Provider communications
Changes to health plan procedures, policies and benefits
We release communications to in-network providers about changes to health plan procedures, policies and benefits, as well as information about larger initiatives. This page lists some of our issued notifications for reference.
Our Medica partnership
Access information about Dean Health Plan’s partnership with Medica, an independent, nonprofit health plan headquartered in Minnetonka, Minnesota, and how both health plans are using the partnership to strengthen their abilities to provide high quality support for providers and members.
- Dean Health Plan Provider Quick Reference by Payer ID – Identifies resources and processes with the addition of payer ID 41822.
- Dean Health Plan’s Just in Time for Providers – Latest information on preparation and processes as we transition to business platforms under payer ID 41822.
See these communications to learn more about our partnership with Medica:
- September 2024 Provider News – Prior Authorization Changes & Changes to the Master Prior Authorization Service List
- Provider Update – Upcoming changes & enhancements to the prior authorization experience with our health plan
- August 2024 Provider News – New Carelon prior authorization program rescheduled for Oct. 1
- May 2024 Provider News – Get tips on navigating new authorization functionality in Availity.
- April 2024 Provider News – Discover new functionality in Availity Essentials. Plus, new member ID cards Commercial plans.
- March 2024 Provider News – Moving Commercial plans to new business platforms.
- February 2024 Provider News – Learn why payer ID is so important.
- January 12, 2024 Provider Information – Are you using the correct resources for your patients?
- January 2024 Provider News – Processes and resources for new payer ID 41822.
- December 2023 Provider News – Preparing to move to new, long-term business platforms for IFB plans, including webinars featuring the new provider portal.
- November 2023 Provider News – Learn more about Availity Essentials provider portal applications and InstaMed payment services for 2024 IFB plans.
- Fall 2023 Provider News cover story – Announcing Availity as our new electronic data interchange (EDI) clearinghouse and provider portal vendor! Plus, new member ID cards and customer care phone numbers and technology.
- Summer 2023 Provider News cover story – Changes coming for claims processing and resources: What you need to know.
- Spring 2023 Provider News cover story – Pursuing innovations with a new partner.
- Growing with a New Partner – What to Expect in 2023 – Find out what’s ahead as we partner with Medica to align best practices and share technology, including a new, shared claims processing platform.
- Medica Q&A – Who is Medica, what's changing and how to stay informed this year.
Provider Authorization Submission Update
Upcoming changes & enhancements to the prior authorization experience with our health plan
Issued: August 14, 2024
Audience: All in-network providers
See August 14 provider communication (PDF)
Change Healthcare cybersecurity incident update
Our planned mitigation to the security incident.
Issued: March 26, 2024
Audience: All in-network providers
See March 26 provider communication (PDF)
Updated FAQ for providers
Services through Change Healthcare with any payer are not operating at this time.
Issued: March 8, 2024
Audience: All in-network providers
See March 8 provider communication (PDF)
Plan and benefit changes for 2024
2024 member plan and benefit highlights for provider awareness.
Issued: December 2023
Audience: All in-network providers
Effective date: 1/1/24
New claim appeals portal application
We are transitioning the claim appeals application in the Provider Portal.
Issued: August 2022
Audience: All in-network providers
Effective date: Changed to 8/24/22
View the new claim appeals portal application
Billing & reimbursement change for certain skilled nursing facility claims
Per Wisconsin Medicaid policy, providers must use HIPPS code with a corresponding revenue code on applicable SNF claims submitted to Dean Health Plan.
Issued: May 2022
Audience: SNF providers serving DeanCare Gold or Dean Select members.
Effective date: 1/1/22
Medical and drug policy updates
Starting November 1, 2023, policy notices are published in our monthly newsletters.
Audience: All in-network providers
Notice dated: September 1, 2023
Notice dated: Dec. 30, 2022: Features new medical policies for oncology genetic testing and transplantation.
Notice dated: Dec. 1, 2022: Features rare diseases and system specialty specific new genetic testing medical policies.
Notice dated Nov. 1, 2022: Features prenatal new genetic testing medical policies, updated clinical guidelines for imaging and MSK, oncology program reminders and ACA medical record reviews.
Pharmacy material change notices
For pharmacy updates issued on and after April 1, 2022, see the medical and drug policy updates listed on this page.
Audience: All in-network providers
ALDURAZYME-laronidase, ARANESP-darbepoetin alpha, ELAPRASE-idursulfase, ELELYSO-taliglucerase alfa, Epoetin Alfa Products, NAGLAZYME-galsulfase, VIMIZIM-elosulfase, and retired policy
Issued: February 2022
Effective date: 6/1/22
Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies
Issued: February 2022
Effective date: 5/1/22