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.

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.