Get the latest news and information to help providers stay up to date on policy changes and recent developments in the industry.
Coverage Requirement Changes for Provider-Administered Specialty Infusions
Effective October 1, 2019, Prominence Health Plan and CDS Group Health now require additional justification for medical necessity for infusion therapies of select drugs performed at outpatient hospital settings.
Elimination of PCP referral requirement
Effective immediately, Prominence has terminated the referral requirement for our Medicare Advantage members. In support of this change, we will reprocess all claims that may have received a denial for no referral on file.
Provider News and Updates
Get the latest news and information to help providers stay up to date on policy changes and recent developments in the industry.
Coverage Requirement Changes for Provider-Administered Specialty Infusions
Effective October 1, 2019, Prominence Health Plan and CDS Group Health now require additional justification for medical necessity for infusion therapies of select drugs performed at outpatient hospital settings.
Elimination of PCP referral requirement
Effective immediately, Prominence has terminated the referral requirement for our Medicare Advantage members. In support of this change, we will reprocess all claims that may have received a denial for no referral on file.
