2/16/2022. Clay joined Lucent Health In 2014 and has extensive experience working with health plan benefit designs, physician and hospital contracting, pharmacy formulary management, care management, reference-based pricing and value-based payment plans. Forgot Password? The Lucent Health provider portal helps you spend less time on administration so you can focus more on patient care. The best way to prevent fentanyl use is to educate your loved ones, including teens, about it. Until December, doctors who went through the process of acquiring a waiver still faced a cap on how many patients they could treat with the medication at once. The use of continuous data analytics provides ongoing insights that lead to better care management, ensuring that participants receive the right care, at the right cost, at the right time. solutions. To access the Lucent Health provider portal, you need to register and have an account with them. See the[Drug Plans]link. We want to make sure our members can get the high-quality care they need with providers, physicians and facilities that work collaboratively with us to ensure the best possible health care experience. Some subtypes have five tiers of coverage. When someone overdoses from fentanyl, breathing slows and their skin often turns a bluish hue. This delivers self-insured employers the type of care management that helps health plan participants make smarter, cost-saving healthcare decisions. You are in the right place. Healthcare. Medical schools tend not to incorporate opioid addiction in their curriculums, leaving younger doctors without specific training in treating drug users. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. Ive had to rebuild so many times, Mr. Lambert, who works at the rehab site supervising medications for other residents, said on a recent afternoon. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Phone: 800.895.0621 810 Sharon Drive, Westlake, Ohio 44145 Copyright ECHO Health, Inc. 2023. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. We help providers incorporate behavioral health assessments into their practice, track the patient care journey, and more, all through our easy-to-use platform and library of valuable resources. Its just one more thing at a time when weve been doing a lot of one-more-things, she said. The use of both medications is not uniformly embraced. Tina joined Lucent Health in 2018 and is responsible for the companys account management and customer success teams. reached record highs in the United States in 2021, drugs sold online or by unlicensed dealers, proposed that after the pandemic public health emergency is lifted, lacked buprenorphine-prescribing physicians, safe to sell over the counter without a prescription, By far the largest factor is drug overdoses, mostly from fentanyl. Provider. We understand that the complexity of healthcare billing can sometimes be as intimidating as the health event itself, and we strive to make members experience as stress-free and frictionless as possible. It is often given under the brand name Suboxone, which is administered in small orange strips under the tongue. She dug deep into the correspondence between the hospital and the insurance company. Use the Hospital Compare database to compare the quality of care at more than 4,000 hospitals. Treatment for Black and Hispanic people is often spotty and shorter. The payer will contact us if needed. Go to the American Medical Association Web site. She wanted to be present in her life. The obstacles could feel arduous to physicians uncertain about working with opioid users, functioning as a permission structure for avoiding that work in their practices, addiction experts said. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. WE ARE Human Focused Our "people first" approach delivers better outcomes. Generally, you will get your health care services from your personal doctor. The ABA Medical Necessity Guidedoes not constitute medical advice. As the appointment began, Dr. Umer Farooq erased his X waiver in a computer form a moment that encapsulated the changes from the federal legislation. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. Forgot Password? By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. Login. Treating providers are solely responsible for medical advice and treatment of members. only those credentials to sign in to the portal. Oak Street Health puts your health needs first, with easy to book appointments and a 24/7 patient support line to ensure you have coverage around the clock. