New York
Provider Communications

June 2018 Empire Provider Newsletter

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Title Category

Important Update: June 15, 2018 - Access to the Empire Facility / Professional Secure Portals Only on the Availity Portal

Administrative

Availity is now our designated EDI Gateway

Administrative

Introducing Interactive Care Reviewer for Online Authorizations

Administrative

Empire streamlines member identification cards

Administrative

Updated Provider Manual now available

Administrative

Receive Direct Deposit of Patient Payments with Healthcare Bill Payments

Administrative

Reminder: Miscellaneous durable medical equipment billing guideline:

Administrative

Empire Adopts MCG Care Guidelines for Behavioral Health Services

Behavioral Health

Outpatient visits

Behavioral Health

Making a change for the better - FEP® system migration information

Federal Employee Plan (FEP)

Empire to conduct post-payment reviews of distinct procedural services modifiers

Medicaid

Miscellaneous durable medical equipment billing guidelines

Medicaid

Prior authorization requirement update for Mylotarg (gemtuzumab ozogamicin)

Medicaid

Electrical stimulation device to require prior authorization

Medicaid

Chimeric antigen receptor T-cell therapy requires prior authorization for all places of service

Medicaid

Lower extremity vascular intervention codes require prior authorization

Medicaid

Prior authorization requirements for Darzalex (daratumumab) drug

Medicaid

Services requiring prior authorization

Medicaid

Medical Policies and Clinical Utilization Management Guidelines update

Medicaid

Behavioral health network provider training

Medicaid

Behavioral health Discharge Action Plan: improving care transitions

Medicaid

Provider surveys

Medicaid

Use the Provider Maintenance Form to update your information

Medicaid

Complex Case Management program

Medicaid

What Matters Most: Improving the Patient Experience

Medicaid

Coding Spotlight: Pregnancy, A provider’s guide to diagnose and code for pregnancy

Medicaid

Medical Policy Updates

Medical Policy & Clinical Guidelines

Clinical Guideline Updates

Medical Policy & Clinical Guidelines

Cologuard covered for Medicare Advantage

Medicare

Peer-to-peer process can help clarify clinical record

Medicare

Motion Picture Industry Pension and Health Plans Offers Medicare Advantage Option

Medicare

Connecticut Teachers’ Retirement Board Offers Medicare Advantage Option

Medicare

MA home health network to be delegated to myNEXUS

Medicare

Medication adherence incentive offered to EPHC providers

Medicare

Keep up with Medicare news

Medicare

Empire expands Specialty Pharmacy Clinical Site of Care (Level of Care) drug list

Pharmacy

Empire expands specialty pharmacy prior authorization list

Pharmacy

Reminder: Empire accepts prior authorization requests for prescription medications online

Pharmacy

Pharmacy information available on empireblue.com/provider

Pharmacy

Policy Updates

Policy Updates

Update to claim processing for services requiring AIM prior authorization

Products & Programs

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Products & Programs

Coverage Guideline not implemented - Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing (CG-MED-53)

Products & Programs

Verifying eligibility for expanded hospice benefits

Products & Programs

Empire’s Individualized Care Program to support palliative care for commercial members

Products & Programs

Professional Reimbursement Policy Update

Reimbursement Policies

Reimbursement Policy Reminder - Durable Medical Equipment (Professional)

Reimbursement Policies
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