; booster dose

10/20/2021

Report for the administration of Johnson and Johnson booster dose 91303.

91306

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use

10/20/21

Moderna Low Dose

0064A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, booster dose

10/20/2021

Admin Moderna Low Dose, Report for the administration of 91306

Our COVID-19 vaccination status report can help PCPs identify which of their patients have not been vaccinated. This report contains all commercial HMO members on your panel who are partially vaccinated or unvaccinated, and is available on our provider portal. 

You can find the report under the "Reports" tab after logging in to your provider portal account. 

COVID-19 testing and treatment

Read our COVID-19 payment policy.

For the duration of the public health emergency, we have removed copayments, deductibles, or coinsurance for medically necessary COVID-19 testing and treatment. This applies to inpatient and outpatient services at in- or out-of-network providers, including urgent care centers, emergency departments, hospitals, and other facilities. 

These changes are in accordance with guidelines from the Centers for Disease Control (CDC) and the Massachusetts Department of Public Health. Please note that employers offering self-insured plans may have different cost sharing for these services. Members can log into the member portal or call the customer service number on the back of their card for information about their plan benefits.

Testing coverage

In accordance with current CDC and state public health department guidelines, AllWays Health Partners members are covered without cost sharing for COVID-19 testing, when it is medically necessary and ordered by a PCP or treating provider. FDA-approved testing is also covered when a person:

  • Has been identified as a close contact by a public health entity for a known or suspected exposure to COVID-19.
  • Works in an industry with increased exposure to the virus like health care, restaurant, hospitality, and retail industries


Testing is not covered for third party administrative reasons — including but not limited to pre-employment or return to work, public health, return to school, and travel screenings.

Diagnosis Codes for Evaluation for suspected Covid-19

  • Z03.818: Encounter for observation for suspected exposure to other biological agents ruled out
  • Z11.59: Encounter for screening for other viral diseases
  • Z11.52: Encounter for screening for Covid-19.  Effective for dates of service 1/1/2021 and forward.
  • Z20.828: Contact with and (suspected) exposure to other viral communicable diseases
  • Z20.822: Contact w/and suspected exposure to covid-19. Effective for dates of service 1/1/2021 and forward.


Diagnosis Codes for Treatment of Covid-19

  • U07.1: 2019-nCoV acute respiratory disease
  • J12.82: Pneumonia due to coronavirus disease 2019. Effective for dates of service 1/1/2021 and forward.
  • B97.21: SARS-associated coronavirus as the cause of diseases classified elsewhere
  • B97.29: Other coronavirus as the cause of diseases classified elsewhere


If Multisystem Inflammatory Syndrome (MIS) develops as a result of a previous COVID-19 infection, assign codes M35.81 and B94.8.

  • M35.81: Multisystem Inflammatory Syndrome. Effective for dates of service 1/1/2021 and forward
  • B94.8: Sequelae of other specified infectious and parasitic diseases


You can find more information in our COVID-19 payment policy.

The following specimen collection and lab codes are covered when medically necessary and ordered by a provider. For more information, check our COVID-19 payment policy.

Code  

Description 

Coverage Effective Date 

C9803

Hospital outpatient clinic visit specimen collection for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source

3/1/2020

G2023

Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source

3/1/2020

G2024

Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen source

3/1/2020

0202U

Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected

5/20/2020

0225U

Infectious disease (bacterial or viral respiratory tract infection) pathogen-specific DNA and RNA, 21 targets, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique, including multiplex reverse transcription for RNA targets, each analyte reported as detected or not detected

8/10/2020

0240U

Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 3 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B), upper respiratory specimen, each pathogen reported as detected or not detected

1/1/2021

0241U

Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 4 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B, respiratory syncytial virus [RSV]), upper respiratory specimen, each pathogen reported as detected or not detected

1/1/2021

U0002

Laboratories performing non-CDC laboratory tests for SARS-CoV-2/2019 nCoV (COVID-19) can bill for them using this code.   Effective 4/1/2020 for DOS 2/4/2020 and later)

3/12/2020

U0003

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R.

 

3/18/2020

U0004

2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R

3/18/2020

U0005

Infectious agent detection by nucleic acid (DNA or RNA); Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, CDC or non-CDC, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either HCPCS code U0003 or U0004) as described by CMS-2020-01-R2

1/1/2021

86328

Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

4/10/2020

86408

Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]); screen

8/10/2020

86409

Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]); titer

8/10/2020

86769

Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

4/10/2020

87426

Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])

6/25/2020

87428

Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B

11/10/2020

87635

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique

3/13/2020

87636

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique

10/6/2020

87637

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique

10/6/2020

87811

Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

10/6/2020

 

Due to the rapidly evolving nature of Covid-19 testing protocol AllWays Health Partners Clinical leadership continues to track developments regarding COVID-19 antibody testing. Please refer toCDC and FDA websites for further guidance.

Optum is our behavioral health partner. They have detailed COVID-19 information available on both their provider portal and their member portal. Please refer to Optum’s State-Specific Guidance for the most current COVID related updates. In addition, they have a site dedicated to resources for general wellbeing.