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). Todd joined Lucent Health in 2019 via the Narus acquisition. Last Updated Jan 24, 2023 9:32 AM, COVID-19 Information for Network Health Members. Youll need to understand some new terminology, understand different ways the information is presented, and then combine them to help make a good choice for you and your family. Welcome to the Provider Portal, a unique online tool for accessing benefit, eligibility and claims data. Then you can verify benefits, check eligibility, download forms and verify claim status. (Printed directories are only as current as the date indicated on the directory. Some treatment programs and conservative lawmakers have been reluctant to promote buprenorphine, seeing it as swapping one opioid for another. Buprenorphine is one of two effective, commonly prescribed medications for opioid addiction; the other is methadone. If you are interested in scheduling an appointment, please call (888) 8986762 to speak toanagent. Supported Browsers include: Microsoft Edge, version 38.14393.. or later Download here LINK Google Chrome, version 53..2785.116 or later Download here LINK Firefox version, 50.1.0 or later Download here LINK LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). We accept all forms of Medicare, including Original Medicare Part B, select Medicare Advantage plans, Medicare Supplement or Medigap plans and Medicare-Medicaid Plans. | New User Registration? A federal process has been established to resolve disputes regarding plan out-of-network payments for emergency services provided by nonparticipating providers/facilities/air ambulances and for non-emergency services furnished by certain nonparticipating providers/facilities at participating healthcare facilities. Who are Providers? She was there for her methadone dosing. Fentanyl is a potent and fast-acting drug, two qualities that also make it highly addictive. She liked taking buprenorphine at the beginning of the pandemic, she said, before her doctor stopped working with her. It makes me cry that she wants to be under me all the time.. Our doctors specialize caring for anyone with Medicare, including Original Medicare Part B, select Medicare Advantage plans, Medicare Supplement or Medigap plans and Medicare-Medicaid Plans. The risk, he added, was access without quality.. He cycled in and out of rehab facilities and jail, but the buprenorphine he took eased his heroin cravings and kept him from withdrawal. Lucet puts smart technology and human expertise to work to transform behavioral healthcare. Business Gravity Theme by, Medicare: Whats Medicare Supplement/Medigap About, Click here for web sites and phone numbers in your state. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. And they make sure you understand whats going on every step of the way, because it is your health that matters. https:// Phone: (855) 887-0855 Will It Help? Learn more. The Small Business Marketplace (SHOP) can help employers offer high quality, affordable health insurance coverage to employees directly from NY State of Health certified Insurers. Some network providers may have been added or removed from our network after this directory was updated. With over 100 health center locations, our primary care physicians, specialist doctors, and nurse practitioners can provide you a more personal healthcare experience. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Meet our healthcare team with experienced primary care physicians, expert specialist doctors including: gerontologists, geriatricians, social workers, behavioral health therapists, and podiatrists as well as our friendly nurse practitioners and more. If you are looking for Lucent Health Provider Portal? Ms. Williams was once homeless, sleeping in her car and bathing in a Popeyes bathroom. Call us at 877-236-0844. Copyright 2023 Network Health Plan, Network Health Insurance Corporation and Network Health Administrative Services, LLC. At Lucent Health, our mission is helping members navigate both the clinical and the economic impacts of healthcare. Call (844) 808-8263 or fill out an appointment form to schedule an appointment with our Medicare doctors. In addition to a clinic that dispenses buprenorphine and methadone, the facility includes a primary care practice, obstetricians and gynecologists, psychiatrists, therapists and counselors, a syringe exchange program and a common area where patients can relax or get help from employees finding housing. Broker ! Others have four tiers, three tiers or two tiers. If you need more information, please contact our Customer Service Team at 800.895.0621. Nashville, TN 37219 Learn More. Primary care centers &clinics accepting Medicare. This search will use the five-tier subtype. What is Lucent Health Provider Portal. Looking for ways to access the Lucent Health Provider Portal Login? In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Dr. Fiellin, the Yale physician, said that some doctors in the training sessions he held for X waivers perceived a stigma associated with the medication. There would be arbitrary limits. He added that patients would struggleif they were cut off from buprenorphine. We also recommend that, prior to seeing any physician, including any specialists and mental health providers, that you call the physician's office to verify their participation status and availability, since a provider's availability to see new patients may change frequently. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Legal notices Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. BALTIMORE Buprenorphine, a medication to treat opioid addiction, has quietly stabilized Randall Lamberts drug use over the past 15 years, even as chaos surrounded him. Proceed to our sign up process. