New York
Provider Communications

Provider Spotlight

Nov 2, 2021

City of New York Retirees transition to NYC Medicare Advantage Plus

City of New York Retirees will transition to NYC Medicare Advantage Plus offered through an alliance between Empire BlueCross BlueShield ("Empire") and EmblemHealth effective January 1, 2022.  Approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan. If you currently provide care to City of New York retirees you can continue to care for these retirees on the new NYC Medicare Advantage Plus plan whether or not you participate with Empire’s or EmblemHealth’s Medicare Advantage PPO networks.

Read important information about this change here.


Articles Recent

Title Publication Category Date

City of New York Retirees transition to NYC Medicare Advantage Plus

City of New York Retirees will transition to NYC Medicare Advantage Plus offered through an alliance between Empire BlueCross BlueShield ("Empire") and EmblemHealth effective January 1, 2022.  Approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan. If you currently provide care to City of New York retirees you can continue to care for these retirees on the new NYC Medicare Advantage Plus plan whether or not you participate with Empire’s or EmblemHealth’s Medicare Advantage PPO networks.

Read important information about this change here.

City of New York Retirees Transition to NYC Medicare Advantage Plus Administrative Nov 2, 2021

Blue High Performance Network name changing for 2022

November 2021 Newsletter Administrative Nov 1, 2021

Effective January 1, 2022: The 32BJ Health Fund Centers of Excellence for Bariatric and Joint Replacement surgery

November 2021 Newsletter Administrative Nov 1, 2021

Include referring provider name and NPI on home infusion therapy and ambulatory infusion suite professional claims

November 2021 Newsletter Administrative Nov 1, 2021

Time to prepare for HEDIS® medical record review

November 2021 Newsletter Administrative Nov 1, 2021

CME credits available in 2021 for a variety of clinical quality webinars - register now!

November 2021 Newsletter Administrative Nov 1, 2021

Reducing the burden of medical record review and improving health outcomes with ECDS reporting

November 2021 Newsletter Administrative Nov 1, 2021

Join Empire in talking about racism and its impact on health and earn continuing education credits

November 2021 Newsletter Administrative Nov 1, 2021

Be antibiotics aware: Protect your patient

November 2021 Newsletter Administrative Nov 1, 2021

Surprisingly easy ways to help patients quit smoking cigarettes

November 2021 Newsletter Administrative Nov 1, 2021

Change in coverage for continuous glucose monitors for some fully insured groups

November 2021 Newsletter Administrative Nov 1, 2021

EnrollSafe is available: Our new electronic funds transfer enrollment portal

EnrollSafe replaces CAQH Enrollhub effective November 1, 2021
November 2021 Newsletter Digital Tools Nov 1, 2021

Against medical advice (AMA) discharge physician tracking tool

November 2021 Newsletter Digital Tools Nov 1, 2021

Update regarding annual wellness visits for ACA-compliant health plans

November 2021 Newsletter Products & Programs Nov 1, 2021

Important update on Botox® for Empire members

November 2021 Newsletter Pharmacy Nov 1, 2021

Specialty pharmacy updates are available - November 2021

Material Adverse Change (MAC) notification

November 2021 Newsletter Pharmacy Nov 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation (Professional)

November 2021 Newsletter Reimbursement Policies Nov 1, 2021

New York state Medicaid expansion of coverage for colorectal cancer screening

November 2021 Newsletter Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Newsletter Medicaid Nov 1, 2021

Clinical Criteria updates

November 2021 Newsletter Medicaid Nov 1, 2021

Unspecified diagnosis reminder

November 2021 Newsletter Medicaid Nov 1, 2021

4 things you can do to encourage cancer screenings for your women patients

November 2021 Newsletter Medicaid Nov 1, 2021

Keep up with Medicaid news - November 2021

View these Medicaid articles:
  • Medicaid continuous glucose monitoring systems
  • Prior authorization updates for specialty pharmacy
November 2021 Newsletter Medicaid Nov 1, 2021

Webinars for City of New York retirees transitioning to new Medicare Advantage plan

November 2021 Newsletter Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Newsletter Medicare Nov 1, 2021

Clinical Criteria updates

November 2021 Newsletter Medicare Nov 1, 2021

Empire BlueCross BlueShield offering Advance Medical Directives program for 2022

November 2021 Newsletter Medicare Nov 1, 2021

Keep up with Medicare news - November 2021

View this Medicare article:

  • Empire BlueCross BlueShield expands specialty pharmacy precertification list
November 2021 Newsletter Medicare Nov 1, 2021

Join The Fenway Institute for a CME webinar about improving your LGBTQIA+ patient interactions

Join a live webinar, “LGBTQIA+ Care: Delivering Trust and Belonging with Every Interaction,” presented by the National LGBTQIA+ Health Education Center at The Fenway Institute. 