During the public health emergency, you can check this list to locate in-network skilled nursing facilities (SNFs), rehab facilities, and in-patient acute care centers.

Relaxing prior authorization and referral requirements

The tables below provide guidance for prior authorization and medical review requirements during the COVID-19 public health emergency and as a result of the Massachusetts Division of Insurance (DOI) capacity constraint bulletin. 

Please submit notifications in the provider portal per our usual process.

COVID-19 related admissions do not require Prior Authorization.

Prior Authorization (PA) Lift Requirements to address DOI capacity constraint bulletin

Service

Commercial Fully Insured/GIC ASO PA lift Effective Date

Is Prior Authorization (PA)/Notification Required?

Is Review Required?

Requirements

Inpatient admission (acute and scheduled surgery) at In Network Hospital

11/17/2021 to 02/15/2022

Yes

Suspended for Initial Review

Required for Concurrent Review

  • Suspend prior authorization review for In-network Inpatient Scheduled Surgeries and Inpatient Acute hospital admissions.
  • Notification of the admission should be submitted by the provider within 24 hours of admission and updates provided a minimum of every 5 days to support discharge planning.
  • Concurrent review for acute and scheduled surgery admissions at inpatient hospitals will continue to be done business as usual.

Post-Acute care at In Network Inpatient facilities

11/17/2021 to 02/15/2022

Yes

Suspended for Initial Review 

Required for Concurrent Review

  • Suspend prior authorization review for In Network Post-Acute Care, which includes: skilled nursing facility, in-patient acute rehabilitation at an acute rehab, long term acute care (LTAC), and chronic disease hospitals.
  • Notification of the admission should be submitted by the provider within 24 hours of admission and updates provided a minimum of every 5 days to support discharge planning.
  • Concurrent review for Post-Acute Care admissions will continue to be done business as usual.

Out of Network and Outpatient Services

9/1/2021

Yes

Yes

AllWays Health Partners’ standard prior authorization and notification requirements will continue for out of network inpatient services, and for in-network and out of network outpatient services.

 

Quick Reference Guide regarding COVID-19 Public Health Emergency Requirements

For details, please refer to our COVID-19 public health emergency PA grid.

Service

Commercial / ASO Effective Date

My Care Family Effective Date

Is Prior Authorization (PA)/Notification Required

Is Review Required

Requirements

Inpatient admission
Non-COVID-19 related

4/1/2021

9/1/2021

Yes

Yes

Standard prior authorization and notification requirements have resumed for all Commercial and My Care Family inpatient admissions except those related to COVID-19 and as noted above in the requirements due to Capacity/Staffing Issue.

Inpatient admission
COVID-19 related

4/6/2020

4/6/2020

Yes

Suspended

Suspend prior authorization review for initial and concurrent acute admissions at hospitals, related to COVID-19. Notifications should be submitted by the provider within 48 hours of admission and updates provided a minimum of every 5 days to support discharge planning.

Post-Acute care
Non-COVID-19 related

9/1/2021

9/1/2021

Yes

Yes

Standard prior authorization and notification requirements have resumed for non-COVID-19 related Post-Acute Care including: home health care (MVACO), skilled nursing facility, in-patient acute rehabilitation at an acute rehab, long term acute care (LTAC), and chronic disease hospitals. Exception: see Post-Acute care requirements as noted above in the Capacity/Staffing Issue prior auth and notification requirements.

Post-Acute care
COVID-19 related

3/23/2020

3/23/2020

Yes

Suspended

AllWays Health Partners has removed prior authorization requirements for Post-Acute Care, which includes: home health care (MVACO), skilled nursing facility, in-patient acute rehabilitation at an acute rehab, long term acute care (LTAC), and chronic disease hospitals. Notification from the provider of the admission to and continued stay/services at extended care facility or home health care is required. Skilled nursing and acute rehab will be reviewed for medical necessity after day 7, home health care will be reviewed for medical necessity after day 30.

 

Referral requirements continue to be suspended for all lines of business during the COVID-19 public health emergency. Please note, AllWays continues to require prior authorization for HMO members seeking non-COVID, non-emergent care from an out of network provider.

For details about authorization and referral requirements during the pandemic, please refer to our COVID-19 public health emergency PA grid

If you need to change the service location for an authorization, please follow standard procedure. The new location must enter a prior authorization request in our provider portal. If possible, the new location should include the previous authorization number.

Telemedicine and other technology

To help prevent the spread of the coronavirus and support our provider partners during the public health emergency, we have expanded the scope of allowed telemedicine services and provider specialties.

In addition, to ensure continued access to care, we have removed cost sharing (copayments, deductibles, or coinsurance) for medically necessary COVID-19 telemedicine visits. As of January 1, 2021, cost sharing has resumed for non-COVID-19-related telemedicine visits with PCPs, specialists, and additional providers, such as urgent and routine care, and outpatient behavioral health services.

AllWays on Teams

AllWays Health Partners offers a free telehealth platform to  all providers in our network. You can learn more and register here.

Providers are not required to use AllWays on Teams. This service is designed to support providers who do not have existing technology for virtual visits. AllWays Health Partners reimburses for telemedicine on any HIPAA-compliant platform.

