Select News: April 2017
Mission GED and Reading Assistance Services
Select Health is proud to announce two programs, Mission GED and Reading Assistance Services, designed to support the educational needs of our First Choice members.
Mission GED assists eligible members with obtaining their GEDs and covers the cost of the GED exam and one retake, if needed. Reading Assistance Services connects eligible members with community-based adult literacy/limited English proficiency (LEP) programs to improve their reading and writing skills. Both programs are provided at no charge to the member.
To participate in the programs, members must:
- Be an eligible First Choice member at the time of enrollment into the program.
- Be at least 19 years or older.
- Not currently have a high school diploma or GED.
Members can apply for either program by completing the application located on the Select Health website. The application can be completed and submitted online; printed, completed manually, and mailed; or completed manually using the form that can be obtained by contacting Member Services at 1-888-276-2020 (TTY 1-888-765-9586).
Members should mail their completed forms to:
Select Health of South Carolina
Attention: GED Program/Reading Assistance Services
P.O. Box 40849, Charleston, SC 29423
Please share this information with any of your First Choice patients who could benefit from this program. For more information, please email Mission GED or Reading Assistance Services, or call Elice Graham at 1-843-414-3157.
Reminder: Corrected claims submission
For paper claim resubmissions or adjustments/corrections, you must enter the appropriate bill frequency code (7 or 8; see below) left-justified in the Resubmission code section (box 22) of the
CMS 1500 claim form. The original claim ID number must also be included in the Original Ref. No. section of this field.
- 7: Adjustment/replacement of prior claim.
- 8: Void/cancel of prior claim.
For electronic claim resubmissions, the bill frequency code would be entered into loop 2300, CLM05-03 (837P), and the original claim ID number in segment REF01=F8, and REF02= the 12-digit claim number, with no dashes or spaces.
Submission of corrected claims without the required information will result in denials.
Providers can significantly affect the lives of their patients who have asthma and are a key resource to help these patients manage their conditions successfully.
When you speak with your patients affected by asthma, you may want to cover the following topics:
- Identifying and avoiding asthma triggers.
- Differentiating between rescue and controller medications.
- Adhering to controller medications.
- Considering the use of an asthma action plan to review these topics at each office visit.
If your patients with asthma are children, you may want to provide their caregivers with additional information or training in topics such as:
- Identifying asthma symptoms.
- Managing an acute asthma attack.
- Ensuring that the child avoids asthma triggers.
- Using peak flow meters.
You might also consider prescribing spacers for children who would benefit, and make sure that the caregivers understand how to use these important tools.
If you have First Choice/Select Health members with asthma whom you believe would benefit from care management, please contact Care Management at 1-888-559-1010, ext. 55251. Care managers will work with you and your patients to assess their health status, develop an asthma action plan, provide educational materials, and provide continuing care management support.
As a reminder, our preferred medications include Ventolin, Dulera, and Breo Ellipta. Our non-preferred medications requiring prior authorization include Symbicort and Advair.
Please visit our website for up to-date pharmacy information, including changes approved by the Pharmacy and Therapeutics Committee, and for information on:
- Preferred drug list (PDL) updates.
- Drug recalls.
- Updated pharmaceutical management procedures.
- New prior authorization (PA) criteria and procedures for submitting PA requests.
- Pharmacy benefit restrictions or limitations.
Reminder: Provider disputes
A provider dispute is an escalated expression of dissatisfaction not resolved by previous inquiries submitted to Select Health. Usually, disputes are post-service and claims-related in nature.
Select Health’s centralized one-level provider dispute process ensures all disputes are promptly addressed by a dedicated team of reviewers.
Disputes mailed to an incorrect mailing location may cause a delay in resolution. If you are submitting provider disputes in writing, please send them to:
Select Health of South Carolina
Provider Claims Disputes
P.O. Box 7310
London, KY 40742-7310
Or, you may fax them to 1-844-249-9841.
For more details on provider disputes, visit the Health Care Professional and Providers Manual (PDF) on the Select Health website or contact your Network Management Account Executive.
First Choice Fit® football camps with Marcus Lattimore!
Select Health is happy to announce that we will once again be conducting First Choice Fit football camps with former University of South Carolina star running back, Marcus Lattimore. These camps are designed to encourage our youth to stay First Choice fit. First Choice members ages 5 – 17 may be eligible to attend free of charge. For more information or to register, call 1-843-569-4643.
This year, the camps are scheduled for:
- Saturday, May 20, 2017
Spartanburg Day School
1701 Skylyn Drive, Spartanburg, South Carolina 29307
- Saturday, June 17, 2017
Carolina Forest High School
700 Gardner Lacy Road, Myrtle Beach, South Carolina 29579
- Saturday, June 24, 2017
201 President Street, Charleston, South Carolina 29403
- Saturday, July 22, 2017
Heathwood Hall Episcopal School
3000 Beltline Boulevard, Columbia, South Carolina 29201
Please encourage your First Choice patients to attend.
Select Health is co-sponsoring the American Lung Association’s Breathe Easy South Carolina!
Camp Breathe Easy is a free day camp for children ages 6 to 13 who have been diagnosed with asthma, and their parents. The camp provides:
- Fun and educational activities for children and adults.
- Peak flow meters and spacers for all children.
- Drawings for giveaways, including Walmart gift cards.
- Experts on hand to answer questions.
- Asthma resources for parents.
- T-shirts (must register early!).
The camp is scheduled for:
Date: May 20, 2017
Time: 10:30 a.m. – 2:30 p.m.
Location: Meeting Street Academy
642 Meeting Street, Charleston, South Carolina
Registration is required.