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Provider Communications

Provider Spotlight

Oct 9, 2020

Information from Empire for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.

Oct 1, 2020

Keep up with important news from Empire and receive notifications by email


Articles Recent

Title Publication Category Date

Nominate someone today for the Empire Whole Health Heroes Awards

Empire Whole Health Heroes Awards Administrative Oct 20, 2020

Register today for a Racial Trauma Forum hosted by Empire and Motivo on October 28, 2020

Racial Trauma Forum Invitation Behavioral Health Oct 14, 2020

Information from Empire for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.

COVID-19 Information Administrative Oct 9, 2020

Site of Care medical necessity reviews for a wide range of surgical procedures beginning January 1, 2021

Material Adverse Change
October 2020 Empire Provider News Products & Programs Oct 1, 2020

REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020

October 2020 Empire Provider News Products & Programs Oct 1, 2020

Empire updates formulary lists for commercial health plan pharmacy benefit

October 2020 Empire Provider News Pharmacy Oct 1, 2020

Designated Specialty Pharmacies in 2021

Material Adverse Change
October 2020 Empire Provider News Pharmacy Oct 1, 2020

National Drug Code requirement on outpatient claims

Material Adverse Change
October 2020 Empire Provider News Pharmacy Oct 1, 2020

Prior authorization updates for specialty pharmacy are available

October 2020 Empire Provider News Pharmacy Oct 1, 2020

Updated Coverage for Breast Cancer prevention medications

October 2020 Empire Provider News Pharmacy Oct 1, 2020

FDA approvals and expedited pathways used - New Molecular Entities (NMEs)

October 2020 Empire Provider News Pharmacy Oct 1, 2020

Pharmacy information available on empireblue.com

October 2020 Empire Provider News Pharmacy Oct 1, 2020

Keep up with important news from Empire and receive notifications by email

October 2020 Empire Provider News Administrative Oct 1, 2020

New Digital Provider Enrollment tool added to Availity for New York

October 2020 Empire Provider News Administrative Oct 1, 2020

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

October 2020 Empire Provider News Administrative Oct 1, 2020

Charges for Personal Protective Equipment by Participating Providers

October 2020 Empire Provider News Administrative Oct 1, 2020

Electronic member ID cards available on the Availity Portal

October 2020 Empire Provider News Administrative Oct 1, 2020

Empire Chat: A fast, easy way to have your questions answered

October 2020 Empire Provider News Administrative Oct 1, 2020

Interactive Care Reviewer adds outpatient medical authorization requests for Empire local, State and City plans

October 2020 Empire Provider News Administrative Oct 1, 2020

Request referrals for Empire Individual Network Plan through Interactive Care Reviewer

October 2020 Empire Provider News Administrative Oct 1, 2020

New Medical Claim Attachment Webinars: Register Today

October 2020 Empire Provider News Administrative Oct 1, 2020

National Accounts 2021 Pre-certification list

October 2020 Empire Provider News Administrative Oct 1, 2020

CRA Reporting Update: New guidance on telephone-only service CPT codes for Risk Adjustment Program

October 2020 Empire Provider News Administrative Oct 1, 2020

What Matters Most: Improving the Patient Experience

October 2020 Empire Provider News Administrative Oct 1, 2020

Medical Policy & Clinical Guideline updates

Material Adverse Changes
October 2020 Empire Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Clinical Criteria updates for specialty pharmacy are available

Material Adverse Change
October 2020 Empire Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

October 2020 Empire Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Reimbursement Policy Update: Emergency Department: Leveling of Evaluation and Management Services (Facility)

Material Adverse Change
October 2020 Empire Provider News Reimbursement Policies Oct 1, 2020

Reimbursement Policy Update: Laboratory and Venipuncture (Professional)

Material Adverse Change
October 2020 Empire Provider News Reimbursement Policies Oct 1, 2020

Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List

Material Adverse Change
October 2020 Empire Provider News Federal Employee Plan (FEP) Oct 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations

October 2020 Empire Provider News Medicaid Oct 1, 2020

SOMOS to manage delegated functions effective October 1, 2020

October 2020 Empire Provider News Medicaid Oct 1, 2020

Prior authorization requirements for E0482

October 2020 Empire Provider News Medicaid Oct 1, 2020

Asthma controller medications

October 2020 Empire Provider News Medicaid Oct 1, 2020

Patient360 enhancement for medical providers

October 2020 Empire Provider News Medicaid Oct 1, 2020

Coding spotlight: providers guide to coding for behavioral health disorders

October 2020 Empire Provider News Medicaid Oct 1, 2020

Keep up with Medicaid news

October 2020 Empire Provider News Medicaid Oct 1, 2020

Prior authorization requirements for the below codes (December 1, 2020)

October 2020 Empire Provider News Medicare Oct 1, 2020

Prior authorization requirements for the below codes (January 1, 2021)

October 2020 Empire Provider News Medicare Oct 1, 2020

Patient360 enhancement for medical providers

October 2020 Empire Provider News Medicare Oct 1, 2020

Social determinants of health support expanding with GroundGame Health

October 2020 Empire Provider News Medicare Oct 1, 2020

Evaluation and management services correct coding

October 2020 Empire Provider News Medicare Oct 1, 2020

Provider transparency update

October 2020 Empire Provider News Medicare Oct 1, 2020

Medical drug benefit Clinical Criteria updates

October 2020 Empire Provider News Medicare Oct 1, 2020

Keep up with Medicare news

October 2020 Empire Provider News Medicare Oct 1, 2020

Updates for specialty pharmacy are available

September 2020 Empire Provider News Pharmacy Sep 1, 2020

Empire to update formulary lists for commercial health plan pharmacy benefit

September 2020 Empire Provider News Pharmacy Sep 1, 2020

New provider directory indicators for medication assisted treatment (MAT) providers

September 2020 Empire Provider News Administrative Sep 1, 2020

EDI gateway migration deadline is September 15, 2020

September 2020 Empire Provider News Administrative Sep 1, 2020

Patient360 adds care gap alert feedback for medical providers

September 2020 Empire Provider News Administrative Sep 1, 2020

Enhanced medical records submission process to support claims processing

September 2020 Empire Provider News Administrative Sep 1, 2020

Providers can now receive and respond to medical record requests for postpay audit via Change Healthcare’s Assurance Attach Assist module

September 2020 Empire Provider News Administrative Sep 1, 2020

CRA reporting update: 2020 prospective program continues

September 2020 Empire Provider News Administrative Sep 1, 2020

Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions

September 2020 Empire Provider News Administrative Sep 1, 2020

Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)

September 2020 Empire Provider News Reimbursement Policies Sep 1, 2020

Frequency Editing (Professional)

September 2020 Empire Provider News Reimbursement Policies Sep 1, 2020

What Matters Most online training course: improving patient experience

September 2020 Empire Provider News Medicaid Sep 1, 2020

Medical drug benefit Clinical Criteria updates

September 2020 Empire Provider News Medicaid Sep 1, 2020

Medical Policies and Clinical Utilization Management Guidelines update

September 2020 Empire Provider News Medicaid Sep 1, 2020

Keep up with Medicaid news

September 2020 Empire Provider News Medicaid Sep 1, 2020

Update: Notice of changes to the AIM musculoskeletal program

September 2020 Empire Provider News Medicare Sep 1, 2020

Medical drug benefit Clinical Criteria updates

September 2020 Empire Provider News Medicare Sep 1, 2020

Keep up with Medicare news

September 2020 Empire Provider News Medicare Sep 1, 2020

New York Department of Financial Services Circular Letter on PPE

The New York Department of Financial Services (“DFS”) recently issued a circular letter, “Charges for Personal Protective Equipment by Participating Providers”.  In support with the letter, Empire is sharing with participating providers their responsibilities and working with providers to report the findings to DFS.
COVID-19 Information Administrative Aug 25, 2020

