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Provider News - May 2016

Security Health Plan·Provider News
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Security Health Plan has implemented multiple billing changes including matching place of service codes for facility and professional charges (effective July 1, 2016), extended appeal timeframes to 365 days for most products except BadgerCare which remains 60 days, and coverage for colonoscopy prep kits at $0 cost-sharing for preventive screenings.

Action Required

Action needed
By July 1, 2016: Billing team must ensure place of service codes match between facility and professional charges or both claims will be denied. Update billing system edits to verify matching POS codes. Front desk staff must verify patient status (observation vs inpatient) and communicate changes to billing. Update appeal submission timelines to 365 days for post-service claim denials (except BadgerCare which remains 60 days). For SAS members: use new Payer ID #35202 and contact SAS directly for eligibility verification at 1-800-570-8760.