COVID-19 Coronavirus Provider Updates
Independent Health has a comprehensive preparedness plan in place to help us deliver coverage and services to our members without interruption.
Last Updated 4/6/20

Independent Health is monitoring the rapidly changing developments of the COVID-19 Coronavirus. Given the amount of attention and variety of information about COVID-19, patients will need to receive the proper guidance and direction from their health care providers. With the ongoing situation changing daily, general and specific information will be posted here and/or communicated directly through secure messages accessible when you log-in to our provider portal.

With the uncertainty everyone is facing, we know health care providers have many questions. We’ve compiled a list of Frequently Asked Questions to provide more guidance and support. If your practice has questions, contact our Provider Relations Department by phone at (716) 631-3282 or 1-800-736-5771, or email at providerservice@servicing.independenthealth.com, Monday through Friday from 8 a.m. to 6 p.m.

Medical Coverage

Independent Health has waived copayments or cost-sharing for COVID-19 medical testing, diagnosis and treatment at least through May 31, 2020. This applies to all fully insured commercial plans (including HSA-qualified high deductible health plans), Medicare Advantage, State Products and Individual plan members.

This coverage includes in-person visits and telehealth visits, urgent care center, outpatient hospital or emergency room visits when the primary purpose of the visit is COVID-19 testing, diagnosis and treatment.

Coverage for self-funded employer plans varies by employer group.

Telehealth and Telemedicine

To encourage social distancing and help reduce the risk of spreading this virus, Independent Health will cover any in-network telehealth/telemedicine services, whether or not COVID-19 related. There will be $0 copay or cost-sharing for members for these services. We’ve organized important information in the Telehealth Fee Schedule, Coverage Grid, and Policy.

Medicare Members are responsible for the cost share associated with ancillary services (e.g. dietitians).

Self-Funded Members should contact customer service at 716.631.2661 or 1.800.257.2753 for more information on telehealth benefits and the cost.

Teladoc®

Although Independent Health encourages its members to contact their primary care physician for their medical needs, we realize this isn’t always possible. So, when a member can’t reach your primary care practice, Independent Health’s telemedicine benefit is provided through Teladoc®. Independent Health is waiving the cost share for Teladoc services during the COVID-19 outbreak.

Teladoc is not available to Essential Plan members and availability to self-funded members varies by employer group.

Coding for Services Related to COVID-19

Please follow ICD-10 CM Diagnosis Coding guidelines published by CDC if the need arises to report claims for COVID-19 related services. For claims with dates of service on or after April 1, 2020, there is a new diagnosis code for COVID-19 infection. The updated CDC guidance further outlines the appropriate use of the new diagnosis code.  If the CDC makes additional recommendations in the future, please adhere to updated guidance.

Pharmacy and Medication Updates

NYS Governor Executive Order: Prescribing Hydroxychloroquine

There has been a recent surge in prescribing hydroxychloroquine. Some prescriptions appear to be off-label for acute respiratory infection and some for the purpose of stockpiling. This creates risk that patients with an FDA-approved diagnosis will not have access. In response on March 23, NYS Governor Andrew Cuomo ordered that hydroxychloroquine and chloroquine only be dispensed for an FDA-approved indication or in the setting of a clinical trial for COVID-19.

  • In support of the governor’s order, Independent Health is requiring prior authorization on any new prescriptions.
  • Patients previously prescribed hydroxychloroquine for the FDA-approved indications of Lupus or Rheumatoid Arthritis can continue to fill this medication as a 30-day supply.
  • Please do not stockpile medications during this epidemic.
  • If you have questions around this change in coverage, please call our Pharmacy Help Desk at (716) 631-2927 or 1-800-993-9898, Monday through Sunday from 7 a.m. to 11 p.m.

Access to Medications

Independent Health is prepared to continue to provide access to our members with pharmacy benefits who need their medications, including medication alternatives. In response to drug shortages related to COVID-19, we will cover alternative medications, including the brand name medication if there is a shortage of the generic.