Mental Health Services for Fully Insured New York Members including Essential Workers

Effective May 2, 2020, Empire began waiving cost sharing for in-network outpatient mental health services for all New York fully-insured members, including essential workers.  This waiver will be in effect until September 28, 2020, unless further extended.
COVID-19 Information Administrative Aug 13, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020

August 2020 Empire Provider News Products & Programs Aug 1, 2020

Prior authorization updates for specialty pharmacy are available

August 2020 Empire Provider News Pharmacy Aug 1, 2020

Empire to update formulary lists for commercial health plan pharmacy benefit

August 2020 Empire Provider News Pharmacy Aug 1, 2020

Voluntary Site of Care outreach for Oncology Checkpoint Inhibitors beginning August 1, 2020

August 2020 Empire Provider News Pharmacy Aug 1, 2020

Clinical Criteria updates for specialty pharmacy are available

August 2020 Empire Provider News Pharmacy Aug 1, 2020

Pharmacy information available on empireblue.com

August 2020 Empire Provider News Pharmacy Aug 1, 2020

Migrate Your EDI Transactions to Availity Today

August 2020 Empire Provider News Administrative Aug 1, 2020

Electronic Claims Submission - Clinical Laboratory Improvement Amendments (CLIA)

August 2020 Empire Provider News Administrative Aug 1, 2020

Empire Electronic Attachments - X12 275 5010

August 2020 Empire Provider News Administrative Aug 1, 2020

Coming Soon: Enhance your Prior Authorization and Inpatient Admission

August 2020 Empire Provider News Administrative Aug 1, 2020

Medical Record Standards

August 2020 Empire Provider News Administrative Aug 1, 2020

Appropriate coding helps provide a comprehensive picture of patients’ health

August 2020 Empire Provider News Administrative Aug 1, 2020

Resources to support diverse patients and communities

August 2020 Empire Provider News Administrative Aug 1, 2020

Controlling High Blood Pressure (CBP)

August 2020 Empire Provider News Medicaid Aug 1, 2020

Medical drug benefit Clinical Criteria updates

August 2020 Empire Provider News Medicaid Aug 1, 2020

Provider data update

August 2020 Empire Provider News Medicaid Aug 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

August 2020 Empire Provider News Medicaid Aug 1, 2020

Keep up with Medicaid news

August 2020 Empire Provider News Medicaid Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Empire Provider News Medicare Aug 1, 2020

AIM Musculoskeletal program expansion

August 2020 Empire Provider News Medicare Aug 1, 2020

Medical drug benefit Clinical Criteria updates

August 2020 Empire Provider News Medicare Aug 1, 2020

Provider data update

August 2020 Empire Provider News Medicare Aug 1, 2020

Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM

August 2020 Empire Provider News Medicare Aug 1, 2020

Keep up with Medicare news

August 2020 Empire Provider News Medicare Aug 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and Setting determinations

July 2020 Empire Provider News Products & Programs Jul 1, 2020

Updated Coverage for HIV PrEP medications

July 2020 Empire Provider News Pharmacy Jul 1, 2020

Prior authorization updates for specialty pharmacy are available

July 2020 Empire Provider News Pharmacy Jul 1, 2020

Changes to Annual Verification Process

July 2020 Empire Provider News Administrative Jul 1, 2020

Suffolk County Lab Network

July 2020 Empire Provider News Administrative Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Empire Provider News Administrative Jul 1, 2020

Claims Status Listing & Remittance Inquiry Updates for Atypical Providers

July 2020 Empire Provider News Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Empire Provider News Administrative Jul 1, 2020

CRA Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

July 2020 Empire Provider News Administrative Jul 1, 2020

Medical Policy and Clinical Guideline updates

July 2020 Empire Provider News Medical Policy & Clinical Guidelines Jul 1, 2020

Clinical Criteria updates for specialty pharmacy are available

July 2020 Empire Provider News Medical Policy & Clinical Guidelines Jul 1, 2020
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