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.
Select "Opt-In for Electronic Communications" in your Dean Health Plan portal account settings.
This guide highlights specific areas of business and functionality for new and long-time in-network providers. Use the Quick Reference chart for links to a variety of resources.
Upcoming changes as we partner with Medica to align best practices and share technology.
Issued: January 2023
Audience: All in-network providers
What to expect in 2023
2023 member plan and benefit highlights for provider awareness.
Issued: November 2022
Audience: All in-network providers
Effective date: 1/1/23
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
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
Annual notification with member-centered plan and benefit topics for provider awareness for 2022.
Issued: November 2021
Audience: All in-network providers
Effective date: 1/1/22
FDA approved drugs that are new to the market will not be covered until they are reviewed and approved by P&T Committee.
Issued: September 2021
Audience: All in-network providers
Effective date: 12/1/21
Issued: August 2021
Audience: All providers
Effective date: N/A
Issued: August 2021
Audience: In-network prescribers
Effective date: 10/1/2021 & 1/1/22
Issued: July 2021
Audience: All in-network providers
Issued: July 2021
Audience: All in-network providers
Effective date: 7/1/21
Issued: May 2021
Audience: All in-network providers
Effective date: 7/1/21
Dean Health Plan BadgerCare Plus available to residents in Fond Du Lac and Green counties.
Issued: May 2021
Audience: Fond Du Lac and Green providers
Effective date: 7/1/21
Changes to the prior authorization process for inpatient and outpatient total knee arthroplasty and total hip arthroplasty procedures.
Issued: April 2021
Audience: Orthopedists and orthopedic surgeons
Effective date: 7/1/21
Announcement of provider network change detailing continuity of care and transitional information.
Issued: February 2021
Audience: Providers in Dodge and adjacent counties
Effective date: 3/1/21
Audience: All in-network providers
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: June 1, 2022
Notice dated: April 1, 2022
Notice dated: April 29, 2022
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
INFUGEM-gemcitabine, Parenteral Iron products and retired policy
Issued: December 2021
Effective date: 4/1/22
CRYSVITA (burosumab)
Also includes changes to fax and phone numbers on Medical Benefit Drug Prior Authorization Forms and the new Pharmacy and Therapeutics Committee review process.
Issued: December 2021
Effective date: 3/1/22
Medicare Part B Step Therapy, ORENCIA (abatacept-IV) SIMPONI ARIA (golimumab), FLOLAN-epoprostenol-REMODULIN-treprostinil and New Drug Policies for Medicare Advantage
Issued: October 2021
Audience: All in-network providers
Effective date: 2/1/22 & 4/1/22
Medically Administered Oncology Products, Pegfilgrastim Products, PROLIA, XGEVA and Retired Policies
Issued: October 2021
Audience: All in-network providers
Effective date: 1/1/22
ADAKVEO (crizanlizumab) and SIMPONI ARIA (golimumab)
Issued: July 2021
Effective date: 11/1/21
ALPHA 1- ANTITRYPSIN INHIBITOR, KRYSTEXXA (pegloticase), VISUDYNE (verteporfin), Antihemophilic Factor VIII Products, Antihemophilic Factor IX Products, Hyaluronic acid derivatives, Duchenne NMN, ENTYVIO (vedolizumab) and Antihemophilia Factors and Clotting Factors
Issued: July 2021
Effective date: 10/1/21
Medically administered oncology products, SPRAVATO (eskatamine) and retired drug policies.
Issued: June 2021
Effective date: 9/1/21
OCREVUS (ocrelizumab)
Issued: April 2021
Effective date: 8/1/21
BELEODAQ, BLINCYTO, ERBITUX, CEREZYME®, ELAPRASE®, EVRYSDI, LUMIZYME®, NAGLAZYME®, VIMIZIM®, & VPRIV®.
Also includes changes to preventive drug list for commercial members
Issued: April 2021
Effective date: 7/1/21
PROLIA/XGEVA, LUPRON-ELIGARD & INFLIXIMAB infusions
Issued: March 2021
Effective date: 6/1/21
Immune globulin
Issued: January 2021
Effective date: 5/1/21