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. With their constant support, we are working together to provide oral healthcare for all. Need a username and password? BALTIMORE Buprenorphine, a medication to treat opioid addiction, has quietly stabilized Randall Lambert's drug use over the past 15 years, even as chaos . Once the official login page is opened, find the email address and Clay joined Lucent Health in 2014 and has extensive experience working with health plan benefit designs, physician and hospital contracting, pharmacy formulary management, care management, reference-based pricing and value-based payment plans. Director, Clinical Quality and Patient Enrollment, Corporate Headquarters You can access a provider portal 24 hours a day, seven days a week to manage and improve the health and well-being of more than a million patients. Missing doses of treatment can lead to withdrawal and elevate the risk of relapsing. You are now being directed to CVS Caremark site. If you have non-Medicare dependents, you need to be sure that you understand your spouse/dependents health insurance status before you decide to sign up to leave Nokia. This means you can select any doctor who accepts Medicare beneficiaries. Treating providers are solely responsible for dental advice and treatment of members. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. https://mylucenthealth.com/lucentprovider. FCH Providers portal provides access to benefits and eligibility, status of claims and payments, payor search, provider update form, and more. Let us help. Previously, Tina was an Account Executive at Cottingham & Butler, was a Client Services Account Manager at Willis Towers Watson, and held various leadership positions at Humana for 15+ years. Explorerecent.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Job specializations: Social Work. sessionStorage.setItem('cypress', true); console.log("Cypress session detected"); var collection = document.querySelectorAll("a[href='https://mylucenthealth.com/v3app/publicservice/loginv1/login.aspx?bc=ae502dbd-bedd-42b5-beb1-ebf7da174d0a&serviceid=2b669142-c317-44b6-803f-f0ecd4f6d43a']"); collection = [].slice.call(collection); console.log("Found buttons:" + collection.length);if (collection.length > 0){for (var x = 0; x < collection.length; x++){collection.map(y => y.href = "https://ebixhub.ebix.com/sso/client/clientlogin.aspx?client=cyp"); console.log("Updating button");}}}. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 424 Church St, Suite 2300 Many Americans lived far away from doctors who had a waiver. With her drug use under control on buprenorphine, she was looking for jobs. We believe in a more direct path to better mental health, connecting people to the care they deserve. Explore our primary care doctors today. We do not guarantee that each provider is still accepting new members. Prior to joining Lucent Health, Clay worked at HealthSmart for 17 years as the National Vice President of Sales. User name. Then you can verify benefits, check eligibility, download forms and verify claim status. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. It is such a genuine privilege to work with these wonderful professionals. else if (sessionStorage.getItem('cypress') === "true" || window.location.href.includes('/cypress')){ No fee schedules, basic unit, relative values or related listings are included in CPT. Prior to joining Narus, Todd spent 10+ years at HCA, where he served as Vice President of the Special Assets Group and was responsible for relationships with both existing portfolio companies and potential investment targets. Lucent Healthcare - ePayment Portal. Lucent Health has assembled specialists with the training and the heart to help members experience the least amount of friction in their healthcare journey. New Directions Behavioral Health and Tridiuum are now Lucet. For a complete listing of specialists, please contact us at 800-769-3186. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Network Health 2023 Medicare Advantage PPO plans are rated 5 out of 5 stars by Medicare. To learn more, see the Aetna Signature Administrators solution flyer (PDF). March 3, 2023, 3:00 a.m. BBB Business Profiles are provided solely to assist you in exercising your own best judgment. Your plan may have limitations regarding accessibility and referrals to specialists, as well as other restrictions imposed by your provider network. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). In this article, youll find information on how to access the Lucent Health Provider portal for either hospital or doctors office visits. Across the street from an addiction center in Baltimore is a building with missing and boarded-up windows, next to which people sometimes sell or consume drugs. Megan Wojtko, the chief clinical officer at Choptank Community Health, a network of community clinics in rural Maryland, said that while some of her newer physicians had X waivers and could treat opioid users with buprenorphine before December, many doctors at the clinics did not. Patients have also faced changing rules about how they can get the medication. