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.

See these communications to learn more about our partnership with Medica:

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

See 2024 changes

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: October 1, 2023

Notice dated: September 1, 2023

Notice dated: August 1, 2023

Notice dated: July 1, 2023

Notice dated: June 1, 2023

Notice dated: April 28, 2023

Notice dated: March 31, 2023

Notice dated: March 1, 2023

Notice dated: Feb. 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. 

Notice dated: Sept. 30, 2022

Notice dated: Sept. 1, 2022

Notice dated: Aug. 1, 2022

Notice dated: July 1, 2022

Notice dated: June 1, 2022

Notice dated: April 1, 2022

Notice dated: April 29, 2022 

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