Early Refills

Independent Health members who are considered to be at higher risk as defined by the CDC guidelines or members who may not have access to a pharmacy will be able to obtain an early refill or an extended supply of their medication if needed. Early refills will be for the day-supply currently allowed, typically a 30-day supply. For maintenance medications, an early refill for a 90-day supply will be allowed. This early refill policy is in place for all Independent Health members, including those with a Medicare Advantage plan, Commercial plan and MediSource/Child Health Plus.

Independent Health network pharmacies will be able to use a Submission Clarification Code (SCC) to allow an override for the refill too soon (RTS) edit.

  • Please use Submission Clarification Code 13 to override the refill too soon and allow members to obtain an early refill of their medication(s).
  • This SCC applies to all Independent Health lines of business and can be used at any network pharmacy within the United States.
  • If your claim still rejects after entering the SCC, please contact our Pharmacy Help Desk at (716) 631-2927 or 1-800-993-9898, Monday through Sunday from 7 a.m. to 11 p.m.

Mail Order for Maintenance Medications

Independent Health members may have their maintenance medications delivered to their homes through one of two mail-order vendors Independent Health has partnered with.

In addition, some pharmacies offer prescription delivery. We encourage our members to contact their preferred pharmacy to see if home delivery is available.

Other Changes to Help with Social Distancing

At this time, we are temporarily waiving the requirement for a physical signature from members upon prescription receipt. In addition, we encourage pharmacies to use other means of prescription pick-up, including delivery and mail, to help limit possible exposure to the virus.

Additional Provider Updates

Medicare Advantage Members: Receiving Care During An Emergency Declaration

Due to the emergency declaration, Medicare Advantage members may obtain care from out-of-network providers at the in-network cost sharing. For more information, see the page called “Getting care during a disaster.”

Personal Protective Equipment

As you know, supplies of personal protective equipment for providers are limited. The NYS DOH has developed guidance for county health departments to uniformly be able to dispense PPE. If your practice is having trouble obtaining this equipment from your normal sources, please see the attached guidance. Please be considerate in your requests for these scarce items by only ordering when you are in need and requesting stock appropriately.

All local county health departments have requested that your practice contact them directly for assistance as follows:

  • Erie County has the following email process:
    Email: esf8@erie.gov
    Include practice name, 24-hour contact phone number, type of clinic, location(s), and items needed, including quantity.
  • Niagara: (716) 438-3171
  • Orleans: (585) 589-3278
  • Wyoming: (585) 786-8890
  • Alleghany: (412) 687-2243
  • Genesee: (585) 344-2580
  • Cattaraugus: 1 (800) 251-2584
  • Chautauqua: 1 (866) 604-6789

Please note: a previous related notification from Howard A. Zucker, MD, JD, Commissioner of Health, NYSDOH, with additional information is available here.

Submitting Practice Data Changes and Credentialing Requests

Since many provider offices have support staff working from home and may not have access to a fax machine to submit data changes, your practice may also notify Independent Health of any changes that may occur within your practice by email at networkoperations@independenthealth.com. Your practice may also continue to submit data changes by fax.

To check on the status of new provider application or if you would like to credential a new provider for participation, you can email those requests to credentialing@independenthealth.com

Authorization and Claim Review Activity Changes in Response to COVID-19

Independent Health is suspending authorization and health plan activities as detailed here.

Prior Authorizations

Independent Health is extending certain prior authorizations set to expire before April 30th. These prior authorizations will now expire 90 days from their original expiration date. This applies only to medications treating certain chronic conditions, which were submitted as a pharmacy prior authorization. This change affects all insured lines of business. We will continue to monitor the situation and prolong extensions, if needed.

Stay Up-to-Date

Because this is a rapidly evolving issue, please check the following sources regularly:

If you have questions related to Independent Health, please contact our Provider Relations department Monday through Friday from 8 a.m. to 6 p.m. at (716) 631-3282 or providerservice@servicing.independenthealth.com