Updated Clinical Influenza and Streptococcus Group A Policy

Date: 06/21/18

Thank you for your continued partnership with PA Health & Wellness.  We always strive to ensure that our clinical and payment policies are structured to ensure the health and wellness of our members.  With that in mind, we often review clinical and payment policies to verify that they align with the current health needs of our communities.

We have recently reviewed our Clinical Policy ‘Influenza and Streptococcus Group A Testing,’ and have decided to discontinue this policy.  Effective January 30, 2018, we are no longer implementing the edit denying payment for influenza testing performed on the same date of service as streptococcus testing.  This decision was based on an ongoing analysis of the clinical basis for the policy, and more importantly, based on compelling clinical feedback from network providers. 

Please don’t hesitate to reach out to Provider Services at 844-626-6813 with any questions you may have.