Provider Materials

At Senior Whole Health of Massachusetts, we value you as a provider in our network. That’s why we work hard to provide you with the resources you need to help care for our members.

Senior Whole Health newsletters

Provider Insider Volume 14 Issue 1- Winter 2020

Provider Insider Volume 14 Issue 2-Fall Edition 2020

Significant Formulary Changes Digest Volume 1- Issue 1 January 2021

Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension

Senior Whole Health (SWH) is pleased to announce our acquisition by Molina Healthcare

Our transportation provider, LogistiCare® has changed its name to ModivCare™ (January 6, 2021)

Changes to our Dental and Behavioral Health Benefit Administrators (Oct. 29, 2020)

DentaQuest Transition FAQ

Magellan Behavior Health FAQ

Molina Healthcare Acquisition FAQs

Important Changes to Claims Processing System

Sepsis Policy Notification (1/11/2021)

Part B Drugs Requiring Prior Authorization (Updated May 1, 2021)

Changes to Prior Authorization Requirements (Oct. 15, 2020)

Concurrent Review with DME Notice

Important Provider Policy Code Notice

Model Certificate of Medical Necessity-Oxygen

CL490 Bridging Policy

Mass Immunizer Provider Requirements and Payment for Coronavirus Vaccine (January 2021)

Update to Payment for Coronavirus Vaccine Administration (January 2021)

Updated Payment Rates and Authorized Providers for Coronavirus Vaccine (January 2021)

Covid-19 Vaccine-Provider-FAQ’s (March 2021)

Harvard Medical School’s Impact of COVID-19 on Provider Practices survey

Funding for Telehealth Available Under FCC’s COVID-19 Program

COVID-19 Telehealth Provider Q&A

What Massachusetts COVID-19 Vaccine Providers Need To Know (June 2021)

COVID-19 Provider Webinars
To view information & materials for past and upcoming Provider Webinars

click here

How to build resilience and adaptive skills during the pandemic
Tips for caring for the emotional health and wellness of you and your family during these uncertain times. Learn more.
If you missed the live webinar, the recording is posted here.

Magellan Healthcare manages Senior Whole Health’s behavioral health benefits. The links below provide important tools and guidance for the management of behavioral health conditions.

Magellan Toolkit
Providing Care
Substance Abuse Treatment

Recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 Influenza Season.

Shared Decision Making Tools

Clinical Practice Guidelines
Atherosclerotic Cardiovascular Disease
Diabetes
Dementia
CHF
COPD
Depression

Preventive Health Guidelines:
Fall Risk Reduction
Adult Preventive Health

Health Resources and Care Recommendations
Preventive Health Tips – Health in Aging Foundation: Aging and Health A to Z
Elder Abuse – NIH National Institute on Aging: Elder Abuse
Million Hearts Toolkit
Health in Aging Foundation

Senior Whole Health’s HEDIS Tips for Quality Care

HEDIS Adults’ Access to Preventive-Ambulatory Health Services

HEDIS Breast Cancer Screening (BCS)

HEDIS Care of Older Adults (COA)

HEDIS Comprehensive Diabetes Care (CDC)

HEDIS Controlling High Blood Pressure (CBP)