New and updated Payment Policies

CarePartners of Connecticut has developed a new Payment Policy for Urgent Care, as well as updated our policies for Ambulance and Transportation Services and Nutritional Counseling.     
  
Ambulance and Transportation Services     
  
We are updating our Ambulance and Transportation Services Payment Policy, effective for dates of service beginning Sept. 1, 2024, and will consequently implement the following change to our billing and reimbursement practices.  
  
As of the Sept. 1 effective date, we will no longer reimburse non-emergent ambulance services provided to a member during an inpatient or outpatient admission. Consistent with industry-standard practices, these services are included as part of the facility reimbursement and should be billed to the facility.  
  
For more information, please refer to CarePartners of Connecticut’s updated Ambulance and Transportation Services Payment Policy.  
  
Urgent Care  
  
CarePartners of Connecticut has developed a new payment policy outlining essential billing and reimbursement guidelines, provider requirements and responsibilities, and other information pertaining to urgent care services. The policy documents existing requirements for CarePartners of Connecticut providers and does not represent a change in processes or services.  
  
CarePartners of Connecticut reimburses services provided by uniquely contracted urgent care providers that meet participation criteria, in accordance with applicable referral, notification, and authorization policies and procedures.  
  
The Urgent Care Payment Policy identifies prerequisites for reimbursement of urgent care services used to treat an acute or chronic illness or injury that is immediate in nature and requires professional attention, but is not life threatening — and additionally clarifies services for which reimbursement is not considered appropriate, such as:  

• Handling fees, routine blood draws, or special reports
• High end radiology services
• Preventive or routine services   

Nutritional Counseling   
  
We’ve bolstered our Nutritional Counseling Payment Policy with additional clarity and guidance, and to specify that CarePartners of Connecticut does not routinely compensate for the following:  

• Commercial diet plans, weight management programs or any related food or services
• Gym membership therapy
• Holistic therapy
• Nutritional counseling when offered by health resorts, recreational programs, camps, wilderness programs, outdoor skill programs, relaxation, or lifestyle programs, including any services provided in conjunction with such programs  
• Supplemental foods
• Treatment by a physical therapist for weight loss