New York
Provider Communications

November 2019 Empire Provider News

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Title Category

Changes to timely filing requirements for Commercial plans for all claims submitted to plan on or after October 1, 2019

Administrative

Additional improvements coming to empireblue.com

Administrative

Appropriate coding helps provide a comprehensive picture of patients’ health

Administrative

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicaid

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

Medicaid

Keep up with Medicaid news

Medicaid

Medical Policy & Clinical Guideline updates

Medical Policy & Clinical Guidelines

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Spine Surgery Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Electronic submission is preferred method for requesting pharmacy prior authorization

Medicare

CMS reminder: expedited/urgent requests

Medicare

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

Medicare

Keep up with Medicare news

Medicare

Remaining members will transition to new PBM, IngenioRx, on January 1, 2020

Pharmacy

Prior authorization updates for specialty pharmacy are available

Pharmacy

Clinical Criteria updates for specialty pharmacy are available

Pharmacy

Reminder about AIM’s new Rehabilitative Program effective November 1, 2019

Products & Programs
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