Remind patients to schedule a colorectal cancer exam starting at age 45. A screening can detect cancer early, when it's easier to treat.
Healthfirst recommends the following screening methods and their clinically appropriate intervals for applicable adult members:*
*Screening frequency is at the discretion of the provider. For information regarding your patient’s eligibility for colorectal screening options, please reference their plan’s summary of benefits and coverage.
**FIT-DNA test (Cologuard) may be eligible only to Healthfirst Commercial plan (QHP) members, Medicaid/Personal Wellness Plan members and Medicare Advantage plan members
Screenings for colorectal cancer is a measure that may be eligible for an incentive in the 2025 Healthfirst Quality Incentive Program.
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Targeted Healthfirst members are in our Essential Plan, Medicare Advantage plan, and Medicaid/Personal Wellness Plan who:
Your patients can return their completed tests to the vendor via an enclosed pre-paid postage envelope. You will get a letter from the vendor with your patients' results.
*Screening frequency is at the discretion of the provider. For information regarding your patient’s eligibility for colorectal screening options, please reference their plan’s summary of benefits and coverage.
To order Cologuard test kits and have them mailed directly to your patients or to your practice, visit cologuardhcp.com. This service is available to targeted:
Tell patients that they will receive information to complete the screening. UPS® will pick up completed tests from the specified address. Results will be shared with you to review with your patients.
*Screening frequency is at the discretion of the provider. For information regarding your patient’s eligibility for colorectal screening options, please reference their plan’s summary of benefits and coverage.
This screening is a HEDIS measure to target:
*Screening frequency is at the discretion of the provider. For information regarding your patient’s eligibility for colorectal screening options, please reference their plan’s summary of benefits and coverage.
Advise your patients that they may be eligible to receive Wellness Rewards if they complete a colorectal cancer screening. Reward eligibility and amounts may vary depending on the member’s Healthfirst plan participation and screening modality.
Patients can contact their plan’s Member Services team for help scheduling or getting to their appointments, or for more information about Wellness Rewards. Member Services contact information can also be found on the back of the member’s ID card; see sample ID cards here.
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Monday to Friday, 8am–6pm |
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7 days a week, 8am–8pm (October through March), and Monday to Friday, 8am–8pm (April through September) |
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24 hours a day, 7 days a week |
For more information about recommended health screenings for your patients, please contact your assigned Clinical Quality Manager or Network Account Manager. You can also call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm.
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