You have javascript disabled. We recommend that you turn it on for the best experience on our site.

Provider Updates

Medicaid Updates 

To reference archived updates, click here

Aug 2017 IMPORTANT ANNOUNCEMENT REGARDING OPIOID PRESCRIPTION PRIOR-AUTHORIZATION REQUIREMENTS (Effective September 15, 2017)
Aug 2017 Notice of Sept 15 Medical and Drug Policy Updates For PA Medicaid
Aug 2017 Obstetrical Needs Assessment Form (ONAF) Update for Practitioners Providing Maternity Care
Aug 2017 Provider Update
July 2017 Provider Update
July 2017 Provider Update and Practice Change Form
June 2017 Provider Update and Practice Change Form
June 2017 Medical and Drug Policy Notice for July 19
May 2017 Environmental Lead Investigation
May 2017 Provider Update
May 2017 Provider Update and Practice Change Form
Apr 2017 Provider Update and Practice Change Form
Apr 2017 GATEWAY HEALTH: Selects KeyHIE as Our Preferred HIO
Apr 2017 Provider Update
Mar 2017 Provider Update and Practice Change Form
Mar 2017 Expansion of Genetic Testing Available at Preferred Lab Facilities
Feb 2017 Provider Update and Practice Change Form
Feb 2017 Provider Update
Feb 2017 Enhancements to Prior Authorizations 
Jan 2017 Notice of Weekend Authorization Coverage
Jan 2017 835 Process Update
Jan 2017 Provider Update and Practice Change Form
Jan 2017 Medical Policy Update Exondys 51 (Eteplirsen)
Jan 2017 Notice of Practice/Practitioner Changes
Dec 2016 MUE Reimbursement Policy Update
Dec 2016 Provider Update and Practice Change Form
Nov 2016 Provider Update and Practice Change Form
Nov 2016 Provider Update
Oct 2016 Provider Update
Oct 2016 Provider Update and Practice Change Form
Sept 2016 Provider Update and Practice Change Form
Aug 2016 Provider Update and Practice Change Form
Aug 2016 Provider Update
Aug 2016 Effective Immediately All Hospital-Based Providers Are Required to Bill With Their Group NPI
July 2016 Gateway Health To Offer Telephonic Psychiatric Consultation Service Program (TiPS)
July 2016 Provider Update and Practice Change Form
June 2016 Provider Update and Practice Change Form
June 2016 Announcing New IVR Changes/Provider Phone Tree
June 2016 Provider Revalidation Deadline - July 30,2016
May 2016 IVR Provider Update
May 2016 Provider Update and Practice Change Form
April 2016 Provider Update and Practice Change Form
April 2016 New Fax Number for Claims Dispute Requests
March 2016 Yervoy Medical Payment and Prior-Authorization Policy
March 2016 Payment Dispute Requests and Refunds
March 2016 Provider Update and Practice Change Form
February 2016 Retrospective Authorizations for Pennsylvania Medicaid and New Cataract Removal Reimbursement Policy for Medicare
   -Cataract Removal Questionnaire * NOTE - effective 1/1/17 this policy has been retired.  The New Policy can be found here
February 2016 Provider Update and Practice Change Form
February 2016 Incontinence Supplies Policy

Medicare AssuredSM Updates

Gateway Health Medicare AssuredSM is a Medicare approved Special Needs Plan for people with both Medicare and Medicaid. To become a member, beneficiaries must be entitled to Medicare Part A and enrolled in Medicare Part B, receive Medicaid (full or QMB) and reside in our service area.

Aug 2017 NOTICE OF SEPT. 15 MEDICAL POLICY UPDATES FOR MEDICARE ASSURED (KY, NC, OH and PA)
Aug 2017 Provider Update
July 2017 Provider Update
July 2017 Provider Update and Practice Change Form
June 2017 Provider Update and Practice Change Form
June 2017 Drug Policy Update Notice for July 19
May 2017 Provider Update
May 2017 Provider Update and Practice Change Form
Apr 2017 Provider Update and Practice Change Form
Apr 2017 Provider Update
Mar 2017 Provider Update and Practice Change Form
Mar 2017 Expansion of Genetic Testing Available at Preferred Lab Facilities
Feb 2017 Provider Update and Practice Change Form
Feb 2017 Provider Update
Feb 2017 Enhancements to Prior Authorizations
Jan 2017 835 Process Update
Jan 2017 Provider Update and Practice Change Form
Jan 2017 Notice of Practice/Practitioner Changes
Dec 2016 MUE Reimbursement Policy Update
Dec 2016 Provider Update and Practice Change Form
Nov 2016 Provider Update and Practice Change Form
Nov 2016 Provider Update
Oct 2016 Provider Update
Oct 2016 Provider Update and Practice Change Form
Sept 2016  Provider Update and Practice Change Form
Aug 2016 Provider Update and Practice Change Form
Aug 2016 Provider Update
Aug 2016 Effective Immediately All Hospital-Based Providers Are Required to Bill With Their Group NPI
July 2016 Provider Update and Practice Change Form
June 2016 NIA Implementation
June 2016 Provider Update and Practice Change Form
June 2016 Announcing New IVR Changes/Provider Phone Tree
- PA       - NC       - KY       - OH
May 2016 IVR Provider Update
May 2016 Provider Update and Practice Change Form
April 2016 Provider Update and Practice Change Form
April 2016 New Fax Number for Claims Dispute Requests
March 2016 Yervoy Medical Payment and Prior-Authorization Policy
March 2016 Payment Dispute Requests and Refunds
March 2016 Provider Update and Practice Change Form
February 2016 Retrospective Authorizations for Pennsylvania Medicaid and New Cataract Removal Reimbursement Policy for Medicare
   -Cataract Removal Questionnaire * NOTE - effective 1/1/17 this policy has been retired.  The New Policy can be found here
February 2016 Provider Update and Practice Change Form

To reference archived updates, click here