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Frequently asked questions

AllWays Health Partners is working to expedite access to critical care during the COVID-19 state of emergency. The questions and answers below detail the changes to date, including:

  • AllWays on Teams free telemedicine app for network providers
  • Removing cost-sharing for medically necessary testing for COVID-19
  • Expanding access to telemedicine services for providers and members
  • Implementing an expedited credentialing process

We will continue to review and update our COVID-19 information as new guidance becomes available, so please check this page regularly.

 

Table of Contents



COVID-19 testing and treatment

Diagnosis Codes for Evaluation for suspected Covid-19

  • Z03.818: Encounter for observation for suspected exposure to other biological agents ruled out
  • Z20.828: Contact with and (suspected) exposure to other viral communicable diseases


Diagnosis Codes for Treatment of Covid-19

  • U07.1: 2019-nCoV acute respiratory disease
  • B97.29: Other coronavirus as the cause of diseases classified elsewhere

Please refer to the table below for code details regarding laboratory tests for COVID-19.

covid-19-faq-billing

 

To expedite access to critical health care services for COVID-19 in accordance with guidelines from the Centers for Disease Control (CDC) and the Massachusetts Department of Public Health, our coverage criteria, which may be updated in response to an evolving situation, includes:

  • Removing cost-sharing (copayments, deductibles, or coinsurance) for COVID-19 testing and treatment at provider offices, retail health clinics, urgent care centers, and emergency rooms.
  • Removing all cost-sharing for telemedicine services to enable our members to seek care virtually, reducing the need to go to medical offices.
  • Supporting access to out-of-network providers for the above COVID-19 testing or treatment when no in-network providers are available.
  • Allowing early refills for prescription medications, in addition to the benefits and services that are already available through our FlexRx pharmacy benefit program.

Optum is our behavioral health partner. They have detailed COVID-19 information available on both their provider portal and their member portal. In addition, they have a site dedicated to resources for general wellbeing.  

Relaxing prior authorization requirements

For a 90-day period (March 23 – June 23, 2020), AllWays Health Partners has removed prior authorization requirements for post-acute care including: home health care, skilled nursing facility, in-patient acute rehabilitation at an acute rehab, long term acute care (LTAC), and chronic disease hospitals. Skilled nursing and acute rehab will be reviewed for medical necessity on day 7, home health care will be reviewed for medical necessity on day 30. This applies to all lines of business.

Telemedicine and other technology

Yes. We are removing all cost-sharing for telemedicine services to enable our members to seek care virtually, reducing their need to go to medical offices. This will be applied to all commercial plans.

For more information including reimbursement details, please refer to our COVID-19 state of emergency telemedicine policy.

To make critical telemedicine services more available during this public health crisis, we partnered with Microsoft to offer a free virtual visit platform to all interested providers in our network. This will expand the use of telemedicine services for our members and help providers to protect themselves while caring for their patients.

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

For more information, please refer to our COVID-19 state of emergency telemedicine policy.

Yes, our network providers have expressed a need for a fast, HIPAA-compliant telemedicine solution to help them care for patients during the COVID-19 crisis. In response, AllWays Health Partners is working with Microsoft to offer AllWays on Teams, a virtual visit platform for 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.

 

Please note that Partners HealthCare providers should contact their site representatives with virtual care questions and for access to clinical tools.

Home visits

AllWays Health Partners covers home visits. Please reference our Evaluation and Management Services provider payment guidelines on coding and payment.

Medications

Beginning on 3/13, AllWays Health Partners is lifting the early refill rules on all medications. This includes allowing early refills for up to a 30-day supply of non-maintenance prescription medications and up to a 90-day supply of maintenance prescription medications.

This will enable pharmacists to override this requirement at the point of service. This applies to all lines of business and to all medications except narcotics. We will allow early refills of specialty pharmacy, and this will be limited to a 30-day supply.

If any specific medications are developed to treat COVID-19, AllWays Health Partners would expect to follow any 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.

We anticipate that once a COVID-19 vaccine is available, it will be available through all established channels, including primary care, minute clinics, urgent care, specialty care offices, and pharmacies. Approved vaccines are preventive services per the Affordable Care Act.

Credentialing and enrollment

We are working to update our procedures to support your medical practice with expedited credentialing when needed. If you have an immediate need, please let us know when you submit your request to enroll providers. Please indicate if the request to urgently credential or enroll a provider is for permanent or temporary placement at your practice.

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 COVID-19 state of emergency telemedicine policy for details.

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

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. For additional information about the provider portal, or to validate if your account has provider enrollment access, please email prweb@allwayshealth.org.  

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.

Need the FAQ for our My Care Family plans?

Read the FAQ

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.

You can also refer to our FAQ for members.

Contact us

Partners Health Care COVID-19 hotline for Partners clinicians and patients: 617-724-7000 

AllWays Health Partners staff is available at 855-444-4647 Monday-Friday (8:30 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.