Commercial Bulletin: January 26, 2021

COVID-19 vaccine update reminder: who is eligible and how to schedule

We know the details of when and how your employees will receive their vaccine is important to you. Geisinger is administering the COVID vaccine in accordance with state and federal recommendations. Based on federal and state guidelines, we are only able to offer vaccines to those in the current vaccine rollout phase. More information on vaccine phases and rollout timing can be found on Pennsylvania’s Department of Health webpage and on our vaccine FAQ webpage.

If you have employees who qualify to receive the vaccine, contact your account executive. In addition, we are contacting groups with employees that fall into a qualifying category. We will share what we know as soon as new information is available.

Who is eligible to receive the vaccine today?

Geisinger is vaccinating those in Phase 1A of Pennsylvania’s vaccination rollout plan. As of today, this includes:

Geisinger employees
Healthcare workers, including EMS, nurses, physicians, dentists and other community medical providers
People age 65+
People age 18-64 with high-risk medical conditions
Residents of long-term care facilities

How can my groups and their employees schedule their vaccine?

Your groups can self-schedule your vaccination through myGeisinger.org or on the myGeisinger app.

Note: Qualifying healthcare providers over age 18 will need to enter their employer/organization, their work title/position, their EMS certification number (if applicable) and a contact person and phone number for their employer/organization in order to schedule their vaccine.

Here’s how to get started with self-scheduling, depending on which category your groups fall into:

I have been cared for at Geisinger before (or I have Geisinger Health Plan insurance) and I have a medical record number (MRN) and a myGeisinger account.
- Download this guide to learn how to schedule your vaccination through myGeisinger.
I have been cared for at Geisinger (or I have Geisinger Health Plan insurance) and I have an MRN, but I don’t have a myGeisinger account.
- Download this guide to learn how to create a myGeisinger account so you can schedule your vaccination.

As we expect high demand for appointment scheduling, if no appointments are available, please check in with the scheduling tool on myGeisinger regularly as more appointments will be published on a weekly basis as supply, logistics and staffing allow. We appreciate your patience and understanding.

If you’re unable to schedule through myGeisinger, call 570-284-3657. However, we’re experiencing high call volumes — scheduling through myGeisinger is the fastest way to secure your appointment.

More things to consider

We trust the development and testing process for the COVID-19 vaccine. The findings to date show the vaccine’s safety and effectiveness.
When scheduling appointments, it’s important to remember that two doses of the vaccine are required so healthcare personnel are encouraged to consider that timing when scheduling. The second dose of the Pfizer vaccine is needed 21 days after the first, and the second dose of the Moderna vaccine is needed 28 days after the first. It’s required to receive both vaccines doses at the same location.
The vaccine is a two-step process. At no time – before, during or after – receiving a vaccine, should you stop preventive steps like masking, physical distancing and handwashing. It will likely be well into 2021 before enough people are vaccinated to allow for relaxed preventive measures.

The Feb. 2021 billing schedule is now available

*The catchup is a bill run that picks up new groups or groups that did not receive a bill in a prior run.

Don’t forget: we’re working with HealthHelp for specialty procedures

Geisinger Health Plan is implementing a consultative authorization program for musculoskeletal and interventional pain management services effective January 25, 2021.

We’re working with specialty benefit management company HealthHelp to establish a consultative authorization process for our providers to improve quality, reduce the cost of care and ensure members receive clinically appropriate and medically necessary services. The HealthHelp authorization process will involve:

Collecting relevant clinical information from the ordering/treating physician’s office;
Reviewing this information alongside the latest evidence-based medical criteria for certain musculoskeletal and interventional pain management procedures; and,
If necessary, providing expert peer consultation on treatment and/or test appropriateness and patient safety. If a requested service does not meet evidence-based guidelines, HealthHelp will facilitate a physician-to-physician conversation with the requesting provider to consider alternatives.

Services that will require authorization

All requests as of Feb. 1, 2021 — for the tests and procedures listed below — will go through HealthHelp, except services rendered in an emergency or inpatient setting. Services ordered before January 25, 2021 will not need authorization through HealthHelp.

Musculoskeletal – hip, knee, shoulder, spine
Interventional pain management - injections

A complete list of associated procedures requiring authorization can be found at www.healthhelp.com/Geisinger. A HealthHelp authorization will be required to ensure your claims process and pay correctly. All tests and procedures identified above will require authorizations through HealthHelp beginning Mar. 1, 2021.

Here is the link to all of the codes that are effective 2/1/21 (MSK pg. 6/Pain pg. 14). You can find this by going to www.healthhelp/Geisinger and scrolling to the very bottom of the page on the left.

AdaptHealth is saying goodbye

AdaptHealth, a company that provides home medical equipment, will stop participating with Geisinger Health Plan effective March 21, 2021. AdaptHealth is the corporate parent company that operates under the following business names: Young’s Medical, Royal HomeStar and McKesson Patient Care Solutions.

Please know that Geisinger Health Plan is committed to making this transition as smooth as possible for members. We’re working with Tomorrow Health to ensure an efficient transition with no gap in service. Existing orders and rentals will continue without interruption and Tomorrow Health will contact members to coordinate new orders.

We want to make this an easy and stress-free process and ensure members get the most out of their healthcare benefits. If you have any questions or concerns, please contact your service representative.

In addition to AdaptHealth’s departure, we have a whole slew of vendors and internal teams that are now active with Geisinger Health Plan, including First Health®, our Behavioral Health Care Connector Team, PerformRxSM, Rx Savings Solutions and Tomorrow Health. Here’s who’s who:

Stay informed about COVID-19

Geisinger.org/coronavirus is full of the most up-to-date information about the latest on COVID-19 including vaccine FAQs, our safety checklist, community resources and much more.

Want the latest updates sent right to your inbox? Simply scroll down until you see the blue email sign-up box.

Save the brokerHUB to your bookmarks

Can’t keep all our brokerHUBs straight? Save these links to your bookmarks or wherever you can easily access it to enter with just a click:

Fast Facts

Joseph R. Biden Jr. and Kamala D. Harris were officially sworn in Tuesday as president and vice president of the United States, respectively. Following in the footsteps of his predecessors, President Biden immediately signed a host of executive actions.
CMS released the final 2022 Notice of Benefit Payments and Parameters late last week, one of the last major final rules released by the Trump Administration. However, unlike in previous years, the final rule did not address many of the initially proposed changes. CMS instead opted to separate the most bold and controversial changes from the rest, which are set to be released at a later date.

This week’s fast facts are brought to you by the National Association of Healthcare Underwriters.

**If you choose to share this information with others, be mindful. Please take care to avoid altering or modifying the original messaging in this bulletin, or any Geisinger communications, in any way.**