There are two scenarios for billing clinically appropriate, medically necessary telemedicine:

  • For well visits and existing or new patient visits, use the appropriate E/M codes (service must meet E/M coding guidelines) with modifiers GT or 95 and place of service 02
  • For all other services, bill telemedicine using telephonic or digital codes with place of service code 02

You can find complete information in our COVID-19 payment policy.

We have expanded access to telemedicine services during the COVID-19 epidemic. 

For more information, please refer to our COVID-19 public health emergency telemedicine policy.

If a preventive visit has been rendered and billed via telehealth, AllWays Health Partners does not reimburse separately for a follow-up preventive visit in your office. Vaccinations and vaccine administration are separately reimbursable.

Medications

As specific medications are developed to treat COVID-19, AllWays Health Partners follows Federal and/or State guidance for how it would be made available and for any applicable cost sharing requirements. There are currently some medications being utilized that are on our existing formulary without a prior authorization. Non-formulary prescriptions can be reviewed within 24 hours in cases of exigent circumstances. Please note COVID-19 on the request.

AllWays Health Partners is committed to ensuring timely access to critical health care services for COVID-19 for our members. During the COVID-19 public health emergency, we will cover immunizations for members age 3+ at a retail pharmacy, in addition to a provider’s office. As always, we encourage members to consult their primary care provider or pediatrician regarding childhood immunizations.

Please note employers that are self-insured may not offer prescription drug coverage through AllWays Health Partners. Members should check the details of their coverage by contacting their employer, visiting the member portal (allwaysmember.org), or using the AllWays Member app (allwayshealthpartners.org/memberapp).

  • Several drugs and therapies have received FDA or emergency use approval (EUA) for treatment of COVID-19 and post-exposure prophylaxis (PEP) for qualifying patients.
  • The following medications are covered without prior authorization for outpatient treatment of COVID-19. Coverage applies to the cost of administration as the medication is being provided by the government.
  • Sotrovimab and tocilizumab won't be purchased and distributed for free by the federal government. You may purchase these products through typical purchasing channels.

 

Code

Description

Effective

Q0240

Injection, casirivimab and imdevimab, 600 mg

7/30/2021

 

 

 

M0240

Intravenous infusion or subcutaneous injection, casirivimab and imdevimab, includes infusion or injection and post administration monitoring, subsequent repeat doses

7/30/2021

Q0243

Injection, casirivimab and imdevimab, 2400 mg

11/21/2021

M0243

Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring

11/21/2021

Q0244

Injection, casirivimab and imdevimab, 1200 mg

6/30/2021

Q0245

Injection, bamlanivimab and etesevimab, 2100 mg

2/9/2021

M0245

Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring

2/9/2021

Q0247

Injection, sotrovimab, 500 mg

5/26/2021

M0247

Intravenous infusion, sotrovimab, includes infusion and post administration monitoring

5/26/2021

Q0249

Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, 1 mg

6/24/2021

M0249

Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, includes infusion and post administration monitoring, first dose

6/24/2021

M0250

Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, includes infusion and post administration monitoring, second dose

6/24/2021

 

Credentialing and enrollment

If you have an immediate need to credential or enroll a provider, please indicate that on your request. In addition, please indicate if this is a permanent or temporary placement at your practice.

Prior to submitting any request to enroll or credential a medical provider, please check your rosters via the AllWays Health Partners provider portal to validate current provider enrollments to your group billing NPI.  

Providers who have already been credentialed by AllWays Health Partners will not require any additional credentialing to provide services at a new location, however, they will need to be enrolled. To enroll a new provider to your group billing NPI:

Behavioral health providers should refer to the information on the Optum provider portal.

There are no additional credentialing or enrollment submissions required for a medical provider that is enrolled in the AllWays Health Partners network to provide telemedicine services. Please refer to our public health emergency telemedicine policy for details.

Behavioral health providers should refer to the information on the Optum provider portal.

Administrative information

AllWays Health Partners is adhering to standard turnaround times and prompt pay standards for all claims processing.  Standard claim editing applies and some claims may pend for manual review.  Manually reviewed claims are also subject to standard turnaround times.

AllWays Health Partners is paying in accordance with DOI guidelines during the public health emergency. Providers are not permitted to balance bill members for any costs above the DOI-mandated rates. This applies to fully insured and most self-insured commercial plans.

Click here to find instructions on submitting out-of-network claims to AllWays Health Partners.  

Contact us

Mass General Brigham COVID-19 hotline for MGB clinicians and patients: 617-724-7000 

AllWays Health Partners staff is available at 855-444-4647 Monday-Friday (8:00 AM - 5:00 PM EST).

For urgent prior authorization requests outside of regular business hours (including weekends and holidays), please contact at 1-855-444-4647 and follow the prompts.

Where can I get updates on coronavirus?

The best source for credible news on COVID-19 is the CDC (Centers for Disease Control and Prevention). You can check their website to find the latest updates and recommendations, including resources like:

The Massachusetts Department of Public Health is also a helpful resource for more of the latest updates.

Massachusetts Contact Tracing Collaborative

FDA guidance for COVID-19 testing

You can also refer to our FAQ for members.