Gain LGBTQIA+ Patient Interaction Knowledge Administrative Oct 21, 2021

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management


Chronic disease management strategies for your patients with hypertension and diabetes

Date: Friday, October 8, 2021

Time: 12:00 p.m. ET

Clinical Quality CME Webinar Series Continues - New York Administrative Oct 5, 2021

Familiarize yourself with Empire’s Simplified Networks

October 2021 Newsletter Administrative Oct 1, 2021

Meet Dr. Carolyn Langer, Empire’s new Chief Medical Officer

October 2021 Newsletter Administrative Oct 1, 2021

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

October 2021 Newsletter Administrative Oct 1, 2021

Clarification: Empire’s enhanced claim edits for outpatient facility claims

October 2021 Newsletter Administrative Oct 1, 2021

Your recommendation is key to encouraging cancer screenings for your female patients

October 2021 Newsletter Administrative Oct 1, 2021

Are you talking to ALL of your patients about breast cancer screenings?

October 2021 Newsletter Administrative Oct 1, 2021

Looking to earn continuing medical education credits? Register for these on-demand webinars

October 2021 Newsletter Administrative Oct 1, 2021

Clinical appeals

October 2021 Newsletter Administrative Oct 1, 2021

Provider claim payment disputes for Empire’s Commercial lines of business

October 2021 Newsletter Digital Tools Oct 1, 2021

Good news! Non-payment remittance advice enhancements coming soon

October 2021 Newsletter Digital Tools Oct 1, 2021

REMINDER: EnrollSafe, the new electronic funds transfer enrollment portal for Empire providers – replacing CAQH Enrollhub effective November 1, 2021

October 2021 Newsletter Digital Tools Oct 1, 2021

Procedure searches in Find Care

October 2021 Newsletter Digital Tools Oct 1, 2021

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
October 2021 Newsletter Pharmacy Oct 1, 2021

Designated specialty pharmacy network updates effective January 1, 2022

Material adverse change (MAC) notification

October 2021 Newsletter Pharmacy Oct 1, 2021

Specialty pharmacy updates - October 2021

Material adverse change (MAC) notification
October 2021 Newsletter Pharmacy Oct 1, 2021

Pharmacy information available on empireblue.com

October 2021 Newsletter Pharmacy Oct 1, 2021

Medical policy and clinical guideline updates

Material adverse change (MAC) notification

October 2021 Newsletter Medical Policy & Clinical Guidelines Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Newsletter Medicaid Oct 1, 2021

Diabetes testing and screening HEDIS measures

October 2021 Newsletter Medicaid Oct 1, 2021

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

October 2021 Newsletter Medicaid Oct 1, 2021

FAQ: Update to AIM phone number

October 2021 Newsletter Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy IV

October 2021 Newsletter Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy V

October 2021 Newsletter Medicaid Oct 1, 2021

Keep up with Medicaid news - October 2021

View these Medicaid articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Newsletter Medicaid Oct 1, 2021

Webinars for City of New York retirees transitioning to new Medicare Advantage plan

October 2021 Newsletter Medicare Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Newsletter Medicare Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Newsletter Medicare Oct 1, 2021

HEDIS® medical record submission made easier with our Remote EMR Access Service

October 2021 Newsletter Medicare Oct 1, 2021

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

October 2021 Newsletter Medicare Oct 1, 2021

New Medical Step Therapy Requirements

October 2021 Newsletter Medicare Oct 1, 2021

Keep up with Medicare news - October 2021

View these Medicare articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Newsletter Medicare Oct 1, 2021

Register today for the Exploring the Impact of Racial Trauma on the Health & Wellbeing of Children forum on September 29, 2021

Join us to hear from a diverse panel of experienced Motivo and Empire professionals about the impact of racial trauma on the health and wellbeing on children and adolescents.

Racial Trauma & Children Administrative Sep 15, 2021

Register now for our September CME webinars!

September 2021 Newsletter Administrative Sep 1, 2021

Statin therapy for patients with diabetes

Achieve 90% patient statin therapy adherence with a personalized approach
September 2021 Newsletter Administrative Sep 1, 2021

6 SIMPLE strategies to help increase medication adherence

September 2021 Newsletter Administrative Sep 1, 2021

Cure for the common cold: rest, fluids and this free prescription pad

Be Antibiotic Aware campaign offers a prescription solution to antibiotics

September 2021 Newsletter Administrative Sep 1, 2021

National Accounts 2022 Pre-certification list

September 2021 Newsletter Administrative Sep 1, 2021

HEDIS® medical record submission made easier with our Remote EMR Access Service

September 2021 Newsletter Administrative Sep 1, 2021

Get your payments faster when you sign up for electronic funds transfer

Introducing EnrollSafe, the new electronic funds transfer enrollment portal for Empire providers - replacing CAQH Enrollhub effective November 1, 2021.

