Tips to Increase Colorectal Screenings

Inform patients of their screening options

FIT (Fecal Immunochemical Test) kit – mailed directly to the member from a designated Healthfirst vendor.

Targeted Healthfirst members are in our Essential Plan, Medicare Advantage plan, and Medicaid/Personal Wellness Plan who:

• are 45+ years old and
• have not completed their colorectal cancer screening as recommended.*

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.

Cologuard® at-home test kit

To order Cologuard test kits and have them mailed directly to your patients or to your practice, visit cologuardtest.com/hcp/resources/how-to-order.

This service is available to targeted:

• Healthfirst Commercial plan (QHP, HFIC) members 45–75 years old*
• Essential Plan and Medicaid/Personal Wellness Plan members 45+ years old*
• Medicare Advantage plan members 45-85 years old*

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.

Colonoscopy, CT colonography, flexible sigmoidoscopy, and fecal occult blood test (FOBT) - referral for GI specialist required*

This screening is a HEDIS measure to target:

• Essential Plan and Medicaid/Personal Wellness Plan members 45+ years old*
• Medicare Advantage plan members 65+ years old*

Best practices and tips

• Document colorectal cancer exams on preventive health flowsheets, lab and surgical reports, and in progress notes—with type of screening, dates, and results.
• If exact dates are not known, document screening type, month, and year.
• Utilize EMR trigger reminders and preventive health flowsheets to know when patients are due for colorectal cancer screening.
• View our Colorectal and Bladder Cancer Coding Tip Sheet to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst.

Member wellness rewards

Advise your patients that they may be eligible to receive Wellness Rewards if they complete a colorectal cancer screening. Reward eligibility and reimbursement amounts may vary depending on the member’s Healthfirst plan participation and screening modality. Members can call Member Services for additional information.

Member Services' contact information

Medicaid Managed Care: 1-866-463-6743, Personal Wellness Plan 1-855-659-5971, (TTY 1-888-542-3821), Monday to Friday, 8am–6pm

Healthfirst Medicare Plans Comprise All Medicare plans (including CompleteCare and Signature Plans): 1-888-260-1010, Signature PPO 1-833-350-2910, Signature HMO 1-855-771-1081, (TTY 1-888-542-3821), 7 days a week, 8am–8pm (October through March), and Monday to Friday, 8am–8pm (April through September)

Senior Health Partners Managed Long-Term Care Medicaid Plan: 1-800-633-9717, (TTY 1-888-542-3821), 24 hours a day, 7 days a week

A printable PDF is available here.

* For information regarding your member’s eligibility for colorectal screening options, please reference their plan’s summary of benefits and coverage.

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”).

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