Table Of Contents

Medical Director’s Letter Together, we can improve care for our patients. HNE NEWS Updates on HNE's financial performance, quality improvement initiatives, network development and medical service news. HEDIS® Results HNE 1998 results are in. Dropping Prior Authorization Revised pre-certification listings now available. HNE Utilizes Physician Reviewers HNE utilizes board-certified specialty physicians to assist in making utilization management determinations. HNE Makes UM Criteria Available to Physicians Upon request, HNE makes clinical criteria used for rendering decisions regarding the appropriateness of medical services available to physicians. Member Confidentiality A reminder about the confidentiality of member information and access to medical records. REMINDER: 2000 CPT and ICD-9-CM All claims on or after 1/1/2000 should reflect the new codes and diagnoses from the 2000 CPT Code Book and 2000 ICD-9-CM.

Member Rights & Responsibilities Updated version of HNE's Member Rights and Responsibilities Statement. Change of Heart Innovative lifestyle modification program available to patients with coronary heart disease. Injectables Reimbursement policy for injectables. Preventive Care Recommended Screenings for Healthy Adults and Children. Benefit Update: Durable Medical Equipment (DME) Disease Management Program Chart A high level overview of the three HNE Disease Management Programs currently in place. Important Information About Motor Vehicle Accidents Even in the case of a Motor Vehicle Accident, members must use HNE providers and follow HNE guidelines. REMINDER: It is HNE's policy to encourage open dialogue between providers and members.

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ABOUT HNE Welcome Mission Statement Press Releases Annual Report Corporate Officers Contact CEO Search HNE.com Web Site Feedback Directions Disclaimer for Members for Providers for Employers for Brokers Web Site Feedback We would like to know what you think of our Web site. Stay tuned for new and exciting changes about to take place on our Web Site. At Health New England, we are continuously looking for ways to meet and exceed the needs of our members and providers. Look for upcoming information on disease management, nutrition and wellness programs. We’ll also have information on benefits, access to care and referrals, as well as a variety of tips on not only being healthy, but also staying healthy. At this time, we are not able to respond to billing or claims questions via our Web Site. Please continue to call the HNE Member Services Department at 1-800-310-2835 with these issues. As always, your feedback is important to us, so if you have a comment, we'd love to hear from you! Name *: Street Address: City: State: Zip: Phone: E-mail *: Comments: * Required

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