September 2021 Newsletter Digital Tools Sep 1, 2021

Updates for specialty pharmacy are available - September 2021

Material adverse change (MAC) notification

September 2021 Newsletter Pharmacy Sep 1, 2021

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
September 2021 Newsletter Pharmacy Sep 1, 2021

Reimbursement policy update: Sexually Transmitted Infections Testing (Professional)

Material adverse change (MAC) notification

September 2021 Newsletter Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Drug Screen Testing (Professional)

Material adverse change (MAC) notification
September 2021 Newsletter Reimbursement Policies Sep 1, 2021

Reimbursement policy reminder Professional Anesthesia Services (Professional)

September 2021 Newsletter Reimbursement Policies Sep 1, 2021

Federal Employee Program® AIM Radiology prior authorization review transition delayed until November

Material adverse change (MAC) notification

September 2021 Newsletter Federal Employee Plan (FEP) Sep 1, 2021

Keep up with Medicaid news - September 2021

View these Medicaid article: 
  • Clinical Criteria Updates Notification May 2021
  • Iron Infusion Step Therapy
  • Iron Infusion Prior Authorization Update
September 2021 Newsletter Medicaid Sep 1, 2021

City of New York Offers NYC Medicare Advantage Plus Medicare Advantage Option

September 2021 Newsletter Medicare Sep 1, 2021

Reimbursement Policy Update: DRG Inpatient Facility Transfers (Effective 11/30/21)

September 2021 Newsletter Medicare Sep 1, 2021

Utilization management authorization rule operations

September 2021 Newsletter Medicare Sep 1, 2021

Prior authorization/Precertification form notification

September 2021 Newsletter Medicare Sep 1, 2021

Keep up with Medicare news - September 2021

View this Medicare article:

  • Clinical Criteria Updates Notification May 2021
September 2021 Newsletter Medicare Sep 1, 2021

2021 Provider Manual now available

August 2021 Newsletter Administrative Aug 1, 2021

Telehealth visits can impact after-hospitalization follow-up care for mental illness

August 2021 Newsletter Administrative Aug 1, 2021

Clearing up coding confusion for retinal eye exams (DRE)

August 2021 Newsletter Administrative Aug 1, 2021

Register now for our August CME webinars

August 2021 Newsletter Administrative Aug 1, 2021

Digital scheduling feature in the Availity Portal: the Appointment Scheduler application

August 2021 Newsletter Digital Tools Aug 1, 2021

Specialty dose rounding program for certain oncology medications

August 2021 Newsletter Pharmacy Aug 1, 2021

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

August 2021 Newsletter Pharmacy Aug 1, 2021

Immune globulin adjusted body weight dosing program beginning August 1, 2021

August 2021 Newsletter Pharmacy Aug 1, 2021

Clinical criteria updates for specialty pharmacy

Material adverse change (MAC) notification

August 2021 Newsletter Pharmacy Aug 1, 2021

Empire to update formulary lists for commercial health plan pharmacy benefit

August 2021 Newsletter Pharmacy Aug 1, 2021

Updates for specialty pharmacy effective November 1, 2021

August 2021 Newsletter Pharmacy Aug 1, 2021

Pharmacy information available on empireblue.com

August 2021 Newsletter Pharmacy Aug 1, 2021

Transition to AIM Specialty Health Imaging of the Heart clinical appropriateness guideline for Computed Tomography to detect coronary artery calcification

August 2021 Newsletter Medical Policy & Clinical Guidelines Aug 1, 2021

Medical policy and clinical guideline updates

Material adverse change (MAC) notification
August 2021 Newsletter Medical Policy & Clinical Guidelines Aug 1, 2021

Inpatient Readmission (Facility)

August 2021 Newsletter Reimbursement Policies Aug 1, 2021

Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU

Material adverse change (MAC) notification
August 2021 Newsletter Reimbursement Policies Aug 1, 2021

Virtual Visits - Professional and Facility

Material adverse change (MAC) notification

August 2021 Newsletter Reimbursement Policies Aug 1, 2021

Change in email submission of service requests for Federal Employee Program members

Material adverse change (MAC) notification
August 2021 Newsletter Federal Employee Plan (FEP) Aug 1, 2021

Keep up with Medicaid news

August 2021 Newsletter Medicaid Aug 1, 2021
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