Provider communications

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.


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Select “Opt-In for Electronic Communications” in your Prevea360 Health Plan portal account settings.

See pharmacy material change notices.

New partnership with Medica

Issued: August 2021
Audience: All providers
Effective date: N/A

See provider announcement

See announcement Q&A


New policy for viscosupplement products 

Issued: August 2021
Audience: In-network prescribers
Effective date: 10/1/2021 & 1/1/2022

See new vicosupplement policy


Enhanced Prevea360 website 

Issued: July 2021
Audience: All in-network providers ­
Effective date: 7/22/2021

See website info


Preventive Care and Screenings 

Issued: July 2021
Audience: All in-network providers  

See preventive care/screening info


New member ID cards issued for some members 

Issued: June 1, 2021
Effective date: 9/1/21

See new ID cards

       


Total knee & total hip arthroplasty prior authorization changes

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: 7/1/2021

See knee & hip arthroplasty changes        


Plan and benefit changes for 2021

Annual notification with member-centered plan and benefit topics for provider awareness for 2021.
Issued: October 2020
Audience: All in-network providers
Effective date: 1/1/2021

See 2021 plan & benefits changes        


Medicare Advantage product expansion

Prevea360 Medicare Advantage Plans from Dean Health Plan available to residents in Door County.
Issued: October 2020
Audience: Door County providers
Effective date: 1/1/2021

See Door County expansion        


Member cost-share waiver

Cost share waiver for office visits through Dec. 31, 2020.
Issued: October 2020
Audience: All in-network providers
Effective date: 10/15/2020

See cost-share waiver        


Provider portal bulk edit function

Portal function allowing Provider Portal Site Administrators to apply updates to multiple user accounts all at once.
Issued: June 2020
Audience: Portal site administrators
Effective date: 6/29/2020

See bulk edit info        


New provider portal

Introduction to new provider portal and its features.
Issued: May 2020
Audience: All in-network providers
Effective date: 6/1/2020

See portal info        


Medicare Advantage product expansion

Prevea360 Medicare Advantage Plans from Dean Health Plan available to residents in Sheboygan County.
Issued: November 2019
Audience: Sheboygan County providers
Effective date: 1/1/2020

See Sheboygan expansion        


Plan and benefit changes for 2020

Annual notification with member-centered plan and benefit topics for provider awareness for 2020.
Issued: October 2019
Audience: All in-network providers
Effective date: 1/1/2020

See 2020 changes        


Skilled nursing facility swing bed policy changes

Skilled nursing facility (SNF) swing bed medical policy updates to align with evidence-based standards and health care industry standards.
Issued: March 2019
Audience: Facilities and SNF providers
Effective date: 5/1/2019

See swing bed changes        


Prior authorization change for inpatient musculoskeletal surgeries

New Musculoskeletal Care Management (MSK) Program for the review of non-emergent inpatient and outpatient musculoskeletal surgeries.
Issued: January 2019
Audience: Neurologists, orthopedists & orthopedic surgeons
Effective date: 4/1/2019

P360-Prior-Authorization-Change-MSK-Inpatient-Jan2019        


Pharmacy material change notices

Audience: All in-network providers

ADAKVEO (crizanlizumab) and SIMPONI ARIA (golimumab)
Issued: July 2021
Effective date: 11/1/2021

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: 10/1/2021

Medically administered oncology products, SPRAVATA (esketamine) and retired drug policies
Issued: June 2021
Effective date: 9/1/21

OCREVUS (ocrelizumab)
Issued: 
April 2021
Effective date: 8/1/2021

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: 7/1/2021

PROLIA/XGEVA, LUPRON-ELIGARD & INFLIXIMAB Infusions
Issued: March 2021
Effective date: 6/1/2021

Immune globulin
Issued: January 2021
Effective date: 5/1/2021

Trastuzumab products
Issued: December 2020
Effective date: 4/1/2021

Pegfilgrastim, Pertuzumaband, and Trastuzumab products
Issued: October 2020
Effective date: 2/1/2021

REBLOZYL, ENHERTU, KADCYLA and TRODELVY
Issued: September 2020
Effective date: 1/1/2021

SOLIRIS and ULTOMIRIS
Issued
: May 2020
Effective date: 8/1/2020

ADCETRIS (brentuximab vedotin) and NULOJIX (blatacept)
Issued
: December 2019
Effective date: 4/1/2020

CYRAMZA (ramucirumab), ERWINAZE (asparaginase Erwinia chrysanthemi), Bendamustine Hydrochloride products TREANDA, BENDEKA, BELRAPZO and VELCADE (bortezomib)
Issued
: July 2019
Effective date: 9/1/2019