What’s New:

• The Provider page of the Hometown Health Website has been updated with a fresh new layout! It has never been easier to access important information such as announcements, forms, authorization matrices, and so much more! Check out our newly designed Provider Addition Form, Provider Termination Form, and Provider Demographic Change Form located in the Forms & Resources section! Stay up to date by visiting: Provider Partners | Hometown Health
  
  
• Hometown Health is proud to announce that Kimberley Capule has been promoted to Provider Services Representative! Kimberley will be joining Brenda Stafford and Christine Crosby in their efforts to support the provider community to ensure our partnership in servicing our members together is successful. For more information about the Provider Relations team visit: Provider Relations Team | Hometown Health
  
  
• The 2024 Provider Experience Survey Results are in! Hometown’s overall score for the question “How likely are you to recommend Hometown?” improved from last year’s score of 7.52 to 8.24 out of 10. THANK YOU for taking the time to provide valuable feedback on how we can better partner together to serve our members.
  
  

Important Reminders:

• Attest or be at risk of being removed from the Hometown Health Directory!
  • Hometown Health is required by the No Suprises Act to have providers attest to their demographic information displayed in the directory every 90 days. To make this as easy as possible for you, Hometown Health has partnered with Quest Analytics’ BetterDoctor to collect your quarterly provider data attestations. There are two options to attest:
    
    
  • Attest via the BetterDoctor portal using the secure access code you receive from Quest Analytics’ BetterDoctor via email, fax, and/or direct mail each quarter.
    
    OR
    
    
  • Attest via roster if your organization includes 20 or more practitioners at multiple service locations. Please send your send your quarterly roster to rosters@questanalytics.com.
    
    
  • For more information on the attestation process, please visit: PRACTITIONER DATA VERIFICATION
    
    

• Referring to Contracted Providers: Providers are responsible for referring members to participating providers within the Hometown Health network. If a member has been referred to an out-of-network provider, Hometown will require the referring provider to coordinate the resolution of the member’s out-of-pocket cost.
  
  
• New Auth Requirements: Due to the new authorization requirements effective 7/1/24, the authorization displays within the Benefit Inquiry screen in EpicCare Link may no longer be applicable. For the most up to date authorization requirements, please visit https://www.hometownhealth.com/authorization-matrices/
  
  
• For more information on Medical Claims Processing for NDOC Offenders, please visit our Forms & Resource page to access the Nevada Department of Corrections (NDOC) Claims Letter: Provider Forms & Resources | Hometown Health . To obtain the NDOC authorization number, please email:medicalbilling@doc.nv.gov
  
  

Tips and Tricks for Timely Turn Arounds

• Attachments now Accepted! Providers can now upload claim attachments via Optum iEDI.
  
  
• Claims Submission Tip: Hometown Health will only accept claims submitted on the CMS-1500 and the CMS-1450 (UB04) forms. The claim form must either be typed or printed from a computer. Please ensure that the claim form is filled out completely and correctly to avoid denials. Any altered or handwritten claim or missing information may result in a denial.
  
  
• Reconsideration Turn Around Timeframes: The standard turnaround time (TAT) for a reconsideration request is sixty (60) days of receipt with either an Explanation of Payment (EOP) or a determination letter. Please allow at least 45 days before calling Customer Service to check on the status of your reconsideration.
  
  

EpicCare Link Updates

• Provider offices may have already noticed the new Submitted CRM search tab in EpicCare Link located in the purple Navigation tab at the top of your screen. This is a great new feature to self-serve and see the status of your reconsideration request.
  
  
• For reconsiderations submitted through EpicCare Link, determinations will be published in the CRM. Please note, if the reconsideration was submitted via mail or fax, your determination would be sent via a mailed letter.
  
  
• EpicCare Link has made it more convenient to submit claim and referral reconsiderations! When in a claim or referral hover over the “Ask A Question” icon and then click the Reconsideration Tooltip that appears! Please reach out to your Provider Relations Representative for any additional training if needed!
  
  
• Adding attachments to a referral in EpicCare Link has never been easier! It is now possible to add more than one attachment to a referral!
  
  
• For any technical issues experienced with EpicCare Link, please contact the helpdesk at 775-982-4042. For all other inquiries, please reach out to our Customer Service Center at775-982-3232.
  
  

Building Partnerships with Hometown:

• The Hometown Health Medical Affairs Committee is looking for new members! The statewide physician committee consists of providers across a variety of specialty types who review physician applicants to the Hometown Health network to determine participation based on the Hometown Health Standards of Participation. For more information or to get involved, please visit: Medical Affairs Committee | Hometown Health