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. CPT is a registered trademark of the American Medical Association. . Please enter your credentials. Call us at (888) 812-1183 to see if we accept your specific insurance. Learn how to spot an overdose. Before starting Lucent Health, Brett Rodewald was a CEO who felt powerless to control the healthcare coverage and experience for his employees. The providers in this search are in-network. While more than 100,000 people die each year from drug overdoses in the United States, many of them from fentanyl, addiction physicians say that only a modest percentage of Americans who regularly use opioids receive treatment. CPT only copyright 2015 American Medical Association. We even offer Telehealth for seniors which are convenient phone or video appointments in the comfort of your own home. BBB Business Profiles may not be reproduced for sales or promotional purposes. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Password Help. Medicare Part D, Medicare's prescription drug coverage, will cover a tetanus shot, however. Drug overdose deaths, largely caused by the synthetic opioid drug fentanyl, reached record highs in the United States in 2021. Because we believe that people deserve a more direct path to better mental health. The ACA Health Care Exchanges may help. Network providers help you and your covered family members get the care you need. And even when someone obtains a prescription for buprenorphine, some pharmacies may not dispense it. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); (adsbygoogle = window.adsbygoogle || []).push({}); You have entered an incorrect email address! It has significant advantages over methadone, which is so restricted that it spawned a Twitter hashtag, #freemethadone. We want to make sure you're connected to the right person as quickly as possible. ET. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 2023 Lucet. It will take some time. The information contained in this directory may change during your plan year. The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. But buprenorphine, he said, got me to a place where I got clean.. Your benefits plan determines coverage. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Patients must regularly travel to special clinics to receive doses of methadone, even if they are given limited take-home privileges. Results will update in place as filters are applied or removed. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. You get a one-stop portal to quickly perform key functions you do every day. A small quantity goes a long way, so its easy to suffer an overdose. Schedule time with one of our providers to start getting the care YOUdeserve. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. ), Become a Network Health Credentialed Provider, Agent Guide to Network Healths Products, http://www.qualitycheck.org/consumer/searchQCR.aspx, http://www.hfap.org/AccreditedFacilities/index.aspx?FacilityType=HOSPN, http://cihq.org/hospital_accreditation_division.asp, https://www.certificationmatters.org/is-your-doctor-board-certified/search-now.aspx, https://www.medicare.gov/care-compare/?providerType=Hospital&redirect=true#search, If you buy health insurance on your own, choose, If you get coverage through a different employer not listed, choose. More Doctors Can Now Prescribe a Key Opioid Treatment. What insurance does Oak Street Health accept? password that you chose when you signed up You can view or print PDFs of our Printable Provider Directories. BSN, RN Director, Clinical Quality and Patient Enrollment, CCM, ONC Director, Large Case Management. He previously held various leadership positions with Bank of America and First Union National Bank. Each of our health care providers have served as mentors to our various outreach programs. HealthSmart's online provider directory is provided for reference purposes only. Member. See what else makes Oak Street Health so unique. Write down some of the facts you learn. As a businessman and a leader who cares about the well-being of those he leads, Brett founded Lucent Health to offer organizations across the country a better way to do healthcare. All services deemed "never effective" are excluded from coverage. Buy naloxone. Looking for the member website? Or to request a hard copy provider directory, call the customer service number on the back of your Network Health ID card. As a subscriber, you have 10 gift articles to give each month. For improving access, it may be that removing the X waiver helps, but it may not be sufficient, said Dr. David Fiellin, an addiction physician at the Yale School of Medicine who has trained other doctors pursuing X waivers. You are strongly encouraged to contact us to verify the status of the providers involved in your care including, for example, the anesthesiologist, radiologist, pathologist, facility, clinic or laboratory, when scheduling appointments or elective procedures to determine whether each provider is a participating or nonparticipating provider. Prior to launching Lucent Health, Brett served as CEO at Comdata Corporation, leading its transition from a card processor to a diversified corporate payments solutions company. Charlene Williams was drinking coffee there last week while her daughter played Jenga next to her. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Save my name, email, and website in this browser for the next time I comment. The health systems gaps in reaching opioid users remain vast despite a catastrophic surge in overdose deaths in recent years, those experts say. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610.