Inclusa Provider Partners – March 2018 4 877-622-6700 | inclusa.org ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● 2018 OTC Benefit Package Changes and Online Formulary Providers of over-the-counter (OTC) products are reminded that some OTC products that were previously authorized for Inclusa members may no longer be covered due to changes in the 2018 Family Care benefit package. For a listing of covered and non-covered products, see the Inclusa Covered and Non-Covered OTC Products and SME list on our website Claims & Billing page. It is highly recommended that you routinely reference the formulary for the most up-to-date information, as the formulary is subject to change. If you have questions regarding coverage for specific products for members you serve, please contact the individual member’s care team. Note regarding OTC items prescribed by a member’s physician: In order for Inclusa to pay for a product that is covered per the Inclusa formulary, the item must also be identified as a part of the member’s long-term care outcome as determined by the member’s Inclusa care team. In addition, as with all products and services for Inclusa members, prior authorization is required to allow for payment. Business System Transition Resources Online http://bit.ly/inclusa1 (this piece is still under devel- opment) Authorization Changes Coming July 1 for Central Region Providers Inclusa Central Region providers were notified in early March that authorization changes will take place as part of the system alignment effective 07/01/2018, including the authorization number used for submitting claims. For providers with authorizations in the Central Region (legacy CCCW/CareDirector) Portal:  Current authorizations in CareDirector will end 06/30/2018 and new authorizations will be created in the Inclusa system with a start date of 07/01/2018. The new authorizations will have a new authorization number.  Authorization information from the CareDirector system should be used for dates of service prior to and including 06/30/2018 for claim submission to WPS.  Authorization information from the Inclusa system (including new authorization number) should be used for dates of service 07/01/2018 and forward for claim submission to WPS. Remember that you must use the new authorization numbers on your claims for dates of service on and after 07/01/2018 or they will deny for payment. Please note that the WPS claim submission process is not changing, and you will continue to use the same WPS claim submission method you are currently using. We are in the process of entering all CareDirector providers into the Inclusa system to ensure there will be a seamless transition for your organization. Transition Resources Online Visit the Business System Transition page at www.inclusa.org for the latest updates and communications, training resources, and more. www.inclusa.org/providers/ business-system-transition/