Provider News - September 2026

REQUIREMENTS: By March 1, 2026: Billing team and office staff must update contact information for all coordination of benefits questions. Direct all COB inquiries to (800) 548-1224 instead of previous contact methods. Update internal protocols, training materials, and staff contact lists. Immediately: Establish written procedures documenting how Medicaid members are informed of denied services, including appeal and grievance procedures. Make copies available to Security Health Plan and DHS upon request. Assign compliance officer to maintain and update these procedures. Non-compliance may result in contract violations. Immediately: For inpatient and outpatient services at critical access hospitals, swing beds, and rural health clinics: Billing staff must ensure the most recent CMS rate letter is submitted to Security Health Plan. Security Health Plan cannot access facility rate letters independently. Contact Security Health Plan Provider Assistance line at (800) 548-1224 if unsure whether rate letter has been submitted. Before submitting Medicare or Medicaid Managed Care appeals: Appeals team must verify appeal is submitted within required timeframe and includes all required forms and supporting documentation. Confirm appeal timeliness and completeness before submission to prevent rejection due to missing documentation or timeframe violations. Ongoing: Billing staff should submit prior authorization requests through the Security Health Plan Provider Portal at www.securityhealth.org/providers rather than faxing or calling, as electronic submission provides faster decision turnaround.