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Provider Manual

Recent Updates

June 17, 2019

Risk Adjustment - Basics

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-basics

Risk Adjustment - Behavioral health disorders

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-behavioral-health-disorders

Risk Adjustment - Cancer

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-cancer

Risk Adjustment - Cardiovascular conditions

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-cardiovascular-conditions

Risk Adjustment - Diabetes

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-diabetes

Risk Adjustment and Hierarchical Condition Category Coding

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-hcc-coding

Risk Adjustment - Kidney disease

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-kidney-disease

Risk Adjustment - Neurological conditions

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-neurological-conditions

Risk Adjustment - Pulmonary disease

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/claims-processing-policies-and-procedures/risk-adjustment-pulmonary-disease

Sleep studies

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/utilization-management/sleep-studies

June 14, 2019

eviCore

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/utilization-management/evicore

Musculoskeletal procedures

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/utilization-management/musculoskeletal-procedures

June 19, 2019

High End Imaging - Cardiac imaging and elective heart catheterization

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/utilization-management/high-end-imaging-cardiac-studies-and-elective-heart-catheterization

June 13, 2019

Physical, Speech and Occupational Therapy

http://www.securityhealth.org:443/enproviders/provider-manual/shared-content/utilization-management/physical-speech-and-occupational-therapy-outpatient