NM | The Office of the Superintendent of Insurance (“OSI”) found that the quality and extent of the information in the communications varied widely. To ensure consistent messaging and avoid confusion as much as possible, the Superintendent directs the carriers to issue communications about the BH cost-sharing prohibition that include the elements described below.
• Bulletin 2021-009 and its attachments. We assume your communication will be posted electronically. Please be sure that the Bulletin is posted along with the notice. A URL link to the Bulletin is not sufficient.
• If the carrier offers HSA-eligible, high deductible health plans or administers self-insured plans, clearly indicate which types of plans (commercial, public employee, retail, etc.) the BH cost-sharing prohibition applies to.
• Emphasize that providers should verify patient eligibility and benefits prior to every appointment.
• If applicable, include any non-standard instructions a provider must follow to be reimbursed correctly, and any other pertinent changes in processes and procedures the provider must follow.
• Identify and override directions in the provider manual that are inconsistent with OSI guidance.
• Inform the provider that the carrier will reimburse the provider at the full contracted rate.
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