New York
Provider Communications

October 2018 Empire Provider Newsletter

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Title Category

Attention: Updated or New Fee Schedules for Commercial products - REVISED DATE

Administrative

Empire launches additional changes to empireblue.com in October

Administrative

Electronic Member ID Cards: Online option available on Availity

Administrative

What Matters Most: Improving the Patient Experience

Administrative

Special Investigations Unit Updates

Administrative

HEDIS® 2018: Provider Incentive Winners Announced!

Administrative

Integrated Medical and Behavioral Healthcare Services

Administrative

Availity as Empire’s EDI Gateway

Administrative

Availity EDI Gateway Webinars Scheduled

Administrative

Empire fights opioid addiction: Extension for Community Healthcare Outcomes and Quality Medication-Assisted Therapy

Administrative

Tips for billing CPT modifier 33

Administrative

Update to Durable Medical Equipment – effective October 14, 2018

Administrative

EDI Gateway migration

Medicaid

Empire Fights opioid addiction: Extension for Community Health Care Outcomes and Quality Medication-Assisted Therapy

Medicaid

Vaginal birth after cesarean shared decision-making aid available

Medicaid

Cervical length measurement by transvaginal ultrasound

Medicaid

Prior authorization requirements for high-level, definitive drug testing

Medicaid

Prior authorization requirements for Interferon beta-1a

Medicaid

Prior authorization requirements for Somatrem

Medicaid

Medical Policies and Clinical Utilization Management Guidelines update: effective 1/25/18

Medicaid

Medical Policies and Clinical Utilization Management Guidelines update: effective 3/22/18

Medicaid

Medical Policies and Clinical Utilization Management Guidelines update: effective 11/1/18

Medicaid

Medical Policy Updates

Medical Policy & Clinical Guidelines

Clinical Guideline Updates

Medical Policy & Clinical Guidelines

Review medical policy and clinical guidelines when referring services to a facility

Medical Policy & Clinical Guidelines

Update to AIM Specialty Health radiation oncology clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Update to AIM Specialty Health clinical appropriateness guidelines: advanced imaging appropriate use criteria: imaging of the heart

Medical Policy & Clinical Guidelines

Update to AIM Specialty Health sleep disorder management clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

Medicare

Empire transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

Medicare

Please evaluate statin use for MA members with diabetes, cardiovascular disease

Medicare

Medicare pharmacy and prescriber home starts January 2019

Medicare

Group sponsored Medicare Advantage plan members to receive new ID cards

Medicare

Keep up with Medicare news

Medicare

Empire expands specialty pharmacy prior authorization list

Pharmacy

Empire Expands specialty pharmacy clinically equivalent drug list

Pharmacy

Empire expands specialty pharmacy level of care (clinical site of care) drug list

Pharmacy

Empire accepts prior authorization requests for prescription medications online

Pharmacy

Access patient-specific drug benefit information through EMR

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

Policy Updates

Policy Updates

Reimbursement Policy Updates

Reimbursement Policies

Reimbursement Policy Update - Readmissions (Facility)

Reimbursement Policies

New Reimbursement Policy - Facility Revenue Code Billing (Facility)

Reimbursement Policies
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