Passage referral plan changes for 2018

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Passage referral plan changes for 2018

01/18/2018

Our "Passage" referral plans are now available to more commercial and Medicare Advantage members and more PCPs will be accepting the plans. Here’s the Passage article from the November 2017 Office Visit if you need to refer to it again.

PCPs, please note:
Remember, if you are not designated as a Passage PCP, you should not provide primary care services to members with Passage plans. If you do provide such services, we will deny claims and tell members they are responsible for the costs. (For Passage members with individual plans through Access Health CT, the Connecticut insurance exchange, the claims will be paid under their out-of-network benefits.)

Specialists, make checking referrals a practice:
Check our website, connecticare.com/providers, to see if your Passage patients have a PCP referral for your specialty care. Passage members can see any specialist in the ConnectiCare network as long as they have valid referrals from their Passage PCPs for each specialist.

Expect your patients with Passage plans to ask you to confirm that their referrals remain valid before they have visits. Without referrals, we will deny claims for specialists’ consultation services and tell members they are responsible for the costs.

Referrals are not required when Passage members need hospital and/or ancillary care services, such as radiology and lab work.