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Articles Recent

Title Publication Category Date

Reimbursement policy update: Laboratory and Venipuncture Services - Professional & Facility

Material Adverse Change (MAC)

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, and XU - professional

Material Adverse Change (MAC)

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

New reimbursement policy: Transitional Care Management - professional

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Retraction for reimbursement policy — Sexually Transmitted Infections - professional

July 2022 Newsletter Reimbursement Policies Jul 1, 2022

New reimbursement policy: Place of Service - facility

Material Adverse Change (MAC)
July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Radiology prior authorization review transitioning to AIM

July 2022 Newsletter Federal Employee Plan (FEP) Jul 1, 2022

Prior authorization requirement changes effective August 1, 2022

July 2022 Newsletter Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Newsletter Medicaid Jul 1, 2022

Update to electronic verification visit key points

July 2022 Newsletter Medicaid Jul 1, 2022

Provider reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Counseling program

July 2022 Newsletter Medicaid Jul 1, 2022

Keep up with Medicaid news- July 2022

View these Medicaid articles:

  • Three-point match verification for professional claims payment
  • Prior authorization updates for medications billed under the medical benefit
  • Updates for medication codes billed under the medical benefit
July 2022 Newsletter Medicaid Jul 1, 2022

MCG care guidelines 26th edition

July 2022 Newsletter Medicare Jul 1, 2022

Bedford Central School District, New York moves to the Empire BlueCross BlueShield Retiree Solutions Medicare Advantage Plan

July 2022 Newsletter Medicare Jul 1, 2022

Update use of Modifier 25 for billing for visits that include preventive services and problem-oriented evaluation and management services

July 2022 Newsletter Medicare Jul 1, 2022

Cancer Care Navigator

July 2022 Newsletter Medicare Jul 1, 2022

Keep up with Medicare news - July 2022

View this Medicare article:

  • New specialty pharmacy medical step therapy requirements
July 2022 Newsletter Medicare Jul 1, 2022

Physician Office Lab Listing - updates effective August 1, 2022

July 2022 Newsletter Administrative Jul 1, 2022

Provider manual updated effective October 1, 2022

July 2022 Newsletter Administrative Jul 1, 2022

Introducing Elevance Health - Focusing on whole health and its most powerful drivers

July 2022 Newsletter Administrative Jul 1, 2022

Help patients heal from the comfort of home with Hospital in Home care

July 2022 Newsletter Administrative Jul 1, 2022

Updates to edits associated with implants

July 2022 Newsletter Administrative Jul 1, 2022

Enhanced reimbursement for voluntary Cancer Care Quality program to be discontinued effective December 31, 2022

July 2022 Newsletter Administrative Jul 1, 2022

Update to facility editing: HCPCS code G0463

July 2022 Newsletter Administrative Jul 1, 2022

CAA: Keep your provider directory information current

July 2022 Newsletter Administrative Jul 1, 2022

More potato chips, sugary drinks, and less physical activity are key contributors to childhood obesity

July 2022 Newsletter Administrative Jul 1, 2022

Clearing up coding confusion for diabetic retinal screenings

July 2022 Newsletter Administrative Jul 1, 2022

Coming soon: The Empire BlueCross BlueShield Provider Learning Hub makes Availity learning easier

July 2022 Newsletter Digital Tools Jul 1, 2022

Enhancing claims attachment processes through digital applications

July 2022 Newsletter Digital Tools Jul 1, 2022

MCG to InterQual Behavioral Health Transition

July 2022 Newsletter Behavioral Health Jul 1, 2022

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)

July 2022 Newsletter Pharmacy Jul 1, 2022

Pharmacy information available online

July 2022 Newsletter Pharmacy Jul 1, 2022

New reimbursement policy: Modifier FB – Professional and Facility

Material Adverse Change (MAC)
July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Modifier Rules – Professional

Material Adverse Change (MAC)
July 2022 Newsletter Reimbursement Policies Jul 1, 2022

Introducing Elevance Health — Focusing on whole health and its most powerful drivers

Elevance Health Administrative Jun 16, 2022

Exploring the Intersection of Race and Disability

Register today for a forum on Exploring the Intersection of Race and Disability on June 22, 2022.
Exploring the Intersection of Race and Disability forum Administrative Jun 8, 2022

Provider outreach to validate your provider data

June 2022 Newsletter Administrative Jun 1, 2022

Evaluation and management services for COVID testing - professional

Material adverse change (MAC)

June 2022 Newsletter Administrative Jun 1, 2022

Exploring the Intersection of Race and Disability

June 2022 Newsletter Administrative Jun 1, 2022

Once-a-year testing is critically important to providing quality diabetes care

June 2022 Newsletter Administrative Jun 1, 2022

CAA: Provider directories accuracy is important

June 2022 Newsletter Administrative Jun 1, 2022

Opioid overdose deaths: What can we do?

