New York
Provider Communications

August 2019 Empire Provider News

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Title Category

Empire customization's to MCG care guidelines 23rd edition

Administrative

New online Provider Manual page

Administrative

AIM Specialty Health programs may require documentation

Medicaid

Pharmacy management information

Medicaid

Use the Provider Maintenance Form to update your information

Medicaid

Prepayment clinical validation review process

Medicaid

Keep up with Medicaid news

Medicaid

Policy updates

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Medicare Advantage: AIM Specialty Health programs may require documentation

Medicare

Medicare Advantage: New service types added to Availity

Medicare

Medicare Advantage: New Reimbursement Policy: Drug Screen Testing (Policy 19-001, effective 10/01/19)

Medicare

Medicare Advantage: Special needs plans - provider training required

Medicare

Keep up with Medicare news

Medicare

Clinical Criteria and Prior Authorization updates for specialty pharmacy are available

Pharmacy

Reminder: Changes to the process for Medical Non-Oncology Specialty Drug reviews effective June 15, 2019

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

Reimbursement Policy Updates

Reimbursement Policies

Update regarding Evaluation and Management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred (Professional)

Reimbursement Policies
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