First Health News

SPT Client changes: First Health has recently announced Hartford as a new client under its Specialized Physical Therapy (SPT) effective July 1, 2004 in California and Texas. Liberty Mutual has been suspended from the SPT program effective 8/24/04.

Updated Client Listings: We encourage you to check the First Health client list for the most up-to-date client information. The list is available on the First Health website, and is state-specific as well as product-specific (indicates if the First Health client is participating with GH, Auto, W/C, SPT, etc.). Instructions on how to access this information are included in the memos originally sent to our members. Additional copies of the memos are available by contacting PREFERRED 800-664-5240.

Non-valued codes clarification: We would also like to clarify that the reimbursement for non-valued procedure codes under the First Health/CCN Fee Schedule are reimbursed at 85% of billed charges. This applies to all product lines including group health, auto liability, workers' compensation, SPT and FHPS (in applicable states). Please note this clarification on your First Health fee schedule.

Affiliated Health Funds

Durable Medical Equipment (DME) requires pre-authorization and may require the use of a contracted AHF network vendor. Please first contact the number referenced on the patient’s card for further instructions. AHF network vendors: Experea 866-397-3732 or Ultimate HealthCare 866-485-8463.

New Agreements

PREFERRED has signed an agreement with Interplan Health Group (IHG); formerly Interplan and Accountable Health Plans, effective November 1, 2004. Previously, PREFERRED held separate contracts with each organization for various states. The new contract reflects the merger of Interplan and Accountable Health Plans as a national contract with the addition of Workers’ Compensation.