June 2022 Newsletter Behavioral Health Jun 1, 2022

Specialty pharmacy updates - June 2022

Material Adverse Change (MAC)
June 2022 Newsletter Pharmacy Jun 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines

Material Adverse Change (MAC)

June 2022 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health musculoskeletal clinical appropriateness guidelines

Material Adverse Change (MAC)
June 2022 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health sleep disorder management clinical appropriateness

Material Adverse Change (MAC)

June 2022 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (Facility)

Material Adverse Change (MAC)

June 2022 Newsletter Reimbursement Policies Jun 1, 2022

Process change for Federal Employee Program® third-party correspondence requests

June 2022 Newsletter Federal Employee Plan (FEP) Jun 1, 2022

Provider notice for COVID-19 testing

June 2022 Newsletter Medicaid Jun 1, 2022

InterQual migration

June 2022 Newsletter Medicaid Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Newsletter Medicaid Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Newsletter Medicaid Jun 1, 2022

Keep up with Medicaid news- June 2022

View these Medicaid articles:

  • Prior authorization update for select durable medical equipment (DME) items
  • Prior authorization updates for medications billed under the medical benefit
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
  • Medical drug benefit Clinical Criteria updates
June 2022 Newsletter Medicaid Jun 1, 2022

Provider notice for COVID-19 testing

June 2022 Newsletter Medicare Jun 1, 2022

Medical drug benefit Clinical Criteria updates

June 2022 Newsletter Medicare Jun 1, 2022

Medical Policies and Clinical Utilization Management Guidelines update

June 2022 Newsletter Medicare Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

June 2022 Newsletter Medicare Jun 1, 2022

Keep up with Medicare news - June 2022

View these Medicare articles:

  • New specialty pharmacy medical step therapy requirements
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
  • Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
June 2022 Newsletter Medicare Jun 1, 2022

Empire announces changes to post-payment audits conducted on our behalf

May 2022 Newsletter Administrative May 1, 2022

Action required: Conversion to a new reimbursement system for outpatient facility services

May 2022 Newsletter Administrative May 1, 2022

Coding tips for reporting administration of Spravato®

May 2022 Newsletter Administrative May 1, 2022

CAA: Timely updates help keep our provider directories current

May 2022 Newsletter Administrative May 1, 2022

Primary care appointment access and open panels

May 2022 Newsletter Administrative May 1, 2022

Resources to support diverse patients and communities

May 2022 Newsletter Administrative May 1, 2022

May is national high blood pressure education month: We’ve got this!

May 2022 Newsletter Administrative May 1, 2022

Alcohol use disorder has a big cost

May 2022 Newsletter Administrative May 1, 2022

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)

May 2022 Newsletter Pharmacy May 1, 2022

Specialty pharmacy updates - May 2022

Material Adverse Change (MAC)
May 2022 Newsletter Pharmacy May 1, 2022

Medical policy and clinical guideline updates

Material Adverse Change (MAC)

May 2022 Newsletter Medical Policy & Clinical Guidelines May 1, 2022

Join us for an FEP Quality Learning program live webinar

May 2022 Newsletter Federal Employee Plan (FEP) May 1, 2022

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP® Quality Reimbursement Program for PPO providers

May 2022 Newsletter Federal Employee Plan (FEP) May 1, 2022

Federal Employee Program® AIM radiology prior authorization review reminder

May 2022 Newsletter Federal Employee Plan (FEP) May 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Newsletter Medicaid May 1, 2022

New Strategic Provider System implementation May 2022

May 2022 Newsletter Medicaid May 1, 2022

CPT Category II update

May 2022 Newsletter Medicaid May 1, 2022

Keep up with Medicaid news- May 2022

View these Medicaid articles:

  • Prior authorization requirement changes for HCPCS code K1022
  • New specialty pharmacy medical step therapy requirements
May 2022 Newsletter Medicaid May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Newsletter Medicare May 1, 2022

HEDIS 2022: summary of changes from NCQA

May 2022 Newsletter Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements

May 2022 Newsletter Medicare May 1, 2022

Keep up with Medicare news - May 2022

View these Medicare articles:

  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
  • New specialty pharmacy medical step therapy requirements
May 2022 Newsletter Medicare May 1, 2022

Information from Empire for Care Providers about COVID-19 (Updated April 20, 2022)

We recently updated information about codes for telehealth and telemedicine care.

COVID-19 Information Administrative Apr 20, 2022

Improving antibiotic use for acute respiratory infections in the outpatient setting

CME Webinar Offers CDC's Best Practices for Safe & Effective Antibiotic Prescribing - New York Administrative Apr 5, 2022

The Anthem, Inc. name is changing

April 2022 Newsletter Administrative Apr 1, 2022

HEDIS 2022: Summary of changes from NCQA

April 2022 Newsletter Administrative Apr 1, 2022

Catching up on routine vaccines

April 2022 Newsletter Administrative Apr 1, 2022

CAA: Update your provider directory information

April 2022 Newsletter Administrative Apr 1, 2022

Procedure searches in Find Care

April 2022 Newsletter Digital Tools Apr 1, 2022

Importance of behavioral healthcare after-hours messaging

April 2022 Newsletter Behavioral Health Apr 1, 2022

Specialty pharmacy updates - April 2022

Material Adverse Change (MAC)

April 2022 Newsletter Pharmacy Apr 1, 2022

Reminder on Botox® for Empire members

April 2022 Newsletter Pharmacy Apr 1, 2022

Pharmacy information available on empireblue.com

April 2022 Newsletter Pharmacy Apr 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Newsletter Federal Employee Plan (FEP) Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Newsletter Medicaid Apr 1, 2022

Syphilis, including congenital cases, on the rise in New York

April 2022 Newsletter Medicaid Apr 1, 2022

Reimbursement Policy Update: Inpatient Readmissions

April 2022 Newsletter Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Newsletter Medicaid Apr 1, 2022

Clinical Criteria updates

April 2022 Newsletter Medicaid Apr 1, 2022

Keep up with Medicaid news – April 2022

View these Medicaid articles:

  • AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
  • Prior authorization updates for medications billed under the medical benefit
  • Medical drug benefit Clinical Criteria updates
  • Medical Policies and Clinical Utilization Management Guidelines update
April 2022 Newsletter Medicaid Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Newsletter Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

April 2022 Newsletter Medicare Apr 1, 2022

Reimbursement Policy Update: Inpatient Readmissions

April 2022 Newsletter Medicare Apr 1, 2022
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