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For Providers

CDC Declares Flu Epidemic: Treatment for Pregnant Women
The Centers for Disease Control and Prevention (CDC) has declared a flu (influenza) epidemic in the United States. Please click here for treatment guidelines for pregnant women from the American College of Obstetricians and Gynecologists (ACOG).

Imaging Review Process
While Christiana Care Quality Partners does not require precertification for imaging services, certain high-end imaging procedures such as CTs and MRIs go through a review process which sometimes results in the ordering provider being contacted by a local radiologist to further discuss the case. For more information about the results of this program so far, click here

Nuclear Cardiology Review Process
Beginning in January, nuclear stress tests ordered to be performed at Christiana Care imaging facilities will undergo concurrent review for appropriateness. The criteria are evidence-based, fully supported by the American College of Cardiology, and have been used effectively both locally and throughout the nation. If a request does not fit the criteria, there will be a physician-to-physician conversation, with the final decision residing with the ordering physician.

Article on Healthcare Delivery Transformation
This month’s article on healthcare delivery change describes the trend in hospitals’ and health systems’ operational shifts towards population health management. Click here to read the article.

For Office Staff

Precertification of Procedures & Services
Please be advised that certain procedures and services require precertification. Click here and bookmark this link for the most current list of all services and procedures that require precertification.

Submit Documentation When Using Modifiers 25 and 59

As a reminder, when submitting non-immunization claims with either modifier 25 or 59, please be sure to include supporting documentation. Please contact us with any questions about this process. 

Notification of Providers Joining or Leaving Your Group
If your practice has providers that are joining or leaving the group, please remember to let your provider relations representative know as soon as possible. If you are unsure as to who is your representative, please call us at 302-623-7959.

Using NaviNet’s Secure Messaging Feature
Once you have added Geisinger to your NaviNet screen, you can take advantage of its secure messaging feature for answers to claims and other questions. You will receive a response to your inquiry within one business day. Click here to see where you can access this feature and for other tips on navigating NaviNet. 

Submitting Flu Vaccine Claims
If you are accustomed to using the code 90658, please note that this code is not recognized by Geisinger and alternatively, a code starting with “Q” should be used instead. Please click here for the details.

Sign Up for Electronic Claims Submission
Sign up for electronic claims submission by clicking here . Note: due to setup timing issues, you may not able to immediately view submitted claims in NaviNet.

Sign Up for Electronic Remits
Sign up for electronic remits by clicking here . Note: due to setup timing issues, you may not able to immediately view submitted claims in NaviNet.

Sign Up for Electronic Payments
Sign up for electronic funds transfer by clicking here . Note: due to setup timing issues, you may receive funds before they are viewable in NaviNet and vice versa.

Member Identification Cards
Please be advised that not all Christiana Care employees and their dependents are members of Quality Partners. If an employee resides outside of Delaware, they and their dependents are still covered under Highmark and still carry a Highmark member ID card (claims for these members should still be submitted to Highmark). All employees who live in Delaware and their dependents are covered by Quality Partners (claims for these members should be submitted to Geisinger). Please be sure to confirm the patient’s address when they present their member ID card.

Who to Call
Click here for a list of numbers for who to call based on your need. Please do not hesitate to contact your Provider Relations Representative anytime you need assistance. Unsure of who is your dedicated representative? Just give us a call at 302-623-7959 and we will be glad to put you in touch with the right person!

Martin Weitzman
Provider Relations Representative
302-623-0363
mweitzman@christianacare.org

Angela Williams
Provider Relations Representative
302-623-0357
angewilliams@christianacare.org

The Quality Partners Team
Doug Azar, Executive Director
Mike Cinkala, Director, Provider Relations
Melissa Maule, Administrative Assistant
Martin Weitzman, Provider Relations Representative
Angela Williams, Provider Relations Representative