Partners Tailored Plan provides a variety of services: mental health, Behavioral Health etc, and it has partnered with Carolina Complete Health to assist physical health providers in Tailored Plan.
What is changing?
- Claim dispute timely filling for INN and OON providers effective DOS 4/1/26 and there after
New claim dispute timely filling:
- INN providers- 90 days from the date of the EOP, ERA
- OON providers-60 days from the date of EOP/ERA
- This change overrides previous timeline of 365 days- when claims were processed by Carolina Complete Health.
Find this information useful? Follow my blog for more!
- Rhode Island Medicaid: update telehealth PT services
- Aetna Better Health NJ: new bundled oncology condition specific prior auth
- Aetna Better Health of NJ: Out of network provider reimbursement update
- Healthfirst PT/OT prior auth and coverage changes
- NYS Medicaid Prior authorization timeframe update- 1/1/27

Leave a comment