New York
Provider Communications

June 2021 Newsletter

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Title Category

Empire to enhance claim edits for Outpatient Facility Claims

Reimbursement Policies

Let’s Vaccinate

Help increase your vaccination rates and close gaps-in-care with these tools and strategies.
Products & Programs

Updates for specialty pharmacy effective September 1, 2021

Material adverse change (MAC) notification
Pharmacy

Designated specialty pharmacy network updates

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

MCG Care Guidelines 25th Edition

Medicare

Medical Policies and Clinical Utilization Management Guidelines update

Medicare

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

Medicare

Keep up with Medicare news

Medicare

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Material adverse change (MAC) notification
Medical Policy & Clinical Guidelines

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Material adverse change (MAC) notification
Medical Policy & Clinical Guidelines

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
Medical Policy & Clinical Guidelines

Provider education program survey: Your Voice Counts

Medicaid

MCG Care Guidelines 25th Edition

Medicaid

Keeping up with routine vaccination during COVID-19

Medicaid

Aspire Health for members in need of palliative care

Medicaid

Complex Case Management program

Medicaid

Important information about utilization management

Medicaid

Members’ Rights and Responsibilities Statement

Medicaid

Keep up with Medicaid news

Medicaid

DEXA bone scan criteria for the Federal Employee Program

Federal Employee Plan (FEP)

Two great learning resources on One Secure Portal

Digital Tools

Digital Solution Options with Availity

Digital Tools

Submit EDI corrected claims via Availity or EDI

Digital Tools

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

Digital Tools

Regular check-ins with your clearinghouse could affect timely filing

Administrative

Keep your contact information current

Administrative

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

Administrative
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