New Century Health (NCH) is a comprehensive quality management company that ConnectiCare has designated as a utilization review agent. NCH offers collaboration and peer-to-peer discussions with oncologists’ and physicians’ offices. They have a provider web portal where you can request preauthorizations, select treatment care pathways, obtain help with documentation, and more.
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ConnectiCare Oncology Drug Management Program
As of Jan. 1, 2021, NCH handles utilization management for most oncology-related chemotherapeutic drugs and supportive agents when delivered in the physician’s office, outpatient hospital, or other ambulatory setting. NCH emphasizes and supports the selection of Preferred Pathways for adult (18+) oncology patient care.
NCH manages medical specialties providing cancer care and its supportive services, including medical oncology, hematology, urology, and gynecologic oncology.
The following services are excluded from the program:
- Requests for patients under 18 years of age
- Equipment requests (e.g., IV pump)
- Inpatient requests
- Hemophilia drugs
- Bone marrow transplants
- Inpatient chemotherapy services
- ESRD patients
- Clinical trials
- Radiopharmaceuticals
- All places of treatment and services not specifically listed above
Register at my.newcenturyhealth.com.
Request training on the provider portal. You may also contact NCH Network Operations at 888‑999‑7713, option 6, 8 a.m. to 8 p.m., Monday to Friday.
Preauthorization
NCH’s provider portal is always available, offering:
- Real-time authorizations for oncology treatment care pathways.
- Reduced documentation requirements.
- View of real-time status of preauthorization requests.
- Eligibility verification.
- Supportive telephonic authorization staff available at 888-999-7713, 8 a.m. to 8 p.m., Monday to Friday.
- Quick turnaround time on preauthorization requests submitted via portal, fax, or phone.
- Peer-to-peer consultations by medical oncologists.
- An NCH provider representative is available for support as needed.
- You can also fax preauthorization request forms to 877-624-8602.
All preauthorizations issued by ConnectiCare before Jan. 1, 2021 will remain valid until they expire.
Claims
ConnectiCare is responsible for grievance and appeals. Providers can initiate a grievance or appeal with ConnectiCare by mail or fax:
Line of Business |
Fax # |
Mailing Address |
|---|---|---|
Medicare |
Standard – 866-854-2763 Expedited – 866-350-2168 |
PO Box 2844 New York, NY 10116 |
Commercial |
Standard – 212-510-5320 Expedited – 866-350-2168 |
